Pulse of the industry
The operating room of the future
Dr. Jens von Lackum
Deputy Member of the Executive Board
Aesculap, a subsidiary of B. Braun
Dr. Boris Hofmann
Head of Business Development
Aesculap, a subsidiary of Braun
The operating room (OR) is well-positioned to be one of the primary platforms for digitally enabled health care. These high-tech spaces have the potential to be more than the information-rich settings they already are. Because they integrate data from multiple sources and incorporate a range of tools, including voice recognition and augmented reality, future operating rooms will operate as distinct medical devices in their own right.
Today, unlocking a car with a specific key can automatically set the mirrors and the seat based on personal settings. At Aesculap, a division of the medical equipment supplier B. Braun, we believe the OR of the future will have that same functionality.
Upon the surgeon’s entrance into the room, medical equipment will automatically be arranged based on the type of surgery being performed and the physician’s predefined preferences. Decision support software that links patient data (e.g., laboratory values or MRI and CT scans) with outcomes reported in the literature will be available in real time. Devices, such as drills used in knee or hip surgery, will collect procedure-specific information that can be analyzed and displayed to reduce errors or allow more experienced physicians to provide advice remotely.
Augmenting performance through augmented reality
Augmented reality will be a critical enabler of this OR of the future. New visualization systems will allow the juxtaposition of real-time anatomical information with a variety of other types of data, dramatically changing how surgeries are performed.
For instance, augmented reality will allow surgeons to review scan data in conjunction with a patient’s anatomy to help guide exactly where — and how much tissue — to cut. For complicated procedures involving soft tissues, such as brain surgery or tumorectomies, augmented reality systems could improve patient outcomes by decreasing the amount of tissue a surgeon needs to manipulate during the procedure. This would result in less trauma to the patient and, therefore, a faster overall recovery time.
Augmented reality could also decrease total time spent in the OR, one of the costliest areas of a hospital. Excluding physician costs, researchers at Stanford Medical School estimate a minute of OR time for a basic surgical procedure costs between US$15 and US$20, with at least half of that sum tied to fixed overhead costs.
Not only could augmented reality eliminate delays linked to surgeons leaving the OR to check test results, but the tool could further standardize procedures that heavily depend on physician judgment and experience.
However, the benefits of augmented reality, both to patients and to a hospital’s bottom line, have yet to be proven. Developing that proof is an important area going forward for B. Braun and other developers alike.
Moving to the future
The OR of the future is quickly becoming the OR of the present. Within two years, augmented reality will become mainstream in most hospital ORs. In addition, we will have the ability to interlink all the devices in a surgical suite via common, open-source software. At the moment, if devices are connected, they are part of closed systems that require surgeons to choose equipment made by specific suppliers.
To provide the greatest functionality for surgeons, however, an OR management system needs to be flexible enough and comprehensive enough to interface with existing and future medical devices — no matter the manufacturer. As a first step, we and others are researching how to connect different instruments commonly used in the operating theater so they can safely communicate. We are also embedding sensors into our surgical instruments to collect additional performance information.
We know it won’t be enough to add a digital solution to a single OR-based device or piece of equipment. To create a comprehensive platform, we are actively partnering with start-ups and IT mainstays that have experience in fields as diverse as artificial intelligence, robotics, visualization and data analytics. It’s about combining capabilities from two very different fields — medicine and information technology — to use data in a fundamentally different way than has been done in the past.