Skip to main content
SpringerLink
Log in

OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC

  • Original Article
  • Published:
International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed technologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders.

Method

The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feedback from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiologists and OR staff.

Results

In the present work, we qualitatively evaluate a subset of the proposed concepts from the perspectives of various stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms.

Conclusion

The implementation of openly integrated operating rooms will positively affect the surgeons, the anesthesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evaluation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Dadam P, Reichert M, Kuhn K (2000) Clinical workflows—the killer application for process-oriented information systems? In: Abramowicz W, Orlowska ME (eds) BIS 2000. Springer, London, pp 36–59

    Chapter  Google Scholar 

  2. Lemke HU, Berliner L (2011) Systems design and management of the digital operating room. Int J CARS 6:144–158. doi:10.1007/s11548-011-0608-y

    Article  Google Scholar 

  3. Christian CK, Gustafson ML, Roth EM, Sheridan TB, Gandhi TK, Dwyer K, Zinner MJ, Dierks MM (2006) A prospective study of patient safety in the operating room. Surgery 139:159–173. doi:10.1016/j.surg.2005.07.037

    Article  PubMed  Google Scholar 

  4. Sexton JB, Makary MA, Tersigni AR, Pryor D, Hendrich A, Thomas EJ, Holzmueller CG, Knight AP, Wu Y, Pronovost PJ (2006) Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel. Anesthesiology 105:877–884

    Article  PubMed  Google Scholar 

  5. Hu Y-Y, Arriaga AF, Roth EM, Peyre SE, Corso KA, Swanson RS, Osteen RT, Schmitt P, Bader AM, Zinner MJ, Greenberg CC (2012) Protecting patients from an unsafe system: the etiology and recovery of intraoperative deviations in care. Ann Surg 256:203–210. doi:10.1097/SLA.0b013e3182602564

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lemke HU, Vannier MW (2006) The operating room and the need for an IT infrastructure and standards. Int J CARS 1:117–121. doi:10.1007/s11548-006-0051-7

    Article  Google Scholar 

  7. Padoy N, Blum T, Ahmadi S-A, Feussner H, Berger M-O, Navab N (2012) Statistical modeling and recognition of surgical workflow. Med Image Anal 16:632–641. doi:10.1016/j.media.2010.10.001

    Article  PubMed  Google Scholar 

  8. Janß A, Benzko J, Merz P, Dell’Anna J, Strake M, Radermacher K (2014) Development of medical device UI-profiles for reliable and safe human-machine-interaction in the integrated operating room of the future. In: Proceedings of the 5th international conference on applied human factors and ergonomics 2014, pp 1855–1860

  9. Guédon A, Wauben L, Overvelde M, Blok J, van der Elst M, Dankelman J, van den Dobbelsteen J (2014) Safety status system for operating room devices. Technol Health Care. doi:10.3233/THC-140854

    PubMed  Google Scholar 

  10. Kasparick M, Schlichting S, Golatowski F, Timmermann D (2015) New IEEE 11073 standards for interoperable, networked point-of-care Medical Devices. In: Proceedings of the 37th IEEE engineering in medicine and biology society (EMBC), pp 1721–1724

  11. Wubben I, van Manen JG, van den Akker BJ, Vaartjes SR, van Harten WH (2010) Equipment-related incidents in the operating room: an analysis of occurrence, underlying causes and consequences for the clinical process. BMJ Qual Saf 19:e64–e64. doi:10.1136/qshc.2009.037515

    Article  CAS  Google Scholar 

  12. Cleary K, Kinsella A, Mun SK (2005) OR 2020 workshop report: operating room of the future. Int Congr Ser 1281:832–838. doi:10.1016/j.ics.2005.03.279

    Article  Google Scholar 

  13. Korb W, Bohn S, Burgert O, Dietz A, Jacobs S, Falk V, Meixensberger J, Strauss G, Trantakis C, Lemke HU (2006) Surgical PACS for the digital operating room. Systems engineering and specification of user requirements. Stud Health Technol Inform 119:267–272

    PubMed  Google Scholar 

  14. Köny M, Benzko J, Czaplik M, Marschollek B, Walter M, Rossaint R, Radermacher K, Leonhardt S (2013) The smart operating room: smartOR. Distributed networks: intelligence, security, and applications. CRC Press, Boca Raton

    Google Scholar 

  15. Andersen B, Ulrich H, Kock A-K, Wrage J-H, Ingenerf J (2014) Semantic interoperability in the OR.NET project on networking of medical devices and information systems—a requirements analysis. In: 2014 IEEE-embs international conference on biomedical and health informatics (BHI), pp 428–431

  16. Kasparick M, Schlichting S, Golatowski F, Timmermann D (2015) Medical DPWS: new IEEE 11073 standard for safe and interoperable medical device communication. In: Proceedings of the IEEE conference on standards for communications and networking of the (CSCN), pp 212–217

  17. Koeny M, Benzko J, Czaplik M, Walter M, Radermacher K, Rossaint R, Leonhardt S (2012) Getting anesthesia online: the smartOR network. Int J Adv Internet Technol 5(3 and 4):114–125

    Google Scholar 

  18. Benzko J, Janss A, Dell’Anna J, Radermacher K (2014) Man-machine interfaces in the operating room. Biomed Eng/Biomed Tech 59:430–430

    Google Scholar 

  19. Kühn F, Leucker M (2014) OR.NET: safe interconnection of medical devices. In: Gibbons J, MacCaull W (eds) Foundations of health information engineering and systems. Springer, Berlin, pp 188–198

    Chapter  Google Scholar 

  20. Andersen B, Ulrich H, Rehmann D, Kock A-K, Wrage J-H, Ingenerf J (2015) Reporting device observations for semantic interoperability of surgical devices and clinical information systems. In: Proceedings of the 37th IEEE engineering in medicine and biology society (EMBC), pp 1725–1728

  21. Pfeiffer JH, Dingler ME, Dietz C, Lueth TC (2015) Requirements and architecture design for open real-time communication in the operating room. In: Proceedings of IEEE international conference on robotics and biomimetics (ROBIO 2015), pp 458–463

  22. Mildner A, Janß A, Dell’Anna-Pudlik J, Merz P, Leucker M, Radermacher K (2015) Development of device-and service-profiles for a safe and secure interconnection of medical devices in the integrated open OR. In: Seehusen F, Felderer M, Großmann J, Wendland M-F (eds) Risk assessment and risk-driven testing. Springer, Cham, pp 65–74

    Chapter  Google Scholar 

  23. Dingler M, Dietz C, Pfeiffer J, Lueddemann T, Luth T (2015) A framework for automatic testing of medical device compatibility. In: Proceedings of the 13th IEEE international conference on telecommunications (ConTEL), pp 1–8

  24. Decker N, Kühn F, Thoma D (2014) Runtime verification of web services for interconnected medical devices. In: International symposium on software reliability engineering, ISSRE 2014, Naples, pp 235–244

  25. Andersen B, Kasparick M, Golatowski F, Ingenerf J (2016) Extending the IEEE 11073-1010X nomenclature for the modelling of surgical devices. In: Proceedings of the 3rd international conference on biomedical and health informatics (BHI), pp 244–247

  26. OASIS (2009) Devices Profile for Web Services Version 1.1

  27. Schlamelcher J, Onken M, Eichelberg M, Hein A (2015) Dynamic DICOM configuration in a service-oriented medical device architecture. In: Proceedings of the 37th IEEE engineering in medicine and biology society (EMBC), pp 1717–1720

  28. Plourde J, Arney D, Goldman JM (2014) OpenICE: an open, interoperable platform for medical cyber-physical systems. In: ICCPS, pp 221–221

  29. ASTM International (American Society for Testing and Materials) (2013) ASTM F2761–09(2013), medical devices and medical systems—essential safety requirements for equipment comprising the patient-centric integrated clinical environment (ICE)—Part 1: general requirements and conceptual model. West Conshohocken

  30. Iseki H, Muragaki Y, Tamura M, Suzuki T, Yoshimitsu K, Ikuta S, Okamoto J, Chernov M, Izumi K (2012) SCOT (Smart Cyber Operating Theater) project: advanced medical information analyzer for guidance of the surgical procedures. In: Proceedings of the international display workshops, pp 1880–1883

  31. Pahontu R, Schneider G, Bergh B, Merzweiler A (2015) An IHE based gateway architecture to link healthcare IT with medical devices in the operating room. In: Proceedings of the 17th international conference on E-health networking, application & services (HealthCom), pp 586–589

  32. Kasparick M, Schmitz M, Golatowski F, Timmermann D (2016) dynamic remote control through service orchestration of point-of-care and surgical devices based on IEEE 11073 SDC. In: IEEE-NIH 2016 special topics conference on healthcare innovations and point-of-care technologies, Cancun

  33. Rockstroh M, Franke S, Neumuth T (2013) A workflow-driven surgical information source management. In: Lemke HU (ed) The International Journal for Computer Assisted Radiology and Surgery. Springer, Heidelberg, pp 189–191

  34. Franke S, Rockstroh M, Schreiber E, Neumann J, Neumuth T (2016) Context-aware medical assistance systems in integrated surgical environments. In: 28th conference of the international society for medical innovation and technology (SMIT) (in print)

Download references

Acknowledgements

The authors were funded within the OR.NET project by the German Federal Ministry of Education and Research (BMBF) with the Grant Numbers 16KT1236, 16KT1238, 16KT1239 and 16KT1242.

Author information

Authors and Affiliations

  1. Faculty of Medicine, Innovation Center Computer Assisted Surgery, Universität Leipzig, Semmelweisstr. 14, 04103, Leipzig, Germany

    M. Rockstroh, S. Franke & T. Neumuth

  2. Department of ENT Surgery, University Hospital of Leipzig, Leipzig, Germany

    M. Hofer

  3. Center for Information Technology, Schleswig-Holstein University Hospital, Luebeck, Germany

    A. Will

  4. Faculty of Computer Science and Electrical Engineering Institute of Applied Microelectronics and Computer Engineering, University of Rostock, Rostock, Germany

    M. Kasparick

  5. Institute of Medical Informatics, Universität zu Lübeck, Lübeck, Germany

    B. Andersen

Authors
  1. M. Rockstroh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Franke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Hofer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Will
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Kasparick
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B. Andersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. T. Neumuth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Rockstroh.

Ethics declarations

Conflict of interest

There are no conflicts of interest.

Ethical approval

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rockstroh, M., Franke, S., Hofer, M. et al. OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC. Int J CARS 12, 1461–1469 (2017). https://doi.org/10.1007/s11548-017-1589-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11548-017-1589-2

Keywords

Search

Navigation