Image delivery system finds its way into OR

By: Douglas Page

Once the radiology department becomes filmless, the next step is providing digital images to clinicians in departments throughout the hospital. The operating room, however, continues to be problematic. Most institutions print film for the OR long after filmless imaging has taken root elsewhere in the enterprise. Space constraints present the primary difficulty in providing soft-copy images to OR suites.

In a presentation at the 2002 SCAR conference in Cleveland, Dr. William F. Bennett, an assistant professor of radiology at Ohio State University, outlined how OSU has tackled the task of delivering images to the OR. In a pilot program, the university installed dual flat-panel monitors in six of the institution's 26 operating rooms.

Because of limited space in the OR, an additional computer was discouraged. Bennett therefore mounted the central processing unit tower, keyboard, and mouse on the wall to conserve floor space and reduce interference with existing equipment. Images are displayed on two flat-panel monitors situated above the towers. The monitors simulate traditional viewboxes surgeons use while operating.

Bennett's OR system communicates with the hospital backbone by Ethernet connections. The displays are twin 19-inch active matrix LCD flat panels (1024 x 768 resolution) driven by Matrox G-450 dual-display graphics cards. They allow two or more images to be displayed at reasonable size.

After six months, both successes and failures have been noted. The distance between the operating table and the monitors requires the surgeon to walk away from the table to view the images, although this problem may be addressed by suspending the monitors from the ceiling nearer to the table. A problem that has already been fixed was that orthopedic surgeons were not able to use templates for orthopedic hardware.

Reaction from most of the surgeons has been positive, Bennett said. The most serious problem is the difficulty in displaying MRIs. The department plans to develop protocols in which specific images are selected with thumbnails to reduce the number of images the surgeons must scroll through.

The key to the success of this configuration is acceptance by the surgeons. Training operating room personnel in the use of the system is critical to reducing the number of computer-related complaints, according to Bennett.

"It is helpful if the surgeons are familiar with the system outside the OR, as in our case with the hospital-wide Web-based system," he said.