It would be an understatement to say the investment in healthcare IT continues to offer more potential to support patients and clinicians. Experts report preventative care and patient monitoring technology continue to make this segment of development one of the biggest drivers in the technology industry, just barely behind mobile revenue, experts report to KPMG. The research company reports electronic medical records, remote medicine and medical information are also perceived as some of the areas of innovation that can benefit from healthcare IT advancements.
The technology moguls in this specialty are not the only ones investing. For instance, the Agency for Healthcare Research and Quality (AHRQ) has invested thousands in healthcare IT development annually for years. This year it’s supporting two projects – one targeting inter-system advanced planning procedures and another at understanding how EMR data impacts a patient’s pain management strategy.
Another large area of healthcare IT, specific to the OR, is how collaboration equipment fits into the puzzle of patient outcomes. The opportunity to connect with experts outside of the OR can offer a variety of benefits. For instance:
- Surgical teams can collaborate easily with others remotely by sharing imaging scans and records on a secure network
- Surgeons can offer residents non-critical feedback on procedures from their office
- Electronic scheduling boards, some with video components, can increase staff efficiency by providing more information in real time
- Sales representatives can provide expertise on their equipment and solutions, without having to be present in each OR
- Secure and encrypted collaboration channels limit the potential for Health Insurance Portability and Accountability Act (HIPAA) violations
If a facility is ready to make the investment in technology, the question of how it will impact the surgical team is foremost in the OR. This question can be met with a simple answer if planning is effective, experts say. Jonathan Draper, director of product management at Calgary Scientific, commented that the input of surgical team stakeholders during the planning process will indicate how smoothly a new system is implemented. “The surgical teams’ roll in the roll out is to help hospitals understand what their requirements are for the software, how they want to use the images it makes available and how they want to interact with the images and information,” Draper said.
Eddie Mitchell, CEO of Image Stream Medical, noted that it’s important to consider the unique requirements of the medical environment. “Unlike solutions designed for the general market, medical collaboration systems not only have to comply with HIPAA to protect patient health information, but must be designed to support the clinical workflows in a critical care environment, provide pristine image quality, be highly resilient to changing network conditions, and deliver high audio quality in what are always very acoustically challenging environments,” Mitchell said. The options for surgical teams are limited only by budget, it seems, as technology makes it possible for anyone with clearance to collaborate through mobile and in-line platforms. That is why clearly defining what technology teams want and how they want that technology to support its staff. These requirements can then be relayed to suppliers, like Calgary Scientific and Image Stream Medical, to either create a custom approach or modify a standard solution to meet needs.
Outlining the who, what, where and why behind technical offerings is a fluid conversation, so Surgical Products turned to Draper and Mitchell.
Image Sharing Networks
What: These are networks designed to increase the availability of images when and where clinicians need them, in addition to secure sharing of patient information to facilitate more collaboration.
Who: Surgeons, radiologists and other specialists typically use these secure networks to collaborate.
Where: Larger facilities started using these systems initially, but medium and smaller sized networks have adopted this technology.
Why: The traditional modes of image sharing, including swapping CDs and print outs, resulted in a number of HIPAA violations, said Draper. These included patient information being lost and stolen. The newer methods connect the imaging device straight to the facility’s network to provide instantaneous access. This could be an intranet or cloud-based system, many times relying on a logins and other individual verification systems to ensure security.
Various vendors offer different structures, but the concept is the same – store images somewhere clinicians in multiple departments across a campus or the world can access them to improve workflow and increase the potential for collaboration, in addition to security. This originally meant desktop platforms, but the move to mobile could allow for case preparation and collaboration to be stored in a surgeon’s pocket. “If we can add image access to that environment, it becomes a very fluid aspect of their workflow, and lifestyle as well,” explained Draper.
Connecting with External Experts
What: The potential for surgical teams to connect with experts outside the OR generally means connecting with a mentor or specialist mid-case to offer insight on a non-critical technique or issue.
Who: Surgeons use this, but the whole surgical team will be affected by this technology.
Where: Again, larger facilities were the first to implement this technology, and, more and more mid-size facilities have begun to start incorporating it.
Why: The ‘phone a friend’ concept has been popular in the consumer industry since cell phones became mainstream, but that technology has started to become a norm in healthcare as a certain level of connectivity becomes standard. The prerequisites for a technology like this are huge – demanding detailed video feeds and effective network connections. “If they don’t understand (these requirements) before they try to buy the technology, they are going to be disappointed,” Draper said.
Mitchell adds, “These dynamics are common to any technology adoption lifecycle. The early adopters are always the most tech-savvy. But as the market grows, typical users will demand that the solution is easy to use and bullet-proof. The power of simplicity is key. If it’s difficult to use, it will just sit on the shelf and not deliver the tremendous benefits collaboration offers.”
Medical Virtual Presence
What: Medical virtual presence is the ability to augment the in room caregiver team with clinicians and other stakeholders outside the room, increasing the expertise and capacity of the in-room team.
Who: Commonly clinicians, but also IT, biomed, and industry representatives that support clinicians or equipment in the OR.
Where: Larger facilities with research or education components are starting to transition to this technology.
Why: Medical virtual presence offers the full room experience, without adding another person to the already hectic OR and exposing the patient to another person potentially hosting infection. “There are more and more stakeholders that need to participate in a procedure, without being in the room. In the past, this meant specialized immersive rooms that were available only to a very few,” Mitchell added. “Now, medical virtual presence lets all clinicians collaborate, whether they’re on a mobile device or sitting in a dedicated presence room.”
Comprehensive Scheduling Boards
What: These scheduling boards are large monitors, typically installed outside of the OR, that contain the clinical context needed to understand what is happening in real-time in one or more ORs. They can contain case data, location, and participating surgical team members. “When equipped with live video feeds, an insight board allows a clinician to monitor where a case is and anticipate next steps for one or even several ORs,” Mitchell said.
Who: Circulating staff, OR managers and surgical team members commonly use them.
Where: Larger facilities invested in these early on, but today facilities of all sizes have begun adopting them.
Why: These electronic scheduling boards can be paired with video feeds of ORs and rooms so the whole clinical team can have a bird’s eye view of the room. Mitchell explained this helps surgical team members know how far along a case is and to anticipate whether they are needed as scheduled. It can also cue in OR managers on room availability, whether an OR has been properly prepared for a case or cleaned afterwards and other schedule and quality-related insights.