LiveData OR-Dashboard™

Factors Influencing Installation at MGH

The Operating Room of the Future (ORF) at Massachusetts General Hospital (MGH), site of the first LiveData OR-Dashboard installation, is host to a number of open and minimally invasive procedures. The ORF, due to its parallel workflow, provided a set of challenges and opportunities in the development, deployment, and evolution of the system. Factors to consider included:

• Case Mix: Cases in the ORF typically are focused on minimally invasive procedures and single-team operations.

• Improved OR Throughput: Due to improvements in workflow processes, the ORF has increased throughput compared to typical operating rooms, thus requiring improved information flow, free and complete communication between team members, and robust systems to ensure the timely transfer of data.

• OR Layout: The OR layout, with a separate induction room, results in the patient being unconscious when entering the operating room. Data from the patient in the induction room must be conveyed to staff in the operating room.

• Location Tracking: The ORF and perioperative areas at MGH are equipped with an active RFID location tracking system provided by Radianse, Inc. This system allows for the automatic detection and display of staff and patient location and movement around the ORF.

The ORF at MGH 

General Functionality

Core functionality of LiveData OR-Dashboard includes:

• Real-Time Physiologic and Device Data Capture: LiveData offers a vendor agnostic, full disclosure system—provideing complete capture of perioperative data from a diverse set of devices and information systems. Physiologic data from GE and Philips monitors and device data from Drager, Aspect Medical, Karl Storz, and InstruMed are automatically acquired, integrated, and projected onto a single, unified display. Data from a number of sources and vendors are displayed on the same axis, allowing for a powerful visual representation of intervention, device state, and physiologic response. Physiologic information is also archived for future retrieval and audit. Additional device integration includes the BIS monitor and surgical insufflator. Device data sources are automatically detected on a case by case basis and then displayed if successfully detected.

• Information System Integration: Integration with scheduling, nursing, anesthesia, and allergy information systems populates appropriate data fields on LiveData OR-Dashboard without human intervention or duplicative data entry. LiveData integrates information from a number of clinical information systems including anesthesia information management systems from Drager, the Epic OpTime system, Cerner's CoPath, proprietary hospital information systems, and additional information sources such as the Radianse active RFID location tracking system

• Automatic Event Detection: LiveData OR-Dashboard tracks the status of the case by integrating a number of different data sources, making appropriate changes based on the stage of the case, status of the patient, and readiness of the system. For instance, the dynamic pane displaying setup, timeout, and intraoperative information progresses automatically based on the stage of the case, as determined by a combination of data from nursing information sources, a location tracking system, and anesthesia information systems. This ensures that the appropriate contextual information is displayed at all times during the perioperative process.

Features of MGH's Installation by Workflow

LiveData OR-Dashboard focuses on single-team procedures, display of all pertinent perioperative data, integration with location tracking and custom perioperative information systems, and data delivery to all team members throughout the multi-room ORF operative setting.

The team at MGH has selected to highlight three primary aspects of the perioperative process: Case Setup,Timeout, and Intraoperative. These three aspects form the dynamically progressing panes on the screen, automatically advancing the display based on events that have occurred in the perioperative process.

Case Setup

The case setup screen at MGH—the first screen displayed to the OR team—has particular importance due to the physical layout of the room. With a separate induction room, there must be a convenient way to relay information from the custom Nursing Perioperative Assessment report that occurs in the induction room to the main operating room.

Case Setup highlights case-specific information as well as information and verification that the assessment has been completed in the induction room. View in detail …

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Timeout

The safety pause period is a critical step in any procedure. LiveData OR-Dashboard provides additional checks to reinforce timeout performance and documentation, providing a checklist based on MGH's specific timeout procedures and documenting when the timeout was performed.

During this time period, information such as the physiologic data and staffing list is still displayed. View in detail …

Intraoperative

This period represents the bulk of the perioperative process in the operating room. Process milestones are logged throughout the case, staff are listed automatically courtesy of an active RFID location tracking system from Radianse, Inc., and physiologic real-time waveforms and trend data are recorded and displayed.

Information pertaining to special nursing notes and post-operative care, including the discharge plans and location and presence of family members or other loved ones, is highlighted. View in detail …

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