Operational excellence

EHM talks to Jim Cloar of Medtronic Navigation and Olympus Medical Systems Group’s Richard Harada of the benefits of integrated operating room solutions.

“Interconnectivity is a must now in our digital era, DICOM is just the tip of the iceberg”
-Jim Cloar

Tighter financial constraints and growing staff shortages are making it more difficult for hospitals to meet their operating room performance needs. What can they do to optimize operating room procedures?
Jim Cloar. It really comes down to workflow and familiarity in the OR. A team's protocols and how they work together can be aided or impinged by the physical objects and information sources in that OR. Seamless integration between equipment vendors is an absolute must, as is a centralized information source so that everyone is on the same page and there is no need to examine multiple or divergent info sources. An information hub that is updated frequently provides them one less thing to have to worry about so that they can focus on the procedures and the patients at all times. Simplicity and familiarity with all the technologies enable any staff member to carry out the protocol, even if they are a new or visiting team member.

Richard Harada. Systems integration, before anything, can help facilities meet their operating room performance needs as well as generate potential savings through improved efficiency, reduce work hours, and enhance communication and collaboration. Remote control of laparoscopic instrumentation and the ability to view and collaborate remotely in and out of the procedure room will help lead the way.

What are the advantages of implementing an integrated operating room solution?
RH. In implementing an integrated operating room solution, the possibilities in terms of advantages are endless. Efficiencies and collaboration are immediately improved. The surgeon and team are working with the best technology in doing what they do best - providing patient care. Educational opportunities, with streaming video capabilities, are further enhanced in the form of broadcasting procedures to medical students who now do not have to be in the room. Monitors and displays are everywhere, preventing any leaning over of the surgeon's shoulder throughout procedures as well. The entire team enjoys an optimal view of what is going on at all times. The OR environment also remains clutter free and without any troublesome cords throughout the room that can only cause inefficiencies amongst the OR team.

JC. There are numerous advantages. Let's take a neurosurgery suite as an example. The surgeon must absorb so many disparate data points on the same patient for a single procedure in order to be as precise as possible when going in to operate on that patient's brain. Having all that highly complex data come together for the surgeon in the OR in a single 'map' enables precise surgeries and allows the OR staff to follow along with confidence.

What specific equipment and technology can be used to enable surgical, clinical, engineering and IT staff members to reach their integration goals?
JC. Taking again the example of a neurosurgery suite, we have a lot of experience integrating both image-guided navigation and intra-operative imaging to provide a seamless and dynamic information hub in the OR. The patient's information can be updated live, while they are undergoing surgery. Surgeons and surgical staff enjoy the benefits of a more ergonomic, information-rich OR in which to work. 

Interconnectivity is a must now in our digital era. DICOM is just the tip of the iceberg in terms of what will still transpire with electronic health records (EHR) and other digital information trends occurring in the healthcare market. 

Our StealthStation i7 is a fully boom-mounted navigation solution that can inter-operate with Medtronic intra-operative imaging solutions (PoleStar Surgical MRI system and O-arm 2D/3D Imaging system) as well as other vendors' scanners. Medtronic strives to be an open architecture firm in order to meet biomedical engineering and hospital IT staff needs. We offer an iOR suite of solutions that provide additional services for integration, beyond navigation and intra-operative imaging.

RH. The specific equipment and technology utilized by staff members in reaching integration goals will vary and be dependent on each facility's specific needs and potentially the capabilities of their current system in incorporating those with the new technology. Some of the new technology to be considered would be wireless medical grade displays, long term video archive server solution, and web browser-based viewing of procedures for those in training, such as residents, interns and fellows.

How do you see the area of operating room integration developing within the next few years?
RH. In the coming years, technology and innovation will continue to lead the way within the operating room and systems integration will be the solution to bring it all together in allowing facilities to stay competitive and continue providing the best patient care possible. Going forward, some of the key areas that will play a major role are video streaming through networks, multi-viewing displays teamed with real time information, RFID technology for tracking patients and data, 3-D imaging displays, and the ability to archive video and still images in an EMR system for better handling and preparation of patient records.

JC. I think that operating room integration will continue in many different geographies around the world, and not only in the emerging markets. Data convergence and interconnectivity have hit the healthcare world, just as they did in telecommunications over a decade ago. Integrating the OR suite is just one more step to always having accessible data for the surgeon and the surgical staff, with the ultimate goal of optimized patient care. In terms of the vendors, the key to their success will include their services delivery track record and their closed versus open architecture approach. I believe that a positive services track record and open architecture flexibility will dictate which integrated OR vendors remain at the top of the preferred partner charts.

Jim Cloar was named Vice President and General Manager of Medtronic Navigation in May 2007. He leads the Louisville, Colorado-based company, which is the leading provider of integrated navigation and intra-operative imaging solutions in the world. Cloar has held a series of increasingly broad-reaching and strategic roles in the spinal and siologics business, most recently as Vice President and General Manager of the Thoracolumbar Spine business line.

Richard Harada serves as the Director of Marketing for Olympus Medical Systems Group's Systems Integration business unit. Having over 25-years of experience in product development, marketing and sales management in hospital information systems. Mr. Harada's expertise lies in radiology image archive systems, data storage systems and integration systems.