Operating rooms during complex surgeries such as heart procedures involve a plethora of information systems gathering real-time data from medical devices and nursing, surgery, imaging, lab and anesthesia systems. They also require a workflow and patient flow management system.
But it can be a problem if each clinician is watching a separate computer screen as the surgery progresses. Verbal communications can be challenging because everyone is wearing a mask. To improve communication and begin providing an integrated view of all that data, hospitals are turning to surgical information system vendors with new display solutions. For instance, the Hospital of the University of Pennsylvania (HUP) in Philadelphia has installed LiveData’s OR-Dashboard in all seven of its cardiovascular operating rooms.
OR-Dashboard collects data from various systems, such as HUP’s Epic EHR, pharmacy, lab, and resource tracking systems and displays it on a single large screen for everyone in the OR to see.
“The concept is pretty straightforward, even if the IT development behind it is not,” said Jim Mullen, M.D., associate executive director of HUP, in a recent interview.“We are putting it in every cardio OR because everyone in the operating room has only been looking at only one piece of the elephant,” he said. “Other colleagues couldn’t see the system you were looking at. Now, all that information is fed onto one dashboard that everyone can see. That could help identify a discrepancy or omission or a missing piece of equipment.”
Technologically the integration is a bit challenging, because every piece of equipment is a bit different, with different refresh rates and interfaces that have to be written to them, said, Mullen, who is also corporate director of perioperative services.
A nurse documents in Epic during an operation and the information flows up onto the OR-Dashboard screen, along with feeds from other systems. Ideally, HUP would love to have all that data flow back into the Epic system, but the data flow is not bidirectional, he said. The OR-Dashboard is a display, not a database. “LiveData has work to do with Epic,” Mullen said. That is the case with niche players, he added. “They have to grapple with the big gorillas, and sometimes the big gorillas will choose to copy what they do rather than work with them.”
OR-Dashboard also has an “Active Time Out” feature that displays checklist items, including key safety steps for perioperative care that have been shown to significantly reduce complications and deaths from surgery.
OR-Dashboard was co-developed by Massachusetts General Hospital clinicians and LiveData’s engineering team. After the initial deployment of OR-Dashboard, LiveData and Mass General have continued to develop the technology and clinical applications. Mullen said HUP is part of a consortium of academic medical centers working on OR improvement. “We meet once a year to share best practices. This was developed in Cambridge and first used at Mass General. We had a chance to see it in action there first.”
“There are a few other operating rooms at HUP that handle big complex cases we could put it in,” Mullen said, “but for more basic surgeries this would be overkill.”