If you're about to build new ORs or renovate existing ones, prepare each room for the eventual addition of integrated surgical video and centralized OR controls. Even if outfitting an integrated surgical suite is low on your wish list, designing the space, conduits and basic infrastructure ahead of time will ease the later installation of hardware and cabling. Given the continued rise in minimally invasive and scope-driven procedures, you'll definitely need video and information routing and recording, remote communication for consulting and educating or central access to equipment functions someday.

Building in
Planning ahead is key to this capital investment. For many facilities, that means deciding early which manufacturer's system to install, then getting the architectural team to design and build a room around it. This may also mean, however, that you're committing to one product and finalizing its cost before all your structural needs are known.

A better option is to design for flexibility. At the medical technology planning firm I represent, we've researched each manufacturer's system to devise an OR infrastructure plan that will accept any of them. That takes proprietary design out of the process, allowing facilities to make future purchases based on competitive pricing and service quality, not on previous construction decisions.

Compatibility
When selling cameras and scopes, manufacturers often claim they offer open architecture, then suggest that others' video components aren't compatible with them. The reality is, integrated OR systems are generally intercompatible. Everyone's handheld devices work with everyone else's systems, and most systems are able to control most tables, lights and other adjustable equipment.

We've found, though, that some products' controls are proprietary and unable to be directed from a central station, so providing the manufacturers you're considering with a list of your equipment and asking about their systems' compatibility with those items can provide data for comparison during your request-for-proposal process.

Occupied space
An integrated surgical suite reduces the clutter of cable-intensive video equipment for a safer OR environment. Boom-mounted flat-panel monitors that swing into place make for easier procedure set-ups than pushing a cart or tower into the room, reducing wear and tear and, because they remain in the room, infection control maintenance. But the centralized control unit is a piece of furniture and will require space, which will mean something different to a 400-square foot room than to a 600-square foot room.

We've found that the unit is usually set up at the OR's nurses' station, which is ideal as long as that station is in an efficient place. It'll require a substantial desk, considering that the control console for the video system, along with the documentation workstation and a PACS workstation, amounts to three desktop computers — plus your OR staff is going to need a place to do some handwriting, too.

In order to enable remote communications — for intraoperative pathology consultation or clinical audience viewing, for instance — some systems require a rack of networking equipment, which should be housed with other data and communications devices in an information systems equipment room outside the OR. These are no longer closet-sized spaces, so be sure to consider this demand, as well as the networking standards that may limit its distance from the unit, when designing your surgical spaces.

Intuitive use
Given the complexity of installation, you're not likely to trial centralized OR controls in your own facility. Instead, you might try them out at other facilities, at the manufacturer's locations or in the exhibit halls of association conferences.

The different systems on the market are similar in many ways, so what you're primarily looking for is intuitive use, even as you're seeking buy-in from surgeons.

We've recently consulted for a large teaching hospital. Once we'd helped the surgeons understand which systems offered intercompatibility without the loss of functionality, we were directed to seek the approval of the OR nurses, who have to set up procedures and operate the systems.

The best product demonstration of an integrated surgical suite I've ever seen was when the manufacturer's representative asked for a volunteer from a group of exhibit hall observers. The representative guided the volunteer through a series of steps, proving that the system was logical enough that a person who'd never before used it could easily set it up for surgery. That's the kind of usability you should look for in a system.

CompView Medical
NuBoom
(800) 448-8439
www.compviewmedical.com
List price: $198,000 to $298,000
FYI: The NuBoom Visualization and Equipment Management System upgrades a standard OR to a digital OR in as little as two days, virtually eliminating OR downtime, reducing capital costs and improving productivity and safety, says the company. NuBoom includes the Digital Operating Control System (DOCS), an intuitive touch-panel routing and control system with open architecture that supports multiple camera brands and source inputs.

ConMed Integrated Systems
Nurse's Assistant OR Control System
(800) 470-1106
www.conmedis.com
List price: not disclosed
FYI: The Nurse's Assistant is a powerful, intuitive OR control system that enables clinicians to monitor and control surgical technology, says the company. As part of the Smart OR integrated system, it provides image management of HD video sources, control over medical devices and environmental settings, and remote connectivity to external locations.

Karl Storz Endoscopy
OR1 Video Distribution System
(800) 421-0837 x6643
List price: not disclosed
FYI: The OR1 Video Distribution System provides a fundamental solution for the routing of video images in the minimally invasive surgical suite, says the company. The VDS can power up to three viewing panels and is compatible with Karl Storz's entire line of image capture and medical device control solutions.

Olympus America
EndoAlpha
(800) 548-5515
www.olympusamerica.com
List price: starts at $37,270
FYI: EndoAlpha allows healthcare professionals to access, display and transmit clinical data electronically, control all surgical and ancillary equipment from the sterile field through a single panel and videoconference in real time with high-definition images, says the company, to maximize surgical performance and improve OR efficiency.

Smith & Nephew Endoscopy
Condor Control System and Condor Express
(800) 343-8386
www.global.smith-nephew.com
List price: varies depending on customer specifications
FYI: The Condor Control System is the surgical command center of Smith & Nephew's customized digital operating rooms. Through the use of a touch panel or voice commands, Condor can control individual surgical devices or environmental settings such as the OR's lighting or temperature, says the company. It can stream video of procedures in real time via the Internet to external locations and observers and can be configured to operate with a facility's existing information system for efficient document capture and retrieval. The Condor Express is a cart-based control solution for smaller and office-based facilities.

Skytron
SkyVision
(800) SKYTRON
www.skytron.us
List price: $80,000 to $100,000
FYI: Skytron's SkyVision hybrid integration system is easily installed and provides the flexibility to incorporate past, present and future technology for viewing, archiving and sharing clinical video and data images through an intuitive touchscreen control, says the company. Comes equipped with true remote diagnostics to ensure maximum performance and system reliability.

Steris Corporation
Harmony Integrated OR
(800) 548-4873
www.steris.com
List price: varies depending on customer specifications
FYI: Steris's Harmony Integrated OR features open architecture that's compatible with all major cameras and endoscopes and adaptable to changes and upgrades, says the company. From planning to design to installation to operation, Steris's Harmony is OR integration made easy.

Stryker Communications
Switchpoint Element
(866) 726-3705
www.stryker.com
List price: $34,275
FYI: Stryker's Switchpoint Element serves as a central control point for all OR-based video signals and surgical devices, says the company. The user interface simplifies the complexities of OR technology to a single touch panel, and one-touch routing enables this four-input, four-output system to switch between four different video sources on each monitor.