OPERATING THEATRE TECHNOLOGIES
knowledge, to seek peer advice, to search for more information, or to take the proposed automated action if it makes sense to them.
Had these options been available to the pilot of Flight 610, I suspect he would have been happy with the current flight status, and ignored the MCAS system’s recommendations to go into a nosedive. I do not want to see surgeons needing to cut the power to robots or AI automated systems to save a patient’s life. Rather, let’s imagine if every surgeon could have, right at their fingertips, access to the knowledge and experience of hundreds of other surgeons who had also performed that same surgery. There would be dramatically fewer surprises and sudden crises that couldn’t be addressed, and no loss of patients due to something that another surgeon might have already encountered and knew how to handle, had they just been the one in the operating theatre that day.
Audio visual (AV) over IP, or AVoIP, could make that a reality. It, and its stablemates, Big Data, Industry 4.0, and the Internet of Things, are more than just the latest buzzwords – interesting but, for most people, abstract – they are going to be key in bringing forward huge benefits for patients, healthcare providers, and clinical teams.
Let’s learn from our mistakes According to poetess, Nikki Gipvanni, ‘Mistakes are a fact of life. It is the response to error that counts’. As we have seen in the media over the years, the medical profession has often been criticised for failing to acknowledge surgical errors, which is understandable in a culture with a chain of command, and where challenging the surgeon might be considered unacceptably audacious. The aviation industry has made great progress in changing this culture, and
acknowledging that vital information may reside anywhere. For example, have you ever wondered why aircraft blinds must be up on take-off and landing? The primary reason is because when they are up, the pilot has the potential benefit of around 500 additional image sensors looking for fires or other hazards in the event of a crash – they are in the heads of the passengers. In a very real sense, the passengers are not merely human cargo, but are actually part of the aircraft safety system. There is even a procedure for how this information may be transmitted to the pilot via the cabin crew. Similarly, anyone in the operating theatre should be able to communicate with the surgeon and raise concerns or share knowledge, obviously in a controlled fashion.
Insufficient data collection Healthcare providers are now being urged to improve the way in which they learn
32 Health Estate Journal October 2019
Communication without limitation AVoIP is a radical, disruptive development that is increasingly replacing traditional AV communications. It is also inexorably linked with Industry 4.0 and the Internet of Things – simply put, the use of automation and data exchange in manufacturing. In essence, it is the streaming of audio and video content over an existing Ethernet/IP network with associated data transfer. This completely changes the way that media and data are transmitted and shared, shifting the AV platform to a network, and thus breaking the barriers imposed by physical limitations, such as building layouts or distance.
Why now?
Surgeons need to be empowered to make informed decisions quickly and calmly.
from mistakes – the problem is that there is little data being collected to recreate events, support hypotheses, or spot trends, and to debrief with recorded evidence. I believe that connecting operating theatres to share knowledge and create a feedback loop for research and development will dramatically improve patient care, and I am proud to be part of an ever-growing group of people working with hospitals and med- tech providers to roll out the technology that will make this possible.
Acknowledge, share, learn One of the most effective ways to improve surgery is to collect hard data from the operating theatres to develop new techniques that improve patient care. If that data can be gathered, and then accessed instantly during procedures, clinical teams will not only be able to make better-informed decisions there and then, but will also be able to reflect on events post-surgery to inform how future procedures are carried out. Data can also be collated to look for wider trends and correlations by, for example, evaluating the performance of surgical equipment. This represents a huge move away from the current norm, encouraging surgeons to learn from what happens – even errors – and use the learning to move surgery forward.
What if, thanks to innovation, operating theatres could not only talk to each other at one hospital site, but across multiple sites and rooms – if the conversation could be opened up, and the data gathered shared not only within a single hospital, but with any number of hospitals? Imagine the possibilities for shared learning and dramatically improved patient care. This is where AVoIP takes centre stage.
Until now, the main issue with AVoIP has been that the available bandwidth and speed of network switches was not fast enough to carry video at an acceptable quality. To be so compressed to allow transmission over IP meant long delays (latency) and visible picture deterioration. This was because video technology was always ahead of the IT bandwidth leading edge. Finally, the networks have now overtaken; a 10GBaseT infrastructure is now commonplace, and fortunately just enough to transmit uncompressed (meaning lossless) 4K 4:4:4 video at 60 frames per second (you need 9 Gbps of bandwidth to transmit 4K video with no latency or deterioration).
Software Defined Video over Ethernet (SDVoE) is the most widely adopted standardised solution for distributing and managing AV signals on an off-the-shelf Ethernet network.
So, what are the advantages of AVoIP with SDVoE components? With AVoIP, any source can be shown on any display, not limited to a building, country or continent, provided that the network is
Colin Dobbyne asks: ‘If I like one company’s light source, but want to use it with another’s camera, why can’t I?’
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