OPERATING THEATRE TECHNOLOGY
means having to mine for it, or plead with companies for a specialist piece of software to interface to their system. All activities can produce data: it
could be logs, status reports, statistics, key-presses, messages, audio and video footage, and so on. The problem is that the data can be in any format and on any media – the trick is to compile those data streams into something coherent and usable. This is why we design systems that use open standard protocols, and provide open APIs to give the best chance of exchanging data with other systems. Hospital systems, whether inside the
operating theatre or not, can play a part in publishing and subscribing to a common data platform. Every single piece of data has the power to be useful, and we should gather as much of it as we can and then figure out what is, and what is not, of benefit. The problem is that we currently have very inefficient data management systems. We typically maintain multiple systems for queuing data; what is needed is a centralised system that efficiently stores and can publish that data, but only to those systems that need or want it – subscribers. In resolution of that problem, there are platforms such as Kafka that can collate, normalise, and distribute, seriously large streams of data in a publisher/ subscriber process.
Conclusion
In the main, the operating theatre is digitally cut off from the rest of a rapidly evolving and connected healthcare world, and this is because of inherent limitations in current system design and the underlying technology deployed. To create a new category – that of an open platform and standard IP system – we need a converged video and data services infrastructure that operates on standard IP switch technology. In addition, the data transport streams need to cater for much more than just data or video; to connect multiple devices and appliances that are very different in nature and purpose, the bundle needs to include multiple video and audio streams, IP data,
USB, and KVM extensions, IR and serial command interfaces, and, where possible, power delivery – all over the network infrastructure. Once the theatre’s ecosystem becomes a true cyber physical system, then the outside world – companies like Microsoft, Google, Apple, and other giants, all the way down to small start-ups with a unique innovation – can join the system to provide services using artificial intelligence, 3D modelling, virtual and augmented reality and virtual presence, and remote-control robotic surgery. Once these systems are commonplace, a fertile and accessible market will exist for all newcomers to develop applications and finally create Surgery 4.0. Humans are flawed and prone to error; this is nothing new, and it is no different in surgery. In the safest trains, planes, automobiles, and cars, the ‘driver’ or ‘pilot’ is but a passenger at the tricky moments – like landing, docking, parking, maintaining a safe distance, and emergency stopping etc. The future is bright, and a roadmap to
safer automated surgery by robots, driven by superfast cloud-based AI algorithms, exists, but it requires a collective will to change the current ecosystems, with pressure put on the incumbent providers to open up.
References 1 Stavroulis A, Cutner, A Liao L-M. Staff perceptions of the effects of an integrated laparoscopic theatre environment on teamwork. Gynecological Surgery 2013;10:177-180. https://tinyurl. com/2p83938k
2 Patient Safety Primer: Wrong-Site, Wrong Procedure, and Wrong-Patient Surgery [Internet]. Agency for Healthcare Research and Quality; 2019. Patient Safety Network.
https://tinyurl.com/4ta2h48a
3 Chassin M, Becher. The Wrong Patient. Ann Intern Med 2002;136:826-833.
https://tinyurl.com/5n8mmdru
4 The Commission on the Future of Surgery (Royal College of Surgeons). Future of Surgery Report. 2017. https://tinyurl. com/2p9dh7fp
Colin Dobbyne
Colin Dobbyne CEng, MIET, is an experienced product designer for operating theatre control and workflow systems. He has designed systems for Smith and Nephew, Conmed Linvatec, Maquet, Karl Storz Endoscopy, and the Novanta Group. He is the founder of 4 Medical IT, a specialist in operating room integration and data sharing and communication systems, and the creator of TheatreWatch – a cloud-based service that ‘connects surgeons worldwide to democratise knowledge and share best practices, with live video remote expert interaction and student access to teaching materials’. He has won three international awards for innovation and the best use of technology in healthcare, including a British Medical Journal award for the deployment of TheatreWatch in Tanzania for live surgical tele-mentoring from the UK, helping establish a laparoscopy service for millions of Tanzanians. He said: “The creation of open platform, non-proprietary, data-sharing and connected theatre systems is the fulfilment of a career ambition. I am passionate about what this system can unlock, and how new technologies can transform surgery and herald in Surgery 4.0.”
+44 (0) 161 627 7947
www.safelocking.co.uk
THE KEY TO THE WHEELS TURNING Practically Stored - Securely Managed
FLEET KEY AUDIT TRAIL ENABLE ACCESS TO CERTAIN USERS ACCESS TO BOOKED KEYS ONLY ENSURE MILEAGE & DAMAGE REPORTED
September 2022 Health Estate Journal 61
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