Better care comes with better imaging

All over the world, hospitals and other medical facilities are using audio visual (AV) technology to improve patient care, make time and efficiency savings, and educate the nurses, doctors and surgeons of the future.
Greater colour accuracy, higher brightness, and more complete compatibility with medical imaging standards have all contributed to the greater role played by AV, but other technological developments are also making themselves felt – including the ability to visualise in 3D, to transmit images in real time over long distances, and to store video recordings of surgical procedures as an integral part of a patient’s treatment file.

The history of AV in medical facilities goes back to the development of PACS in the 1980s. It is now nearly 20 years since London’s Hammersmith Hospital became the first filmless medical facility in the world – the first of its kind to store all its imaging, whether still photography or video, digitally.
Today, the DICOM standard allows patient records to be attached to image files in the form of metadata, and increasing numbers of medical equipment manufacturers have recognised the need to ensure that their products are DICOM-compatible. This has given AV professionals the opportunity to integrate this equipment into a single system, smoothing the workflows of doctors and administrators alike. It has also enabled hospitals to gain a faster and more complete picture of a patient’s condition and the procedures that have been used to treat it.
In some ways, the most obvious area of success for AV in hospitals is the operating theatre, where a fully integrated room ensures that all images are viewable at the highest quality and resolution possible, despite the proliferation of video standards currently in use by endo-cameras, fluoroscopy machines, monitors and so on. But hospitals have a large number of secondary uses for the imaging that is captured during a surgical procedure, so it is also incumbent on the AV supplier to ensure that all the video data can be accessed properly throughout a given facility.

At its simplest, this wider distribution of information involves the exchange of audio and video data in real time between the theatre to the pathology lab – which is particularly useful if a procedure requires live collaboration between the two. If the hospital has an educational dimension, lecture rooms can also be linked to the theatre in this way, so that students can view procedures while they are in progress.
Beyond the facility itself, a combination of HD (High Definition) video capture, videoconferencing and projection can enable the deployment of a telemedicine solution. This enables medical professionals to provide expert consultancy and diagnosis to patients who may be thousands of miles from the location of that expertise. Patients who are examined in small or portable medical stations can have their data transferred via satellite to a central hospital where the results are assessed, scanned images examined, and a plan of action formulated – with all relevant images and notes saved in a central PACS database.
At the Heartbeat Education Centre, part of the Wessex Cardiothoracic Centre at Southampton University Hospital, AV technology has been used to link five interventional catheter labs, four seminar rooms, a 120-seat lecture theatre and a videoconference suite. The AV integrator for the project was Video South Ltd, using equipment supplied by InfoComm International member RGB Communications Ltd. Alistair Holdoway, managing director of Video South, comments: “The brief from Southampton University Hospital was to provide excellent facilities and a world-class, live procedure demonstration area in the lecture theatre. We equipped the cath labs with transmission of all imaging and two-way sound, while the lecture theatre has HD projection, clinical links and global videoconferencing. The Centre wanted very good display of specialist cardiology – both live motion from the labs and archived MRI/CT scans from PACS. As well as this, they wanted triple-image projection from a range of sources, all on one screen.”

In the finished lecture theatre, doctors have only to touch a small screen for the room to connect to and then operate a graphic representation of the multi-screen layout. They can snap between single, dual and triple image, and choose which image is in which window. These images are a combination of important camera views, fluroscopy at native resolution, and graphic displays.
Emphasising the medical benefits of the Heartbeat system design, Holdoway continues: “While many cardiology conferences have used video to feature live presentations of fluoroscopic-guided procedures by satellite, this is the first time that procedures depending on both Fluoro and EP (Electrophysiology) techniques can be shown in real time at full resolution, and with multiple live images on screen for an entire procedure.
“Because all the sound is two-way, the chairman of the meeting is able to discuss procedures with the hospital team as they go. Once several hospitals are equipped to a similar level, it will be possible to allow the chairman to see all the procedures simultaneously and put any one to screen on demand, while conducting a fluent discussion between all sites.”
Combining multiple images and data streams to form a wall of knowledge is commonplace in industries such as security and utility production, but relatively new to the medical world because the hardware has only recently been fully compatible with medical calibration standards such as Clearbase and Bluebase. Whether the source is static x-ray or full-motion endoscopy, the need to maintain absolute accuracy of imaging is paramount, and is one of the key reasons why hospitals need to be confident that their AV supplier has sufficient technical knowledge and experience to take on the project.
Yet there is more to integrating AV into medical facilities than simply maintaining image quality. For example, the signals emitted by medical scanners are very low-level and can easily be compromised by AV hardware that is not properly shielded. Legacy equipment such as medical monitoring systems is automatically calibrated and cannot be interfered with. And videoconferencing brings with it uniformity, security, and privacy issues that have to be addressed.

So, is it all worth it? In today’s economically challenged world, the short answer is that it has to be. For the enhanced rendition and wider distribution of medical imaging do not just improve patient care – they increase efficiency. Developments such as the Philips Ambient Experience, in which hospital outpatients awaiting an MRi scan get to choose a personalised ambience based on a palette of different sound, lighting and video effects, help to put the patient at ease both mentally and physically. They also reduce the time it takes to complete each scan, thereby increasing efficiency. The technology also helps hospitals to attract patients, and to recruit the best staff.

Dan Goldstein is the International PR manager for InfoComm International.


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