Connecting workflow management to the OR network: Design and evaluation of a bridge to enable dynamic systems behaviour.

In recent years, multi-vendor interaction and information integration was made possible by automatic discovery and secure communication features. An effective support for the surgeon also depends on machine-readable information about the actual surgical procedure. In the present work a concept for integration of modern OR bus systems and process management is described. Process management in the OR relies on generalized surgical process models (gSPMs) that describe a surgical procedure by work steps performed by the surgeon and the OR personnel. Information extracted from such models need to be provided to the OR devices for effective adaptation to the current surgical situation. A prototype for the integration of process management and OR bus systems was implemented. The process management component consisted of a surgical workflow management system and a sWfMS-ORbus-Bridge. The workflow management system handled the surgical work steps based process information. The sWfMS-ORbus-Bridge acted as service provider to the OR bus system. Thus it converted the communication protocol and transformed the viewpoint from person-centralized to technical resource related. The required mapping from surgical activity to technical resources was based on OR bus system features. As a conclusion, the integration of process management into modern operating rooms can be implemented based on common infrastructure features. It is required for effective support of the surgeon by dynamic adaptation of the compound OR system to the surgical situation. The implementation of integrated OR networks and process management tools will contribute to improvement of surgical patient care.