The equipment gleams and the surgical lights shine in your new OR, but the first thing surgeons will notice are the flat-screen monitors hung around the space you spent so much time designing. Is it worth it to invest in stunning ultra-high-definition video or are the still-brilliant images of high-definition enough of a surgeon satisfier? We asked several facility leaders who went through recent imaging upgrades for their views on 4K and HD and their top tips for adding the technology that meets your facility's clinical and financial needs.

Try before you buy

James Stannard, MD, medical director of the Missouri Orthopaedic Institute in Columbia, knew the video system in his 7-year-old facility was reaching the end of its lifespan. "We were faced with a choice — upgrade with the same vendor or opt for a new one," says Dr. Stannard.

He had 4 vendors, including a rep from the maker of the facility's original imaging system, come in to pitch the features and benefits of their products. Trying out the systems before making a decision had a big influence on which vendors made the final cut. Only 2 of the vendors brought in systems that the surgeons could check out during their pitches. When it came down to deciding which system to go with, the 2 vendors who brought in platforms the surgeons could trial were the only ones Dr. Stannard and his colleagues considered.

"We let our orthopedic surgeons decide which system they liked best and ended up going with a different vendor," says Dr. Stannard. The new vendor offered a 4K system that had remarkably better picture quality than their old 1080p HD system.

Missouri Orthopaedic didn't spend more to switch vendors. "One system had a more expensive maintenance contract, while the other had a higher up-front cost," explains Dr. Stannard. "So the total investment ended up being roughly equivalent."

It's admittedly difficult to trial video platforms if the space where they'll be used hasn't been built yet. Henderson (Nev.) Hospital is part of a large, established healthcare chain. When the hospital's leadership began planning to build a new surgery center, they had already spent years trialing different video platforms in their sister facilities. They knew exactly what features they needed — superior image quality for the surgeons and a user-friendly interface for the staff — but that didn't mean they knew exactly what they were getting when construction wrapped up on the new facility last year.

"Trialing the video platforms at various facilities helped us see how image quality between systems differed, but we had no idea how everything would come together once we finished building," says Tracy Helmer, RN, manager of the new outpatient facility. "It took a bit of a leap of faith to go fully integrated with our video system because it was impossible to fully replicate the set-up that would be installed."

Looks aren't everything

The picture quality of 4K is the most obvious benefit, but new video platforms come with many other features that can make your ORs run more smoothly.

"Our upgraded system has an iPad application that lets surgeons send custom messages to patients that include images and videos from the surgery," says Dr. Stannard. "Surgeons can also upload images directly to the EMR."

The user interface on the new system also makes it easier for surgeons to check instrument settings. In the past, a surgeon who had accidentally lowered an instrument's power had to look over at the power source to check the setting. With the new imaging system, instrument information is displayed on the video monitors. If an instrument's power level suddenly changes, the surgeon can check the setting without looking away from the action.

The new system also integrates the camera, light source and online network capabilities in one reasonably sized box, which saves valuable OR space.

Staff and surgeons at Henderson Hospital's new surgery center love that their video system helps them communicate and keeps the surgical schedule on track. All of the ORs are outfitted with cameras and microphones that can transmit video and sound between rooms.

That means surgeons can alert staff to start prepping their next surgery while they finish up their current case, says Mr. Helmer, who points out that the improved communication lets surgeons increase their productivity by performing one surgery right after another.

The surgeons also have the option to teach from their ORs. Because the video system connects to an online network, they can narrate their movements to someone watching the action from across the street or across the country.

Cost considerations

Keep in mind that you'll need to invest in 4K cameras to fully realize the visual brilliance of 4K monitors. The video system Henderson Hospital chose came in a bundle that includes video monitors, cameras and attachable instruments. The system's entire imaging chain is 4K ready, so surgeons know they're viewing anatomy at the best possible resolution.

True 4K systems are coming down in price, but is it worth it to upgrade your ORs or to outfit your new center with these high-end video systems?

Henderson Hospital spent more than $1 million to purchase and install its new 4K system. "I don't think it was any more or less expensive than other systems out there," says Mr. Helmer. "The user interface and the true 4K image quality is what sold it for us."

The 2 video components Missouri Orthopaedic considered for its imaging upgrade were comparable in price and had very different image quality. For leaders there, it was a no-brainer to go with the true 4K system.

For others, the choice is less obvious. Doris A. Collier, RN, MBA, is an administrator who believes the image quality of high definition video is plenty good enough for the surgeons of Specialists One Day Surgery in Syracuse, N.Y.

The practice's surgery center currently has 40 high definition cameras and HD monitors hung in 5 of its 6 ORs. The facility reluctantly added a 4K monitor to the sixth room and will switch out the other HD monitors when they stop working, but only because they have to.

"Manufacturers will eventually stop making high definition cameras and monitors, so we'll have to upgrade," says Ms. Collier. She looked into transitioning fully to 4K several years ago, but replacing the facility's HD system with 4K components would have cost more than $1 million.

Her practice's surgeons, who specialize in orthopedics, decided the difference in image quality wasn't worth the extra expense. Mark Chudow, RN, CNOR, clinical materials manager at the University of South Florida Endoscopy and Surgery Center in Tampa, had a similar experience. When the facility's surgeons opted to upgrade to a newer HD video system instead of investing in 4K, they saved themselves more than $200,000.

The surgeons had made a strong initial push for 4K, but backed off when they were shown the technology's price tag. "We're a physician-owned facility," says Mr. Chudow. "The surgeons don't earn what they spend. That reality made them come around pretty quickly to the cost benefit of sticking with high definition." OSM