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The VidiView-system is not limited to the main purpose of recording ongoing surgical procedures for achiving purposes but is a rather open ended, customizable application that will fit multiple situations and fulfill many demands!
Distributed Medical has chosen to highlight a few of these areas to set focus on the flexibility and broadness of the system. Below you will find 4 major implementation scenarios which are all proven in combat and easy to apply in most hospital playouts. They are also very relatable for most physicians. The scenarios of choice are;
|
 Scenario 1 - |
Recording for review, archiving and patient records |
| Scenario 2 - |
Demonstrative- and/or educational purposes (live or pre-recorded) |
| Scenario 3 - |
Off-site on-call backup |
| Scenario 4 - |
Off-site expert input |
It’s recommended that you take part of the general product documentation before you read this document. To ensure a broad and complete view of the system it is also recommended that you read through the full document, including the scenarios which do not apply to your situation or need. The document will help you plan for, understand and realize the full use and potential of the VidiView-system.
The most common setup of VidiView is one with one or more cameras in the operating-room. The cameras connect to a control-unit (usually wall-mounted outside the operating-room). The control-unit is connected to the main computer network (LAN) of the hospital. The recording-library unit (a.k.a. “VidiView server”, a server-like appliance) for storing of all recorded material (one unit can contain over 5000 hours of recorded material). The typical setup looks like the conceptual drawing below.
 Click on the image to view it in full size
The most common use of this setup is to record operations of certain types or simply to record procedures deemed to be or to potentially come out as interesting. The recording is started by pressing a “red button” on a small control-panel mounted in the perimeter of the surgeon.. Once pressed, the recording from the set is running and all cameras (1 to 4 units) are active simultaneously. After the operation the “blue button” is pressed and the recording stops. If a moment of “uninteresting” activity is to be expected during the operation a “green button” can be pressed to pause the recording.
Once the operation is over, the recoding is stopped and the surgeon is out of the room the recording is available at the server. The surgeon (or any other user with the sufficient access level) can now go to his/her room, turn on her Windows-based PC-computer, start the VidiView-program (a.k.a. “the client”, or the client software) and browse or search among recordings in the archive. The most recent recording are presented in a “most recent”-list available upon start of the client. The list contains information in the style of;
| Recording start: |
Recording end: |
OP room: |
Surgeon: |
Tagging: |
| 2005-09-12 13:10 |
2005-09-12 15:54 |
4 level 2 |
(n/a) |
(n/a) |
| 2005-09-12 15:55 |
2005-09-12 16:10 |
4 level 2 |
(n/a) |
(n/a) |
| 2005-09-12 21:11 |
2005-09-13 03:21 |
5 level 4 |
(n/a) |
(n/a) |
Table 1: If a recoding is not yet “claimed” in the system information about who the surgeon is and what type of procedure the recoding describes is still unknown (hence the (n/a) marking in those two field. As soon as a recording is “claimed” this information is entered be the “claimer” and displayed to the rest of the users.
Once the desired recording is found in the list or through a search, it can be brought up on screen and playbacked by a simple mouse-click. Just as any kind of video-recording it can be fast forwarded, rewinded or paused at will. The viewer can choose from what camera view he/she wishes to playback and can at any time switch between the existing cameras during the playback.
If an operation is of such importance that it needs to, or should be, kept for future reference it can (and should) be tagged with information related to the specific operation. This information can range from detailed descriptions of the procedure, personal data on the patient or other, more technical reference. The data-tagging-part is user customizable and is designed together with the system owner at installation.
If the user wishes to edit the recording in any way the separate video-files (a 4-camera setup renders 4 separate video files during a single recording session) can be exported out of the system. The files that come out during an export can then be stored on the local harddrive of the system and later edited in any desired way using industry standard video editing software such as Microsoft Moviemaker® or Adobe Premier®. If the user chooses to export and edit (re-cut or in any other way “make a movie” out of the recorded material) the recording can later be re-inserted into the VidiView storage-facility (the VidiView-library) for archiving purposes. A recording can also be exported for recording onto a DVD-disc in order to be distributed outside of the system or hospital.
If the user desires to store or link the recorded material to the patientrecords (located in some kind of hospital-wide journal- or directory system) such connections can easily be established. Usually this kind of connection is specific for each hospital and highly dependent on the system used on site.
The VidiView-system may be an excellent help for educational purposes in surgical or other, non-easy-accessable procedures. Usually complicated procedures are characterized by lack of time to educate. It may even bestressful and personal intense, especially if it is an emergency case.
These factors, and others, make it hard to perform and operate with a crowd or an audience in the room. It makes it even more difficult for the audience to actually see something during the session. The VidiView-system creates a great solution for most educational needs with its “Live-mode” and bi-directional audio-communicational functionality. A typical educational setup can look like the diagram below.
Click on the image to view it in full size
The surgeon can operate with his/her normal team of people while as many as needed (limited only by the size of the auditorium) can watch, interact and learn from a remote location. The “Live-mode” is switched on (from the control-panel) by the surgeon, who is equipped with a microphone to speak to the audience. The auditorium also needs to be equipped with a microphone-installation and speaker system (which most auditoriums are by default), thus enabling bidirectional communication
The only piece of equipment the session lecturer needs to bring to the auditorium session is his/her portable PC-computer with the VidiView-client installed. In place he/she needs to establish a VPN-connection with the hospital network if the auditorium is not located within (connected to) the hospital network. The bandwidth (network performance) needed to run the system is a mere 8Mbit/s (the speed of a common ADSL-connection present in most private households and commercial facilities). Once the show is on the session, the lecturer can pause, keep screenshots (for later reference and discussions) and switch between the existing camera views in the operating room. Every change is performed with a click of the mouse!
This setup and use of the VidiView-system enables a hospital to use it for educational purposes with minimal preparation and minimizing special arrangements why cost per session will be low. The facility to use for the show needs a proper intranet- or internet connection and speakers suitable for the audience in mind. Due to the low bandwidth demand and no network design limitations the system can run in most modern conferencing facilities found within and outside of the hospital perimeter.
In the event of showing pre-recorded material (and not at all interacting with an ongoing operation like described above) the solution is even less demanding. The session lecturer simply brings a portable PC-computer and a suitable set of speakers (could be common PC-speakers) and connects to the intranet- or the internet-connection available at site. Once the setup is in place and the audience is listening the session sponsor can browse or search in the VidiView-library (containing all public previously recorded operations) and selects one of interest for the lecture. By a click on the mouse the recording starts (and can then be paused, fast forwarded, rewinded or stopped at will). The session sponsor can at any moment, switch between the different available camera-views used in the original recording as well as saving single screenshots for later review.
Another very powerful application for the VidiView-system is the possibility for telemedicine use.
A common situation where this is true could be “off-site on-call”-situation. A surgeon who is back up to a less skilled college or perhaps if the advice of a very specialized surgeon is needed in an emergency situation.. Today many surgeon are on call pretty much all the time because the take great pride in their work and are very committed and dedicated employees. This sometimes means that one have to abort private activities such as spending time with family (away or asleep), spending time in the summerhouse or simply being away for some time. When such an abort is needed a great deal of time is usually consumed just to “make one self” available to the hospital. You have to
- abort and explain yourself (20 minutes)
- find means of transportation and actually travel to the hospital (20 – 60 minutes)
- check in, get briefed on the situation and get dressed (15 minutes)
- wash up and get ready for action (10 minutes)
All this adds up to some 70 – 100 minutes (in each direction) just to “be available”. The actual help you give in this demanding situation might not be more than some 10 minutes of expertise (viewing, reviewing and arriving at a conclusion) before the primary surgeon can carry on and finish on his or her own. A quick reflection reveals that less than 10% of your time and resource is actually spent on helping the college (or patient if you’d like) and the vast part is used for surrounding necessities. With VidiView you can now peek into the operating-room
- quickly (takes about 2 minutes to start your portable PC-computer and hook up your hospital VPN-connectivity)
- conveniently (you literally don’t need to leave your bed!)
- cost effectively (you spend way less time in each situation which saves money for your employer and keeps your overtime account on the right side of union limits)
- socially acceptable (as most family members of a physician would say – “Mom is great, whenever we get to see her…” A very important aspect of any parent or spouse in any relationship or family situation)
The setup is, from a technical point of view, very similar to the previous scenarios described above. As you can see the main difference is who or where the viewing part (the client) is located. In the example below the client is located at home (in her bedroom) with the same setup as in previous examples and the only piece of equipment needed to interact with the operation room is the portable PC-computer with the VidiView-client and a internet-connection (of at least 8Mbits capacity) with a VPN-capability to connect to the hospital network. Both which are somewhat of “standard tools” for most physicians and hospitals today!
Click on the image to view it in full size
When setup like described above the surgeon can, some 5-10 minutes after the was received call, be online, interacting with the surgeon on site and discussing how to work the situation. The on-call surgeon (still home, in bed, with her portable PC-computer on her lap) can, by a click on the mouse, switch between the available cameras and ask the operating surgeon to perform various “moves” through the 2-way audible communication integrated in VidiView (ie. lifting, moving, cutting, preying, somehow run tests or otherwise take actions on her command).
Yet another variation of the telemedicine-aspect could be when expert input is consulted or contracted to handle specific cases that rarely occur (but when they do, needs serious and immediate attention).
Click on the image to view it in full size
When a clinic or section of a hospital is about to treat a very specific type of condition often a specialist is brought in. Bringing in specialized personal can be very expensive and stressful as the person with the expertise is often very attractive and sought for. This aspect can easily be bridged with the VidiView-system by bringing the patient to the expert rather then the other way around.
The schoolbook example of such a situation could be a scenario with 9 different cardiovascular treatment centers all equipped with one VidiView-setup each. This cluster of “online-operating rooms” (evenly distributed over a region of great distance) could now, all at once, be the “virtual working field” of one pacemaker-insertion expert. No need to travel, no delay for the patient (waiting for an expert to arrive and continue the surgery) and much needed extra time for the expert to work on his or her research and refinement within the field of expertise.
The expert-surgeon will mainly work from his or her office desk somewhere in the region (necessarily not even at one of the 9 hospital locations) assisting through audio- and video-contact with the on-site surgeon.. Giving advice, gaining detailed knowledge of the situation and spending time with the operation when needed only. The possibility of have multiple operations running simultaneously (potentially in different hospitals) is suddenly a reality!
The setup could, in co-elaboration with on-site surgeons at the 9 operating hospitals help save vast amounts of time, resources, money and, potentially, lives. At the same time it will help the expert-surgeon focus on expert-treatments and expert-projections of his or hers preference. The result will be better treatment for more people with shorter lead time and less money spent. It will also render a more pleasant and humane working effort for the expert at hand – a win – win – win situation!
(c) 2006-2012 Distributed Medical AB. All rights reserved!
Distributed Medical AB reserves the right to alter the exact specification through future development of the system with out prior notice. Any or all information is subject to change. Please always consult technical staff before making business decisions based upon the material in this document!
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