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Optimal Integration of the Hybrid Suite

2Optimal Integration of the Hybrid Suite

The development and success of the hybrid suite in recent years — triggered by a series of factors, including the rapid rise of minimally invasive proce-dures — has caused a paradigm shift in surgical and image guided operations. The non-profit ECRI Institute has projected that 75 percent of cardiovascular sur-geons will be working in hybrid operating suites by 2018. According to Credence Research, Inc., the hybrid market is expected to grow at 16.1 percent per year from

2016 to 2022.

The flexibility of the Hybrid Suite offers clinicians the opportunity to quick-ly convert from open to minimally invasive procedures — or vice versa

— without needing to transfer patients to an OR or another room, a process that results in lost time and can mean the difference between a positive and negative patient outcome. Benefits of minimally invasive surgery include: Increased safety with smaller incisions; less trauma to the body and far less blood loss; de-creased scarring as most incisions just take a stitch or two to close;

recovery often in two weeks versus traditional surgeries that typically can take six to eight weeks; decreased length of hospital stay with

most procedures resulting in a 23-hour discharge or scheduled outpa-tient surgery. (Source: American Institute of Minimally Invasive Surgery)

“The combination of two procedures in one room with just one sedation is not

only beneficial for the patient, it is also efficient in the use of operation time and space, and cost-effectiveness,” according to Drs. Anja Muehle and Ali Khoynezhad in a report on the American College of Cardiology website. Medical centers, such as Omaha-based CHI Healthcare, estimate that the hybrid suite operations generally trim hospital stays by two to three days as multiple procedures are performed in a single room, saving the patient from undergoing separate preparation, anesthesia, and procedures on different days. Given the Becker’s Hospital Review estimates that average costs per inpatient day range from $1,701 at for-profit hospitals to $2,289 at non-profit hospitals in the U.S., the savings for patients and insurers can be significant. While the switch to the more efficient hybrid setting makes perfect sense from the clinical, patient and financial perspectives, it is also important to point out that given the complexity of the procedures and the highly sophisticated technology that supports them, optimal integration of all necessary equipment and systems in order to improve workflow is at the heart of the process.

Introduction

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In fact, without optimal integration in such a complex environment, clinician effi-ciency, patient safety, room throughput, instant communication, and flexibility may be limited, potentially causing delays in surgical procedures as well as bottlenecks in process.

According to research led by Xiufeng Shao of the University of Wisconsin-Madison, workflow disruptions and bottlenecks can negatively affect the ability of surgical teams to remain fully engaged during operations, and are directly related to medi-cal errors in surgical care. Minimizing or avoiding flow disruptions plays a key role in reducing mortality rate.

Optimal integration supports more efficient procedures by deeply connecting all imaging sources and EMR-based patient information to the X-ray system, enabling the video from any procedure to be routed throughout the room, recorded for easy archiving and retrieval from anywhere, and streamed to remote locations within and outside of the hospital.

This white paper will explore the importance of combining imaging and integration technologies to create an optimally performing Hybrid Suite, and how two compa-nies have partnered to ensure that the popular Hybrid Suite reaches its full potential clinically and financially.

It is difficult for clinicians to take full advantage of the power that imaging providers offer in the highly complex and image-centric hybrid environment without a well-planned integration solution.

Following an extensive search, Philips Healthcare partnered with integration vendor Image Stream Medical, a pioneer in the integration space for more than 15 years. Image Stream provides advanced room and environment control, video routing, image capture and management of data and images as well as remote collabora-tion technologies for health-care enterprises.

The two companies are philosophically aligned in the understanding that the med-ical equipment and integra-tion technology have to work together seamlessly to allow clinicians to collaborate effi-ciently both inside and out-side the surgical room during procedures.

Combining Imaging and Integration

Optimal Integration of the Hybrid Suite

4Optimal Integration of the Hybrid Suite

Philips and Image Stream, working closely in partnership, are uniquely positioned to design solutions specifically engineered for clinicians performing procedures in the hybrid suite. With a combined mission to improve patient outcomes together, the companies aim to reduce barriers to safer, more effective and reproducible treatments.

How does the emergent Cardiac Cath team efficiently collaborate with surgeons when time is critical? How does a large Neurosurgery group efficiently share their Neuro Microscope between three different Hybrid Suites? How do clinicians work more efficiently with the complexity of different and disparate technologies?

These are just some of the challenges faced by the multi-disciplined Hybrid Suite clinicians. Optimal integration can solve challenges related to providing high quality audio and visual communication, imaging device connectivity and clinician collaboration.

While the fundamental job of an integration system is the same for a Hybrid Suite and a traditional OR, there are some significant differences. The highly complex Hybrid Suites occupy much larger spaces than traditional ORs with more imaging

sources and larger displays. For example, it is not uncommon in a hybrid to see one or two 58-inch or larger 4K ultra high defi-nition (8-megapixel) screens each displaying four or more imaging sources at a time.

The larger spaces also present new audio challenges that must be addressed to ensure that clinicians, regardless of where they stand in the room, have high quality audio and can eas-ily communicate with one an-other. With enhanced commu-nication capabilities between the control room and procedure room, staff can actually hear more clearly for more efficient interaction and smoother pro-cedures. But more importantly, staff members work better as a team to react instantly to what the patient needs.

Challenges Faced in the Hybrid Suite

Global operating room equipment market was valued at US$ 23,947.3 Mn in 2014 and is projected to reach US$ 42,873.3 Mn by 2023, expanding at a CAGR of 6.9% during the forecast period from 2015 to 2023. (Source: MRRSE.com)

The growth of the overall market is due to:

• Rise in number of hospitals

• Surge in demand for hybrid operating rooms

• Growing number of ambulatory surgical centers

• Growing number of regulations for operating room equipment

• Higher demand for surgical procedures from growing geriatric population

OR EQUIPMENT GROWTH

5Optimal Integration of the Hybrid Suite

A recent study by researchers at Emory University School of Medicine and the Har-vey L. Neiman Health Policy Institute pointed to the growing significance of image- and data-enriched methods in diagnostics, monitoring and reporting. Nearly 80 percent of the 402 surgeons and physicians surveyed cited “easier access to images while monitoring progression of a disease/condition” as one of the key advantages of multimedia-enhancement with the majority responding that they “would preferentially refer patients and peers to facilities offering more meaningful image- and graphically-enriched reporting platforms.” In keeping with that view, the optimal hybrid suite integration system provides easy access to the equipment located around hybrid rooms, inside surgical fields, or on walls, but organized in such a way that floor space remains clear, helping to enhance sterility.

To achieve that optimal integration, Philips and Image Stream have worked closely together to identify and implement the most efficient Hybrid Suite strategies.

Enhanced Clinical Workflow and Tableside Integration

• 1 in 25 patients in US hospitals suffer at least one healthcare- associated infection (HAI)

• Infections create direct medical costs in the range of $28 billion to $45 billion each year.

• They result in longer hospital stays, as well as cases of re-hospital-ization after patient discharge.

Cost of Hospital-Related Infections

• New technology to reduce HAI can cost $80,000, but cost to treat HAI is estimated at $28,000

• Trend now to design ORs to handle new technologies, improve patient outcome

(Source: Meditek)

6Optimal Integration of the Hybrid Suite

Through extensive collaborative research, the two companies have made critical features of Image Stream Medical’s integration system available through Philips’ ta-bleside technology, giving clinicians the unique ability to control not just their X-ray systems, but also images and video from all imaging sources, the room environ-ment and collaboration capabilities – all with a touch of a button.

Only Philips and Image Stream Medical can provide tableside integration, and this capability is proof that the two companies have much more than a partnership. They have a shared mission to build the best possible hybrid suite.

In other integration systems, control of equipment is handled from outside the ster-ile field, requiring physicians to wait while non-sterile team members make the nec-essary adjustments, a process that can result in miscommunication, cause delays, and curbs the physician’s ability to make the precise adjustments needed.

Similarly, when the physician needs to check some diagnostics outside the pro-cedure room, he or she must take the time to break scrub before exiting, then go through the entire scrubbing process once again upon return — all while the pa-tient remains on the procedure table.

The Philips – Image Stream tableside integration provides sterile personnel control of all vital room, procedure, and communication functions by way of a simple inter-face similar to an iPad that attaches to the bedside. This same interface also makes

it easy to conduct timeout procedures as prescribed by The Joint Commission prior to an incision.

Additional features now available tableside include the ability to control calls that come in or need to go out of room during or after procedures. And one of the most important features is music. Soothing music pre-proce-dure has been shown to reduce patient anxiety which results in reduced need for anesthesia medications. For in-room clinicians and staff, music is critical in helping to create the right working environment.

Partnership Collaboration

• A few small cuts versus a large incision

• Less trauma to the muscles, nerves and tissues

• Less bleeding

• Less scarring

• Less trauma to organs

• Less pain and reduced use of narcotics

• Less hospital time

• Less effect on the immune system

(Source: Mount Sinai Medical Center)

Advantages of Minimally Invasive Surgery

7Optimal Integration of the Hybrid Suite

From a business perspective, the partnership offers the benefit of securing the combined Philips imaging systems and Image Stream integration technology in a single, efficient procurement process, saving valuable time and reducing the complexity of involving multiple vendors.

Most U.S. hospitals (87 percent) have OR suites and are estimated to spend $30 billion to $90 billion on their surgical facilities annually—accounting for up to 70 percent of total hospital expenditures., according to a 2013 study published in JAMA Internal Medicine. Consequently, ORs are one of the most expensive func-tional areas in hospitals.

From a cost perspective, fewer hospital stays afforded by minimally invasive pro-cedures in an integrated hybrid suite can help trim many of the expenses incurred through the standard OR setting.

Surgical procedures account for 40–70 percent of hospital revenues and 30–40 per-cent of total costs. The study estimated OR costs to range between $10 and $40 per minute, noting that delayed starts, prolonged cases and overtime are common.

Inpatient hospital-acquired infections (HAIs) also drain financial resources. The report estimated that there are approximately 440,000 HAIs annually among U.S. adult inpatients at an annual cost of $9.8 billion.

Reducing Costs and Complexity Through Integration

1. Equipment

2. Communication

3. External Interruptions

4. Coordination

5. Environment

6. Patient Factors

7. Technical (skills)

8. Training (instruction)

9. General Processes

10. Miscellaneous

OR Disruptions During Surgery, by Type

(Source: Xiufeng Shao of the University of Wisconsin-Madison)

8Optimal Integration of the Hybrid Suite

Conclusion

“Experts say the hybrid environment likely will grow in other medical segments in the years to come and ultimately may become the new hospital standard, reserving the traditional operating room for the most intense invasive surgeries.”

Experts say the hybrid environment likely will grow in other medical segments in the years to come and ultimately may become the new hospital standard, reserving the traditional operating room for the most intense invasive surgeries.

Image Stream Medical’s vendor-neutral ability to integrate components from multi-ple vendors into a single, cohesive collaborative environment gives clinical teams the flexibility to perform a number of different minimally invasive surgical proce-dures in a single hybrid suite or lab.

With the close Philips Healthcare/Image Stream Medical partnership, clinicians have at their fingertips immediate access to real-time information from the vast assortment of medical and imaging technologies within and outside the procedure room.

This immediate access to X-rays and other medical imaging, represents the type of highly efficient operational control that is absolutely critical in the hybrid OR and interventional labs. The potential for improvements in operational efficiency is unparalleled.

Optimal integration within the hybrid suite can eliminate bottlenecks and costly delays in surgical procedures, by bringing access to a range of video, imaging and patient information into one place, improving clinician efficiency, patient safety, room throughput, instant communication, and surgical flexibility.

9Optimal Integration of the Hybrid Suite

Royal Philips is a diversified technology company, focused on improving people’s lives through meaningful innovation. Our health care business makes up 42% of our global sales revenue. With a century of history and more than 450 innovative products and services, we are ready to meet today’s challenges in healthcare by creating solutions that deliver better care to more people at lower cost.

Image Stream Medical is focused on a single mission: to improve healthcare by connecting providers with the visual information and collaborative insight they need to deliver exceptional patient care. Since 1999, the company has achieved that goal by innovating healthcare environment integration solutions that make power-ful capabilities easy to use. The result is a clinical workflow experience that is more intuitive, natural and efficient.

For more information visit www.imagestreammedical.com.

Advantage Business Media (www.advantagemedia.com) is a data-driven marketing solutions company leveraging content, technology, and business intelligence to match its audience’s job performance needs with its clients’ solutions. With a diver-sified portfolio of highly focused websites, e-newsletters, print publications, spe-cialized directories, vertical search databases, conferences, ancillary media vehicles, and associated web-based services, ABM serves more than one million industry professionals in the manufacturing, science, and design engineering markets.

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