Integrating 24 multidisciplinary surgery rooms of the Södersjukhuset hospital (Sös), Stockholm, Sweden.

In 2019 ALVO Medical completed their largest turn-key installation with 24 integrated surgery rooms.  The modular operating theatres were to meet highest ergonomic, hygienic and functional standards. While at the same time respond to individual needs of the endusers in terms of achieving their clinical goals. Our client required an operating room integration system, that would facilitate and improve surgical workflow. Security of data exchanged between hospital systems in the operating theater was of great importance.

 

ALVO integrated modular ORs
24 integrated modular ORs delivered by ALVO Medical.

 

TARGET:

  • Control and/or visual display of vital medical and non-medical devices in the operating room.
  • Advanced video routing options.
  • Image archiving and management in the OR, as well as audio-video transmission to designated rooms within the hospital, and outside of the hospital.
  • Exchange of clinical data between HIS and PACS hospital systems.

All of the above-mentioned are managed from a touch screen installed in each room, on which the Alvo® Integra software works. Centralized control already significantly increased ergonomics limiting the number of device controllers and interfaces.  It also helped optimize teams’ collaboration during procedures. The learning curve was shallow and staff introduction was shorter, compared to projects where each room is fitted with different technology.

Reducing risks in the OR

Apart from standard functionalities of the OR control, such as surgical and room lights control, ventilation etc., we extended the integration scope to:

  • visual display of electric power supply systems,
  • medical gases,
  • visual alarms from ventilation systems,
  • HEPA filter contamination control
  • digital surgeries plans displayed in front of each operating room.

This way medical and technical personnel can quickly react to any emergency occurring within the surgical environment, which translates into the increased safety of the staff and patients. Adjusting, connecting and integrating many standards and communication protocols that came with different technology and vendors, were a huge project themselves. Meeting these challenges proves that the Alvo® Integra is a human-oriented, scalable solution.

Lights scenarios – a unique feature

Ever heard of “lights scenarios”? RGBW technology, also called ergonomic lighting, allows the color of the light in the operating room to be adjusted to the phase of surgery. Individual settings of light scenes can be recalled from the Alvo® Integra touch screen. Light scenes based on the colors of green, red, blue and white are used, depending on the type of procedure, or stage of surgery. For instance, white light will be used for the induction phase, to optimally monitor the patient. Minimally invasive procedures, on the other hand, often use green or blue light, which allow for better contrast with the image on surgical monitors and does not cause operator’s eyes fatique. The lights help hospitals save energy, which is a vital economic benefit. Special sensors will automatically reduce light intensity when the operating room is unused for a longer period of time.

 

ALVO Integra OR lights
RGBW room lights for surgical scenarios. ALVO Integra.

 

Video-over-IP standard

Another important scope of integration was image management. Both inside and outside of the surgery room. We used Barco Nexxis technology. With a goal to provide the highest quality of image transmission without delay and compression in the OR. Also between surgery rooms and conference rooms (mutual communication and audio-video data exchange). We integrated 24 operating rooms and 7 conference rooms that were located in different areas of the hospital. It required the use of high multimedia streaming bandwidth. We applied the IP technology, based on a fiber optic network. And sucessfully performed image transmission to conference rooms set-up several hundred meters away without compression and loss of video signal quality.

Future-proof solution

The Alvo® Integra is a 4K and 3D-ready solution. Open software architecture allows expansion with new video sources and monitors without disturbing the cabling infrastructure. This long-term approach future proofs hospital investment cycle. In each of the operating rooms there are three 26″ surgical monitors in the operating field (on pendants), and an overview monitor built into the modular wall infrastructure (55 inch, 4K resolution). The latter serves as operational support, enabling access to clinical images.

Patient data

Every surgical suite has a scrub nurse station with direct access to PACS and HIS systems.  Video sources are permanently assigned to the specific OR. They include: the camera in the operating field (surgical light), an overview camera installed on the ceiling and the above mentioned computers with access to PACS and HIS. Another group of video sources supported by the Alvo® Integra are mobile devices, which include endoscopic cameras, ultrasound or C-arm. The mobile devices are very often shared between ORs, depending on the needs of a given procedure.

Plug-and-play connection of ‘additional’ video source is important, especially during an ongoing surgery

In order to make it happen, Alvo Medical equipped each operating room with several unified video connection sockets located on the surgical and anesthetic columns. This versatile approach minimized the occurrence of errors resulting from multiple video standards in imaging devices. Dedicated video sockets and video encoders assigned to mobile devices, allow medical personnel to easily and intuitively connect any video source in each OR. The risk of making a mistake is close to zero. Locating connectors on the columns has great advantage over wall-based solutions. It reduces the length and amount of cabling between the operating field and the walls. No hazard of tripping against cables. Increased hygiene.

Telemedicine and live surgeries are no longer a trend

They are standard! Exchanging multimedia and remote collaboration during surgical procedures have become natural. While, letting crowd in the OR does not comply with hygienic regimes. Videoconference option serves university units, as a way of introducing students and surgeons to practical knowledge. The ability to transmit high quality image from the surgery room with simultaneous voice communication solves this problem. Clinicians may now record and stream live video conferences to a large auditorium.

Key tasks for the audio-video transmission at the Södersjukhuset hospital (Sös) in Stockholm:

Audio-video transmission, with no delay, inside the hospital for students’ trainings, conferences and expert’s review.

Special module enables video transmission to any of the 7 conference rooms. Real-time sharing.
No delay, no compression of the video signal
. Alvo® Medical used optical fiber network to provide smooth communication. Conference rooms infrastructure enable receiving any image from the video sources connected at given moment in the OR. Plus two-way voice communication. The hospital is free to hold conferences, trainings and consultations without audience in the operating theater.

Multimedia streaming outside the facility with the use of videoconference modules integrated with the hospital systems.

We provided a videoconference terminal that enables connection with multimedia and streaming to any place inside the hospital and outside. As in the case of transmission to conference rooms, it is the user in the OR that decides about setting-up the connection and which images to share with the interlocutor outside. This is a security issue.

The challenge of the last phase of the project was integration with HIS and PACS. In order for the surgical team to archive images and video sequences on the PACS servers, the Alvo® Integra solution should exchange data at the application level with PACS and HIS systems. Here especially, involving surgical teams was crucial. Alvo® Integra allows downloading surgery plans from the HIS system, in order to assign images and archived data throughout the procedure to a given patient. After the surgery, surgeons may send and archive complete patient data in the PACS system. This way processing surgical patients through the hospital system will come much faster and safer.

Source: ALVO Medical

Project management with: Mitru Group AB 

Södersjukhuset hospital (Sös)

General Contractor: NCC