OR Infrastructure

The realization of this TIMMS concept requires a framework of technical means (hardand software) which enable system and device interaction and by that build up the digital OR infrastructure. The OR infrastructure builds the invisible backbone of the operating room and must meet several requirements:

  1. functional integration of medical devices and information systems,
  2. patient-centered view of the surgical intervention (rather than device-centered),
  3. plug-and-play device setup for non-technical users,
  4. system monitoring and surveillance to ensure safety and reliability in the life critical domain,
  5. use of established standards and protocols to achieve wide acceptance,
  6. central and intuitive access and remote control via the surgical cockpit.

 

 

Prototype setup of the ICCAS integrated demo OR.

To meet these requirements, the TIMMS infrastructure consists of several core components

which interact with the networked medical devices and systems. The TIMMS Component Controller (TCC) is the central infrastructure component which administrates and supervises all connected devices within the operating room. The TCC tracks the system health status of the entire networked devices, monitors the data flow on the network, provides a common time base for the synchronization of TIMMS
components, and ensures rights and access control for security and safety. In other words, the TCC models and controls the IT-world of the digital operating room. It allows different user groups to view and access the OR functionality from different perspectives. On the one hand, the clinical user of the surgical cockpit gets a condensed view, visualization and smart control of the OR functionality, where technical details are abstracted to an appropriate level. The technical or administrator user, on the other hand, has an in-depth view and access to all parameters of the integrated TIMMS system and
is able to adopt specific configuration issues from the background on demand.


To interoperate with the TCC, communication protocols need to be implemented for all TIMMS components, e.g. to announce and register them within the TIMMS network, describe their capabilities and functionalities, and manage the control by the TCC user. Standard protocols that enable plug-and-play auto-configuration and network administration are used to implement this behavior.


Other core components being developed comprise the Workflow Management System for knowledge support and intelligent systems control as well as the Patient Model component that integrates the diversity of anatomical and functional patient data into one unique representation.


The TIMMS OR infrastructure is expected to accommodate a wide variety of medical hard- and software systems with different communication capabilities and requirements. Thus, the networking infrastructure has to meet special requirements for different applications, data types and communication mechanisms. Alongside the established DICOM standard for image information exchange, basic communication methods for device access and control are needed.


These communication methods include

  1. message exchange for the transmission of datasets and commands,
  2. events for the distribution of alarms, status reports and notifications, as well as
  3. streaming of continuous signals.

Message exchange and event mechanisms are implemented on the basis of well
established and accepted industry standards. For the transmission of continuous
information such as tracking data, voice, biosignals, and video the IP based streaming technology is implemented.