By Jeffrey Robbins

CEO, LiveData, Inc.

September 4, 2007

LiveData offers a unique partnership to help hospitals avoid pitfalls and maximize the impact of OR modernization.  Working with the hospital to deliver a ‘Wall of Knowledge,’ or visually integrated operating room (VIOR), LiveData unites disparate information systems, medical devices, imaging and A/V systems as an integrated information delivery system.  We understand what information the OR team needs at each point in the OR workflow, where to get it, and how to synthesize and present it to maximize situational awareness.  We bring this perspective to the hospital’s OR modernization team, with in-depth knowledge of systems from such diverse vendors as McKesson, Epic, Cerner, Picis, Philips, GE, Karl Storz, Stryker, Olympus, ImageStream, and more.

Why is this so important?  The complexity of building new operating rooms is challenging—frankly, it is hard to get it right.   Hospital staff and affiliated clinicians, while expert in delivering excellent healthcare, face unfamiliar terrain in modernization projects that reach into the hundreds of millions of dollars in scope and take multiple years to complete. 

 
Consider what’s involved:  gaining the full benefit of OR modernization requires a strategic view of hospital requirements and priorities for improvement.  This means systematically examining the entire perioperative process to:

• Set objectives for improvement in patient safety and operational efficiency (one good example:  eliminate unsafe manual grease boards);

• Determine how to optimize perioperative workflow, addressing the key needs of patients, surgeons, anesthesiologists, and nurses;

• Consider all of the related delivery systems that need to work together as a system:  instrumentation, information technology, imaging, and communication systems;

• Address implications for OR physical design and supporting infrastructure (electrical, telecommunications, etc.)

Taking a traditional “bricks and mortar” approach to planning a workflow-optimized OR runs the risk of neglecting advances in healthcare delivery practices and technologies.  Hospitals can end up buying old technology and missing major new opportunities.  Workflow-dependent aspects of OR functionality—hand-off procedures, patient awareness, updates to documentation, and OR ergonomics—may be left as late-stage decisions or even afterthoughts.  This leaves critical decisions in the hands of A/V integrators that can lead to wasteful purchases that go unused.

LiveData has developed a unique, five-step process to help hospitals manage the complexity of OR modernization, focusing on the creation of the VIOR:  

1. Requirements:  establish and document the hospital’s specific needs, constraints and operational characteristics for the VIOR.  LiveData consults with clinical, administrative and technical staff, and observes surgical cases to analyze existing OR workflow.  The requirements document reflects an in-depth understanding of hospital objectives and potential barriers to success.

 

2. Conceptual model:  define a comprehensive solution that will meet identified requirements, while capitalizing on the latest advances in technology, practices, and work process design.  The conceptual model presents a vision that is then tested and refined through discussions with all hospital stakeholders.

3. System design and prototype:  design, demonstrate, and specify a concrete solution, based upon the approved conceptual model.  VIOR design incorporates hospital choices for best-in-class products spanning multiple vendors, to create a seamless operating environment.  LiveData’s iterative design process utilizes unique prototype demonstrations to solicit feedback and refine the solution.

4. Implementation:  LiveData coordinates and leads the team of vendors responsible for all aspects of the VIOR.  We work with the hospital to create a unified implementation program, making vendor neutrality a reality, and manage delivery through completion to ensure on-time, on-budget performance.  

5. Evaluation and ongoing refinement: LiveData continues to work with the hospital after the initial implementation, to address unanticipated needs and incorporate new requirements as they become known.

LiveData ensures that the right hospital personnel collaborate at the right time, in meetings of the right duration, ensuring that valuable staff time is used both efficiently and effectively.  By involving everyone, key stakeholders’ concerns and input are built into the hospital's plan from Day One.

As important as internal stakeholders are, it is also imperative to create an effective collaborative project team involving all critical vendors. LiveData ensures that the architects, equipment planners, OR surgical tool vendors, and A/V integrators are truly coordinated as a cohesive team.  Imagine a project with no misplaced wall-jacks, and simple touch screens where each button truly does what it is labeled to do.

When internal stakeholders and vendors are properly aligned, the hospital and its LiveData project team can avoid potential friction and ensure that new ORs will have the safe and efficient, optimized workflow that today’s safety and reimbursement environment demands.  Tangible impact of the LiveData process can be measured by:

1.    Elimination of manual grease boards in all ORs

2.    Reports (like those to SCIP/CMS) have a validated audit trail proving compliance

3.    Team situational awareness and hand-offs improved

4.    Surgeons are in control of a room that runs on-schedule

5.    The perioperative process is coordinated with departments and systems outside of the OR suite

LiveData is ready to partner with hospitals engaged in OR modernization, to ensure that their projects meet with complete success.  We have emerged as the authority in optimizing OR workflow, applying the right technology at the right time.   LiveData client hospitals join an extended community, including such leading healthcare organizations as Massachusetts General Hospital, Memorial Sloan-Kettering Cancer Center, St. Joseph Mercy Hospital, and NewYork-Presbyterian Hospital.  This is the key to LiveData’s success:  LiveData-enabled organizations are passionate about patient safety, work together as a true community, and share best practices that can be cost-effectively implemented.