Integration integral to teaching hospital’s mission

Gerald Harkins

“We are able to control the entire integrated system, allowing for greater surgeon autonomy and improved efficiency”
-Gerald Harkins, MD, Medical Director, Minimally Invasive Gynecologic Surgery, Penn State Milton S. Hershey Medical Center

As the only teaching hospital in Central Pennsylvania, Penn State Milton S. Hershey Medical Center is one of the area's largest healthcare providers and is recognized for its commitment to excellence and ongoing pursuit of knowledge discovery. The hospital is equipped with 23 surgical suites and its Department of Surgery performs more than 19,000 procedures annually. The department is recognized not only for its specialized patient care but also for its pioneering research, nationally recognized physicians, and advanced technology.

Staying Ahead of the Technology Curve
With the industry trend moving toward minimally invasive procedural techniques, the hospital was quick to understand the benefits of integrated surgical suites as a way to stay competitive and keep pace with the specialized technology demands of increasingly sophisticated procedures. "Several years ago, we realized we had a need for advanced, integrated technologies in our operating room as we anticipated the convergence of laparoscopic and flexible endoscopic instrumentation. We also recognized the need for a sophisticated system relative to data acquisition, storage, and transfer," says Randy Haluck, MD, the medical center's professor of surgery and division chief for minimally invasive surgery and bariatrics.

Penn State Hershey began the process of integration in 2005, building three new integrated Olympus ENDOALPHA surgical suites in 2006 and then converting two existing ORs to ENDOALPHAs the following year. By 2010, the hospital anticipates completion of four more integrated ORs, for a total of 27 surgical rooms with one-third of them set up as state-of-the-art ENDOALPHAs. "Penn State Hershey has always proactively pursued and incorporated the latest technological advances into their mix; for example, they were one of the early adopters of video conferencing technology, creating their own proprietary capabilities. Full system integration was another natural step for this forward-thinking organization to once again stay ahead of the technology curve," says Richard Harada, the Director of Marketing for Olympus' Systems Integration Group.

Recognizing the Need for Integration
Penn State Hershey Medical Center wanted to integrate the hospital's various systems into one cohesive unit for better efficiency and a higher level of patient care. This would enable them to create a seamless flow of equipment, data, and video to enable real-time connectivity and collaboration capabilities beyond the hospital's current video conferencing efforts. "Using integration technology, the operating room team can access our other hospital systems, such as lab, pathology, and radiology results. And the surgeon doesn't have to move an inch from the sterile field. So this is all of great benefit to the patient on the table," says Steve Mancuso, the hospital's administrator of perioperative services.

Taking a Comprehensive Approach
"Beyond equipment and the operating platform, true systems integration is comprehensive," explains Donna Ungvarsky, an Olympus Nurse Consultant and member of the implementation team for the Penn State Hershey project. "It also takes into account the ergonomic design, workflow and technology optimization of each surgical suite." This means designing rooms with ceiling-mounted booms for holding imaging equipment and monitors and allowing for more efficient post-procedure cleanup. It means integrated equipment (scopes, imaging platforms, monitors, video and accessories) that all work together and can be easily swapped during a procedure. And it means a cohesive information management system for patient and procedural data, images, and audio that can be captured, stored, and retrieved from both inside and outside the sterile field.

"Olympus ENDOALPHA has been a fantastic platform for us for integration. We needed to have multiple surgical services using the same operating room, between general surgery, urology, and minimally invasive GYN surgery. We're all able to function in the ENDOALPHA laparoscopic suites, and it's been a fantastic platform for that utilization," says Gerald Harkins, MD, medical director for minimally invasive GYN surgery.

Selecting an Integration Partner
Today, systems integration sets the gold standard for procedure room productivity and patient care. With a variety of integration platforms and companies offering systems integration, Penn State Hershey Medical Center did its due diligence during the selection process, ultimately deciding on Olympus and ENDOALPHA. "We looked at all the major manufacturers and suppliers for integration in surgery. We found Olympus to be innovative, technologically savvy, and willing to work with us to utilize infrastructure that we already had in place," says Dennis Way, Penn State Hershey's surgical equipment coordinator.

Experiencing the Installation Process
Olympus offers turnkey systems integration solutions, working with customers from start to finish on the design, construction, and setup of integrated operating and intervention rooms. "The flexibility of Olympus' ENDOALPHA system," says Harada, "means it can be easily customized to create a right-sized solution unique to each facility. In the case of Penn State Hershey, we were able to incorporate their legacy equipment along with their pre-existing video-conferencing system and streaming video package into their ENDOALPHA ORs to create one seamless system. They proved to be very knowledgeable, so it was a highly collaborative effort." Way agrees and adds, "We would ask for changes and Olympus would work with us. They brought people on-site, talked with us about our needs and designed those into our integrated rooms. They also brought their service personnel in, gave us in-service support and were reachable by phone 24/7."

Enhancing Communication, Collaboration, and Education
Penn State Hershey's custom-placed displays ensure all team members have the perfect view of live images. They regularly create video networks for sharing, collaboration, and education from both within and outside the hospital. "There's no question that the Olympus system has dramatically changed how we teach in the operating room," says Peter Dillon, MD, the chairman of the hospital's surgery department and surgical director of its perioperative services. "We're now able to broadcast these procedures to first and second year medical students, exciting them about the wonders of surgery at a much earlier stage in their training. So it really has changed dramatically, and in a very exciting fashion, how we teach medical students, residents, nursing students, and all those involved in the surgical field." Haluck adds that it also gives their team a better way to collaborate with other physicians and share information with patients. "We can educate other physicians and record images for colleagues or bring them in when needed to confer and/or assist on a procedure. We are also able to show the patients what their surgery was about and why they were having a problem. That's a great benefit to us, and certainly patients appreciate it as well."

Partnering for Ongoing Success
"We have a great working relationship with Olympus," says Mancuso. "It's a real partnership with our entire surgical team-surgeons, nurses, anesthesiologists-Olympus listens to what we have to say to meet our needs, all to the benefit of our patients." Dillon feels the positive working relationship started the moment the hospital decided to upgrade their ORs. "Once we chose Olympus and really started working with them, the process was not only gratifying, but very easy. We were able to design a system that was specific to our operating rooms and electronic environment and mesh the new Olympus equipment and technology with our current system. Olympus has been very forthcoming and responsive along the way. In our mind, the service and support functions from Olympus have been outstanding."