The march toward wire-free ORs continues, as wireless technologies let us monitor patients, exchange patient data in real time and perform more precise surgery while ridding our rooms of obtrusive (and dangerous) cords and cables. Here's how 5 wireless technologies will shape the way our ORs operate in the days to come.

1. Wireless video monitors
Installing wireless video monitors eliminates video cables and cords from your ORs. Removing these tripping hazards improves safety and decreases clutter, but there are additional benefits.

Surgeons like to frequently adjust the height and angle of their monitors in order to get the ideal view of video feeds. And you can only stretch a monitor's wires so far. Without a tangled web of cords and cables to contend with, surgeons can more easily move the monitors when they need to, getting a better picture and performing procedures in more ergonomically sound positions to boot.

Switching to wireless monitors can also lessen the chance of contaminating the surgical field during a procedure. You have a "connected" camera that, because of the positioning of its wires, has to sit on a tower just 1 or 2 feet away from your OR table, and you have to change a setting during a case. Now a staff member that's not scrubbed in enters the surgical field, perhaps touching the table and risking contamination in the process.

A wireless video system is easy to install. Do you remember the days' worth of time and effort you spent on running all those wires and cables through walls and around equipment to hook up your wired video monitors? A plug-and-play wireless video system can be installed in about a day.

Wireless video systems are largely comparable to wired systems in size and heft, and the weight of wireless monitors will be a key factor in whether they become the standard. Today's wireless monitors may be slightly heavier — if only by a few ounces — but, like most technology, figure to only get lighter and more compact. Still, surgeons will resist using a monitor that's even 8, 10 or 12 ounces heavier than what they're accustomed to working with. Most surgeons have a light touch with cameras, and are able to position the camera without probing too deeply. But with a significantly heavier camera, that ability is compromised. Let your surgeons get a good feel for how well they can maneuver various cameras before settling on a system.

2. Vital signs monitors
Wireless and portable vital signs monitors will become fundamental tools for anesthesia providers as surgical facilities move to electronic health records. Once that shift occurs, anesthesia providers will need to send vital signs data to digital files in anesthesia information management systems.

Wireless vital signs monitors with sensors that track blood pressure, heart rate, body temperature and other basic functions take patients from beeping machines and let them move more freely, and sends information straight to the AIMS in real time. This immediately captures data in the patient's electronic record, and saves the anesthesia provider from manually entering the information in the perioperative phase. Some monitors also feature direct wireless remote monitoring that enables transportation from room to room without extensive (and expensive) wire router networks.

A word to the wise: Be sure your facility has the radiofrequency capabilities for using monitors on patients throughout the center. When moving a patient from the OR to recovery, will the wireless pulse oximeter you've placed on her finger still function the same? What's your radiofrequency range? If you've got 12 PACU beds, are they all on the same frequency? Manufacturers should test your radiofrequency ranges throughout the building.

3. Handheld devices
From Palm Pilots to iPads, physicians have relied on handheld devices to gather patient data, save paper, make appointments and more for close to a decade. In recent years, though, surgeons have found more clinical applications for their PDAs, connecting digital cameras to these handheld devices to monitor patients' progress after surgery and entering post-op orders and notes in recovery. Looking ahead, personal data assistants (PDAs) are likely to become more prevalent mostly as a means to transfer images throughout the surgical facility as well as to patients. With just an Internet connection and a DICOM server, surgeons can capture and download images to their PDAs, and then e-mail copies of images to patients and other facility personnel. Data security, however, remains the biggest concern surrounding the use of PDAs to transfer patient information. Work with your IT department before issuing handheld devices to your surgeons, to encrypt any and all information you plan to share through them, and to set up firewalls and establish passwords that restrict access to your network.

4. Surgical robotics
The small surgical robotics market will expand only if robotic technology comes down a long, long way in price. I worked on a case using a robotic device for a unicondylar implant. The cost of the device was $950,000 (not to mention the hundreds of thousands spent on annual maintenance fees). You'd have to do a lot of unicondylar implants to justify that expense. That said, robotic devices are amazing and accurate surgical tools. Surgeons direct instrumentation via remote control from an ergonomic workstation where they view a 3D, high-resolution image of the surgical site, while the surgeon's hand movements are translated into precise movements of instruments inside the patient's body.

With robotic technology, surgeons operate in confined spaces of the body, as the computer system locks in the pre-determined parameters before the procedure. Once those parameters are set, the surgeon can't exceed the boundaries, so to speak. This makes for pinpoint accuracy, and avoids trauma to surrounding anatomy.

These benefits aside, robotic surgical devices face significant barriers to more widespread adoption. Setting up equipment and entering parameters can add 20 to 30 minutes to the case. A lack of tactile feedback can make mid-procedure repositioning of the patient difficult. And while robotic surgery instrumentation may be very intuitive in mimicking surgeons' movements, expect many docs — especially veteran ones — to balk at taking the time necessary to master robotic surgery.

5. Patient location devices
From sophisticated bar-code and radiofrequency identification (RFID) systems to simpler solutions like restaurant-style pagers, surgical facilities have relied on electronic patient location devices to locate patients throughout their facilities as well as to measure and improve their own efficiency.

Recording patient flow times for each visit and using that data to measure workloads and allocate staffing and resources helps you reach peak efficiency and boost throughput. Tracking the patient's progress in real time through your facility also helps identify and prevent bottlenecks. You can program many systems to send alerts when a patient hasn't been moved to recovery on schedule, or when a patient has been kept waiting beyond a certain amount of time, say, 10 minutes.

The price of patient location devices continues to drop. RFID systems range from $80,000 to $100,000 for a surgery center with multiple ORs. (Individual tracking chips usually come at about $25 apiece) They're a more expensive option, but offer more accuracy in terms of patient location.