Digitizing the operating room - James Domine, Avail Medsystems : 23

Surgery is not usually considered a spectator sport, but an OR is often filled with the surgical team, colleagues, residents, and medical device clinical representatives, in addition to a patient and equipment. Now Avail Medsystems, based in Silicon Valley, has created a way to increase learning, collaboration, and idea-sharing in the OR – while reducing the headcount – by connecting physicians and care teams to remote experts and device industry representatives during medical procedures. 

The Avail surgical telepresence platform is a hardware and software platform that enables instant, two-way audio/visual communication with high-definition video, surgical imaging views, and even telestration capabilities. 

In Episode #23, Andy Rogers of Key Tech talks with James Domine, CTO at Avail MedSystems, about how data-driven surgical procedures are facilitating collaboration and creating better outcomes. 

Need to know:

• Understand the rules of engagement – the surgeon in the OR is ultimately responsible, so assist without hindrance and design redundancies for reliability, such as battery backup for power failure, etc.
• Take a Silicon Valley approach – strive for a constantly evolving product driving toward a user benefit.
• Internalize security upfront and consider different vectors of attack – healthcare has experienced the largest percentage increase of cyberattacks (it currently ranks 3rd among industries) and is increasingly the choice of bad actors.
• Build a moat – Domine says Avail’s best defense from the competition is being “the best platform on the market, with a custom system that integrates everything to provide the best intuitive UX, optimized for the OR environment.”

The nitty-gritty

The Avail platform connects inside and outside the OR and allows viewers to customize their own experience. This way, clinical specialists, additional physicians, residents, and advisors watching the surgery can be remote but still actively participating and sharing with the surgical team. Med-tech research and development teams can sit in on the action, too, enabling collaboration on device development and creating faster product design cycles.

The complete hardware and software package features a palette of high-tech features, including hi-def video, GigE Ethernet port, built-in dialing for calling remote contacts, and medical imaging. The system is on a wheeled cart, with a camera on a manual boom arm, so surgery can be viewed from various angles. The audio system streaming is custom-built for the OR to reduce background noise from machines and equipment.

Avail is a data nexus – not only capturing real-time data from the surgical procedure itself – but archiving and enabling machine learning to help improve subsequent procedures and outcomes.

Audiovisual data - the remote app works with an iPad or laptop. With two-way audio and video, it’s like being in the room — even if you’re thousands of miles away.

Digital data – the system enables digitization of the OR to guide physicians and allow machine learning.

Secure data - Avail is HIPAA-HITECH protected. To enhance security, designers purposefully avoided certain design patterns and third-party platforms.

User feedback - user input ensures that any new feature added will be used, and Avail generates data on reliability, which is logged on Splunk, a data analysis platform that seeks, monitors, and analyzes machine-generated data via a web-style interface. 

Through collaborating in real-time, sharing knowledge about surgical techniques, and accelerating the development of new products and procedures, data is connecting a world of medi