Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University HospitalFunding This work has been funded by the German Federal Ministry of Education and Research under reference number 16KT1201K as part of the OR.NET project.
14 February 2018
14 February 2018
03 May 2018 (online)
Background Digital operating rooms (ORs), when optimally designed and integrated, can reduce the complexity of the surgery suite. However, many integrated ORs are effectively isolated from other IT systems in the hospital because there is little or no connectivity with them. Within the German flagship project OR.NET, concepts and components were developed for a standard-based connection of the OR with hospital IT systems.
Objectives The aim of this work was to implement and evaluate OR.NET concepts and components within the existing IT landscape of a German university hospital. This article describes and evaluates the implemented architecture and processes for connecting a demo OR to existing hospital IT systems at Heidelberg University Hospital.
Methods For the design, establishment, and evaluation of standard-based connections of the demo OR with hospital IT systems, the iterative method “Design and Creation” with four iterations was applied.
Results A generic and a concrete architecture for several standard-based connection concepts of the demo OR were developed. Furthermore, the concrete architecture was implemented and evaluated for its technical and clinical relevance. The main benefits of the project were the establishment of basic requisites for improving the efficiency within the OR, easier operation of medical devices as a result of harmonized human–machine interfaces, and providing additional data for improving healthcare.
Conclusion OR.NET concepts for a standard-based connection of the OR with hospital IT systems have proven to be promising. They can serve as a reference for further integration scenarios in other hospitals.
Keywordsintegrated operating room - hospital information systems - interoperability - networked medical devices - standards
Clinical Relevance Statement
An open integration of medical devices within the OR and with hospital IT systems offers a broad spectrum of opportunities with regard to the digital transformation of the hospital. Practitioners will profit from the so-called smart services based on data emerging from various medical devices, such as the automatic phase recognition of surgery or an automatically created OR report. Operators of hospital information systems will be able to integrate medical devices from various device manufacturers on a uniform way, avoiding different integration solutions for each medical device manufacturer.
Protection of Human and Animal Subjects
Neither human nor animal subjects were included in the project.
- 1 Nocco U, del Torchio S. The integrated OR Efficiency and effectiveness evaluation after two years use, a pilot study. Int J CARS 2011; 6 (02) 175-186
- 2 Murphey B. Integrating the integrated operating room - Healthcare Design Magazine. Available at: http://www.healthcaredesignmagazine.com/architecture/integrating-integrated-operating-room/ . Accessed July 18, 2017
- 3 Lemke HU, Vannier MW. The operating room and the need for an IT infrastructure and standards. Int J Comput Assist Radiol Surg 2006; 1 (03) 117-121
- 4 Medical Device Plug-and-Play Interoperability Program. Available at: www.mdpnp.org . Accessed May 30, 2017
- 5 SCOT Project. Available at: http://asia.nikkei.com/Tech-Science/Tech/Japan-developing-the-smart-networked-operating-room-of-the-future . Accessed May 30, 2017
- 6 Future Environment for gentle liver surgery using image-guided planning and intra-operative navigation (FUSION Project). Available at: http://www.unitransferklinik.de/SF/ . Accessed May 30, 2017
- 7 Minimal-Invasive orthopädische Therapie (orthoMIT). Available at: http://www.meditec.hia.rwth-aachen.de/de/forschung/abgeschlossene-projekte/orthomit/ . Accessed May 30, 2017
- 8 Schonendes Operieren mit innovativer Technik (SOMIT). Available at: http://www.gesundheitsforschung-bmbf.de/de/1631.php . Accessed May 30, 2017
- 9 Dienst-orientierte OP-Integration (DOOP-Projekt). Available at: http://www.doop-projekt.de/ . Accessed May 30, 2017
- 10 BMWi AUTONOMIK, smartOR - Innovative Kommunikations- und Netzwerkarchitekturen für den modular adaptierbaren integrierten OP-Saal der Zukunft. Available at: http://www.autonomik.de/de/smartor.php . Accessed May 30, 2017
- 11 Secure and dynamic networking in operating room and hospital - Project brochure. Available at: http://ornet.org/wp-content/uploads/2017/07/Broschure2016_ENG_final.pdf . Accessed July 25, 2017
- 12 Pahontu R, Will A, Bergh B. Towards communication requirements in the operating room and clinic IT. Stud Health Technol Inform 2015; 212: 1-8
- 13 Pahontu R, Merzweiler A, Schneider G, Bergh B. Micro- and macrointegration profiles for medical devices and medical IT systems. Stud Health Technol Inform 2015; 216: 222-226
- 14 Kasparick M, Schmitz M, Andersen B. , et al. OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability. Biomed Tech (Berl) 2018; 63 (01) 11-30
- 15 OASIS, Devices Profile for Web Services Version 1.1. Available at: http://docs.oasis-open.org/ws-dd/ns/dpws/2009/01 . Accessed December 4, 2016
- 16 Andersen B, Kasparick M, Ulrich H. , et al. Connecting the clinical IT infrastructure to a service-oriented architecture of medical devices. Biomed Tech (Berl) 2018; 63 (01) 57-68
- 17 NEMA, Digital Imaging and Communications in Medicine (DICOM). Rosslyn, VA, USA: NEMA Standards Publications PS 3.x, National Electrical Manufacturers Association. Available at: http://dicom.nema.org/standard.html . Accessed November 30, 2016
- 18 The Health Level Seven Version 2 (V2) Normative Edition, Health Level Seven International Std. Available at: http://www.hl7.org/implement/standards . Accessed December 30, 2016
- 19 Integrating the Healthcare Enterprise - IHE. Available at: https://www.ihe.net . Accessed May 30, 2017
- 20 IHE Patient Care Device, Integration Profile Device Enterprise Communication. Available at: https://www.ihe.net/uploadedFiles/Documents/PCD/IHE_PCD_TF_Vol1.pdf . Accessed May 30, 2017
- 21 IEEE Project P11073-10207 - Standard for Domain Information & Service Model for Service-Oriented Point-of-Care Medical Device Communication. Available at: https://standards.ieee.org/develop/project/11073-10207.html . Accessed March 5, 2017
- 22 IEEE Standard Association - P11073-20701 - Standard for Service-Oriented Medical Device Exchange Architecture & Protocol Binding. Available at: https://standards.ieee.org/develop/project/11073-20701.html . Accessed July 19, 2017
- 23 IEEE Standards Association, IEEE Standard 11073-20702-2016 - IEEE Approved Draft Standard for Medical Devices Communication Profile for Web Services. Available at: https://standards.ieee.org/findstds/standard/11073-20702-2016.html . Accessed July 19, 2017
- 24 Oates BJ. Researching Information Systems and Computing. Los Angeles, CA: SAGE Publications; 2006
- 25 Mednovo HL7 gateway. Available at: http://www.mednovo.de/produktbereiche/hl7-server/ . Accessed December 22, 2016
- 26 VISUS JiveX DICOM gateway. Available at: https://www.visus.com/de/jivex-produkte/geraeteschnittstellen.html . Accessed December 22, 2016
- 27 IHE International. IHE Patient Care Device (PCD) Technical Framework Volume 3 IHE PCD TF-3 Semantic Content. Available at: http://www.ihe.net/uploadedFiles/Documents/PCD/IHE_PCD_TF_Rev5.0_Vol3_FT_2015-10-14.pdf . Accessed July 26, 2017