Overall architecture of the smart operating room system
The smart operating room system, by applying advanced information technology to the operating room, enables doctors to obtain a large amount of important patient-related information in real time. The smart operating room system is an important part of medical informatization, focusing on the modernization of the operating room, truly realizing the efficient intelligence and flexible expansion of the operating room, integrating the control and management of equipment, the integration of medical informatization, the transmission and storage of medical imaging data, remote surgical guidance, remote consultation and other integrated applications.
In order to regulate the scope of medical behavior during surgery, improve medical quality, and reduce medical risks, the hospital plans to build a smart operating room system, which covers digital operating room system, information operating room system, demonstration room system, surgery announcement and process management system, operating room comprehensive management platform system, family conversation system, director’s office, operating room behavior management system and auxiliary system, and build a smart operating room information platform.
The system uses optical fiber, network high-definition transmission, hardware encoding and decoding, and teaching terminals. By applying advanced information technology to the specific environment of the operating room, the software and hardware data information of various manufacturers are integrated to achieve centralized display and real-time communication, so that medical staff participating in the operation can obtain a large amount of important information related to the patient in a timely manner.
Video communication from the operating room to the outside of the operating room (such as the demonstration room) does not require point-to-point laying of audio and video cables or optical fibers, but can transmit digital high-definition video signals through the hospital’s existing standard local area network (LAN); video acquisition, transmission, processing, storage, and playback all use high-definition signals.
Operating room system
The digital integrated operating room is a perfect fusion of purification engineering and digital informationization. All information about patients is systematically integrated in the best way, so that surgeons, anesthesiologists, and surgical nurses can obtain comprehensive patient information, more image support, precise surgical navigation, and smooth external information exchange, providing a more accurate, safer, and more efficient working environment for the entire operation. It also provides a reliable channel for surgical observation, surgical demonstration, remote teaching, and remote consultation, thereby creating a high success rate, high efficiency, and high safety in the operating room, and improving the external communication of the operating room.
1.Medical equipment access module
The operating room panoramic camera signal, high-definition surgical field camera signal, special medical imaging equipment (DSA, X-ray machine, laparoscope, microscope, monitor, Da Vinci robot, etc.) signal, bedside monitoring equipment (monitor, anesthesia machine, blood gas analyzer), and intraoperative operator voice signal are synchronously digitally integrated and displayed.
It can meet the visual needs of the staff in the operating room. Through simple operations such as clicking or dragging on the touch screen, various videos or data can be displayed on multiple display screens at appropriate locations in the operating room, realizing the switching of audio and video signals and patient medical data, and can be viewed immediately. The control screen can arbitrarily specify one of the video signals as the main display screen, and display it simultaneously with other video channels. The video source display window can be switched by dragging; it is compatible with VGA, DVI, HDMI, color difference, SDI, CVBS and other signals, and supports broadband high-fidelity sound quality.
2.Video routing management module
It can transmit different video sources (including high-definition endoscope images, panoramic camera images, surgical field camera images, microscope images, C-arm X-ray machine images, monitors, intraoperative ultrasound images, PACS images, etc.) to any display screen in this operating room, and can automatically configure the number of screen images according to the number of currently connected video sources.
3.Video Picture-in-Picture Module
It can display multiple screens and realize 1/2/3/4/5/6/7/8/9 split screens. Each video file can be enlarged or reduced separately, can be dragged at will, the screen display can be combined at will, and its display position in multiple screens can be adjusted at will.
Surgery teaching and observation: It can realize high-definition surgery live broadcast through the network, and can watch the surgery video in real time. The operating room scene video, surgical field video, laparoscope and other medical equipment video, surgical patient medical record information, patient vital signs information, etc. must be able to be transmitted at the same time. It builds a platform for medical exchanges for users, enhances academic exchanges and cooperation, and strengthens the construction of talent teams; especially strengthens the learning and training of young doctors; surgical demonstrations and technical exchanges can be integrated and realized through digital operating rooms, making academic exchanges, teaching and training more real and vivid. The comprehensive digital record of the patient’s surgical process provides doctors with real-time data for case research.
Overall embedded installation: provides a better field of view, makes it easier to observe the surgical field, and obtains the information data required for surgery more quickly, enabling staff to give full play to their technology, create an efficient working environment, make the surgical environment more comfortable and tidy, and make the operation and coordination handy, reducing the workload of medical staff. The structured wall-mounted installation module meets the requirements of cleanliness, aesthetics, and space utilization in the operating room.
4.Remote surgical guidance and consultation module
High-definition video online live broadcast can be achieved in places where the hospital network is accessible, and multiple video windows are supported to display the video of the person or remote parties; support real-time transmission of vital signs data such as bedside monitors, and provide continuous and dynamic diagnosis basis for consulting experts; support multi-party audio mixing, which is convenient for multi-party discussions in surgical video conferences and surgical consultations. It can provide remote surgical guidance, support real-time control of the operating room pan/tilt by remote experts, and has the ability to connect remotely. When remotely assisting surgeons in other places, a large amount of real-time surgical process information, patient vital signs change information, and electronic medical record information facilitate real-time remote consultation.
5.Comprehensive integration of patients’ preoperative, intraoperative and postoperative medical data
With the integration and integration of surgical medical equipment, the surgical process is fully recorded, and combined with preoperative medical records and postoperative information, the patient’s perioperative medical data is fully integrated. At the same time, based on the perioperative data of a large number of patients, a patient perioperative clinical data center is formed. Through the comprehensive integration of data, it is convenient to conduct teaching and scientific research on the recorded patient cases, making it more practical.
6.Video recording template
It can terminate the interaction with the observation end, and can record, pause and stop the live broadcast of the operation; it can record up to 8 different video signals at the same time, as well as the overall recording of multiple operating room videos; images and sounds can be recorded at the same time, and can start and stop recording at any time.
7.Patient file module
It can expand and integrate the existing medical platforms HIS, PACS, LIS, EMR and other platforms in the hospital; display the patient’s name, surgeon, anesthesiologist, nurse, according to the relevant needs of the operation, the doctor or assistant can directly query the patient information on the same platform, and pay attention to the patient’s historical diagnosis information immediately, and can manually input and upload the current operation process and patient medical records.
8.Document management module
Search and browse of audio and video documents: It can provide users with the ability to watch past surgical videos, has the function of querying and browsing surgical archives, and can on-demand and download surgical video materials.
Editing and deleting audio and video documents: Videos of each operating room and demonstration room are automatically archived and stored for subsequent viewing. Supports fuzzy query and multiple query methods
Classification and sorting of audio and video materials: According to the characteristics of the department, special high-standard interactive special video files with multiple channels and multiple videos are specially designed to integrate multiple data information. It can perform multiple production functions such as editing, merging, recording narration, image rendering, and adding subtitles. Each video file can be enlarged or reduced individually, can be dragged at will, and the screen displays its own combination, and its position can be adjusted at will. Clips or the entire video can be flexibly deleted according to their own needs.
9.Equipment control module
Shadowless lamp control module: It can control the on and off of the shadowless lamp, the brightness of the light, and the spotlight mode, etc.
Operating table control module: The lifting control of the operating table saves information according to the different habits of each surgeon, and sets it to the best height and angle of the doctor’s habit with one click before the operation.
Lighting control module: can control and adjust the lighting of the entire operating room at any time.
Temperature and humidity control module: can save humidity information according to the different needs of each operation, and the doctor can automatically adjust the humidity according to the situation before the operation.
Background music control module: stores the doctor’s personal preferences and manages the background music playback during the operation with one click.
10.Centralized control module
The centralized control system of operating room equipment can set up multiple devices on the operating room touch screen according to the requirements of surgical operations, assisting doctors to complete the operation efficiently and safely. Medical staff can complete the control of equipment through this system, save the preparation time of surgery, improve the working efficiency of the operating room, and create a first-class surgical environment.
11.Central monitoring and management system of surgery
The central monitoring and management system of surgery provides auxiliary support for decision-making management, hospital infection management, and quality control management of the operating room by associating the panoramic video of the operating room with the surgical information. The central monitoring module of surgery mainly includes unified monitoring and management of the use of the operating room and the surgical situation, and the overall medical process of the surgical patient, so as to ensure the standard use of the operating room and the whole process of the patient’s hospitalization and treatment.
(1) Configure a network hard disk recorder, a control keyboard and a hard disk for recording and storing videos.
(2) The monitoring room is equipped with a display terminal, which uses a codec to encode and decode the video to display the real-time status of multiple operating rooms, and the signal sources of the operating room can be freely switched on the display device.
(3) The difference from general security monitoring is that the video information must be deeply integrated with the surgical and patient information, and can be used as part of the medical record.
Introduction to the surgical doctor-nurse-patient collaborative information system
The large-screen announcement subsystem in the doctor-nurse-patient collaborative system is a computer application that assists doctors and patients in communicating. Its main task is to process information about the patient’s surgical status and help doctors, nursing staff and patients’ families to understand the patient’s surgical status in a timely and accurate manner. The surgical scheduling large-screen function module supports the display of the surgical schedule list, which can dynamically display the scheduling results and surgical progress of the surgery on the same day, and dynamically display the progress status of the current surgery, so that family members can understand the surgical situation. It can support the playback of promotional materials such as videos and ppts; support the release of hospital notices, announcements and other content, and support patient privacy encryption processing.
1.Function introduction
A touch query machine is configured at the entrance of the operating room, which can query the surgical arrangements and surgical status of specific doctors or patients. The nurse station is equipped with two large-size display screens to scroll and publish surgical anesthesia scheduling information, such as the operating room number, patient name, age, gender, surgery name, anesthesiologist, surgeon, surgical nurse and other information. During the operation, the doctor can modify the information and update and publish it in real time. The family waiting area is equipped with two large-size display screens to obtain real-time surgical progress information from the anesthesia system and dynamically display the surgical status to the patient’s family. During the operation, the doctor can release information and call the family. The family waiting area is equipped with an LED announcement screen and runs an LED announcement system, which can display the surgical progress information in real time and dynamically; the doctor can conveniently call the family to talk through voice broadcasts and large-screen prompts; the family can understand the basic knowledge of surgical anesthesia through the content played on the LED screen.
2.Surgery application and scheduling
(1) HIS information synchronization: HIS surgery application form information can be synchronized in real time and manually: surgical method, surgical site, preoperative diagnosis, patient basic information, surgical time, operator, ward, bed, anesthesia method, etc.
(2) Personnel coordination: Combined with nurse duty information, job grade, title, actual work ability, etc., reasonable and fast scheduling is carried out, and printing and viewing are provided.
(3) Anesthesia and nursing synchronization scheduling: Provide scheduling management of anesthesia and operating room personnel, operating room and other surgical related conditions. Real-time synchronization of HIS surgery application information. Support intelligent scheduling engine, automatic batch arrangement according to established rules. Supports simultaneous scheduling of anesthesia and nursing, and can complete integrated scheduling according to hospital rules. Supports scheduling management in multiple modes (specialized hospitals, general hospitals). Displays the total duration of scheduled surgeries under high probability.
(4) Hierarchical management of surgery-related personnel: supports hospital surgery hierarchical management of the entire surgical process. A surgical grading database can be maintained. Surgery grading approval rules: Determine the rules for surgical grading approval according to the patient’s disease condition, the difficulty of the surgery, the degree of surgical harm, and the doctor’s professional title. Customized surgical grading approval settings: The surgical grading process management can be achieved using technologies such as workflow engines. According to the management of the surgical doctor’s surgical authority by the hospital’s functional departments, the system automatically matches and prompts.
Operating room behavior management system
The surgical behavior management system (based on the Internet of Things RFID radio frequency identification technology) realizes the safe access management of medical staff for surgery, the intelligent issuance, recovery and traceability of surgical gowns and surgical shoes, and establishes an intelligent management system for surgical resources and personnel behavior, ensuring the safety and efficient operation of the operating room to the greatest extent. Combined with the hospital access management system, the entire surgical department workflow is automated. Through the control and management of each work node, access permissions are set for three groups of people: medical staff, patients, and nurses, to prevent unauthorized personnel from entering and exiting the operating room at will, thereby improving the cleanliness of the operating room.
(1) The system uses Internet of Things technology
to achieve the identity identification and access management of surgical medical staff, the issuance, recovery and traceability management of surgical gowns and shoes, the intelligent management of electronic clothing and shoe cabinets, and strictly control the entry and flow of surgical personnel. An intelligent management system for surgical resources and personnel behavior has been established. While ensuring surgical safety and infection control, it has achieved efficient utilization of operating room resources and improved the work efficiency and management level of the operating room.
(2) The main functions of medical management should include
Tag management, which can register different categories of tags, group tags, and change the category and status information of tags; medical staff information management; statistical query; abnormal information prompts; SMS publishing function; remote monitoring and control of equipment; door control management; access control management; process control management, etc.
(3) Patient channel management has the function of patient identity verification and tracking
Integrate patient information and doctor information, bind through patient wristband scanning, and swipe card to verify patient information at the door. After the patient’s identity is verified, the patient needs to be transferred to the clean area cart and sent to the ward.
(4) Nursing management has the functions of nurse call-in, card swipe response, real-time tracking and idle management
The processing capacity of the smart operating room system covers all operating rooms in the hospital, providing technical support for the future expansion of the hospital’s digital operating rooms, and also avoiding the hospital’s repeated investment to the greatest extent. The system makes full use of big data information, strives to build research departments, improves the comprehensive management level, enhances the supervision and inspection capabilities, promotes the refined and precise management of the hospital, and makes more contributions to the development of the hospital. The system also provides a strict authentication system to provide security for the participation of doctors, nurses and family members.
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