[25. August 2010 - 14:50]

Multimedia, interactive communication in the OR

Tuttlingen, August 25, 2010. The biomedical manufacturer BERCHTOLD is one of the technological pioneers in telemedicine. The Tuttlingen-based company integrated a ChromoVision® camera in a CHROMOPHARE® surgical light in 1988. This innovation allowed a surgery to be transmitted to a monitor in parallel. Then in 2003, ORICS® was the first device for telemedicine video transmission on the market. Now users can also record and save images. "The engineers at BERCHTOLD have been continually developing the next generation of ORICS® software since 2006," explained Klaus Hammerl, Product Manager at the Tuttlingen-based company. Today, ORICS®, the Operating Room Information and Communication System, can display surgeries live and in television quality on various media.

What is ORICS®?

An interactive communication system, ORICS® transmits the surgical procedure to monitors in the operating theatre as well as PCs and screens located outside of the surgical area. Video images originate from an OR camera or other analogue recording devices. Images taken by an endoscopy camera are suitable as well. The surgeon can receive visual on-screen instructions from the head of surgery or another specialist located outside of the operating theatre. In case of unexpected findings, the OR team can also seek advice from colleagues via headsets. Furthermore, these findings can be discussed post-surgery with experts, colleagues or students, as all images are stored digitally. Fields of application for the ORICS® communication system are, above all, for surgical instructional purposes and documentation at university hospitals.
 

Installation is simple

ORICS® consists of an ORICS® control unit and the ORICS® client communication software. The ORICS® control unit has audio and video connections and USB interfaces for easy system setup and additional hardware. The software can be installed easily and quickly on a standard PC or laptop without the help of an external service technician in almost any OR, even those that are not state of the art. System and infrastructure requirements are minimal: a network with 10/100 MB/s ethernet and IPv4 is sufficient for video streaming. Installing software is comparable to that for a network printer. The ORICS® configuration software and the ORICS® client are installed on a PC or laptop connected to the network. "The hospital IT person usually handles installation," explains Hammerl. "With the ORICS® configuration software, the IT person defines an ORICS® device setup for each ORICS® control unit and copies it to a USB stick." The stick is then inserted in the respective ORICS® control unit. Configuration is automatic with subsequent device booting. The technician sets up every ORICS® device in this way.

Quick startup in the OR

The ORICS® control unit is often brought into the OR on a mobile video equipment cart. An expert then connects the video sources, loudspeakers, microphones or wireless headsets, and a PC to enable transmission from the OR. The hospital's IT department now installs the ORICS® client software on any number of PCs with a network connection. Authorised users with legitimised access can now communicate with the operating theatre and the surgical personnel. System requirements for the ORICS® client software are Windows XP and higher, 3Ghz PIV or Core 2 Duo, 1 GByte RAM, a sound card, a network card, and an optional headset for communication.

ChromoVision® camera system for clear images

ORICS® and the ChromoVision® camera system together are a modular unified concept for video and communication in the operating theatre. Users have the option of either a standalone unit or integrated with the ChromoVision® 1 C or HD camera control unit in a control device. The cameras can be integrated in BERCHTOLD CHROMOPHARE® E series surgical lights or mounted as an external camera system on a separate support arm. With ORICS® BERCHTOLD offers it own surgical lighting camera systems. Third-party room or endoscopy cameras can also be used. Three video sources, in total, can be connected to ORICS®. The user can select these directly via the ORICS® client. Video switches can also be connected. Video, audio and image files are stored to external media or the server, and are available in digital form at any time.

Live and in colour – the Real Time Telestrator

The BERCHTOLD Real Time Telestrator is a real time display on a PC screen. This is an ORICS® feature installed with the ORICS® client software. "The software gives the user three basic functions: live mode, the telestrator function and an image gallery," explains the product manager. In live mode, the surgical events are transmitted to a PC screen in real time. Controlled bidirectional communication guarantees that only one person outside of the OR is ever talking to the surgical team. Using a camera control panel in the monitor's display, a member of the surgical team controls the connected camera. The telestrator feature lets the users mark up image snapshots with dots and arrows, hand drawn circles, or add a frame. Various colours are available. The surgeon can then delete or save the image with or without the illustrations. Immediately switching back to direct transmission is always possible. The picture in picture (PIP) feature shows live images along with the snapshot. A third option for the user is an image gallery. This data storage area saves and organises the recorded images. A tab overview permits quick access to individual snapshots. One click on the respective icon switches the function view. Different background colours clearly tell the user what mode is active.

ORICS® - the future

Today's pressure for lower cost presents great challenges to clinic management decision-makers and buyers. They should be saving money but at the same time upholding the rising standards for quality and efficiency for the biomedical products being used. Moreover, hospitals are seeing a growing need for specialisation and consultation. Today's trends in telemedicine show that hospitals are striving for ever greater internal and external networking. As a result, clinics are increasingly digitising their work processes and documentation. With its tele-consulting options, ORICS® is the wave of the future: for example, a surgeon can set up more efficient workflows. From his office, he can check into the OR with just a mouse-click and be sure that the patient has been prepared for surgery. Often, a surgeon is called in prematurely or with a delay. During the surgery, consulting with a supervisor or expert is possible without any of these people having to leave the office and undergo preparations to enter the OR. If someone's presence is required, then she can decide this on a case-by-case basis. "But the opposite scenario also arises," explains Hammerl. "The specialist is present at the procedure, in the OR, and questions come from the outside. The user can answer via headset without having to leave the OR, or the students do not have to be inside the OR.” ORICS® also offers networking with laptops or PDAs via a wireless LAN connection. This lets experts be reached anywhere and anytime, at the hospital or while they're traveling. The cost for ORICS® is limited to one control unit per OR and one software installation per user on a PC.

Via ORICS® client software, the user can quickly switch between the three basic functions: live, telestrator and gallery modes.

The real-time telestrator permits a look inside the OR. Specialists communicate with the surgeons via configured PC stations.

The surgeon receives advice and support in case of complications via the headset.