Streaming the Operating Theater

Streaming video allows the College of Medicine at Penn State to broadcast complex surgeries outside of the operating room.

Giving 600 medical students, 500 residents, and 1,800 nurses an insider view of what goes on in a hospital operating room is challenging. Filtering all of them into the OR isn't feasible, and HIPAA regulations prohibit blanket distribution of any patient-related material. For many schools, providing students and faculty with a front-seat view of the critical activities is impossible.

That's the problem that Penn State Milton S. Hershey Medical Center and Penn State College of Medicine (collectively known as "Penn State Hershey Medical Center") in Hershey, PA was grappling with a few years ago. At the time, the center relied on a lecture capture system that lacked video capabilities, making it virtually useless for recording operating room activities.

"We needed a way to relay information outside of the OR," said Russ Scaduto, IT director for education technology and the director of multimedia solutions, "and record it so that the events could be viewed over and over again."

Penn State Hershey Medical Center solved the challenge with an IP video solution from VBrick. Scaduto spoke with Campus Technology and discussed the live streaming system and what it does for the center, the challenges it has presented, and how it's being expanded across campus.

Bridget McCrea: Why was streaming video the right choice for your organization?

Russ Scaduto: We knew that we wanted to build a video infrastructure that would be separate from our existing lecture capture system--namely because there are many times when we don't need to capture a screen and video. Plus, that existing system couldn't scale and was extremely primitive. We needed something more robust and cost-effective, but that also had a larger footprint of capabilities. We already had an Olympus recording system set up in these rooms, where the primary operation was laparoscopic surgery. These operations were actually done on camera, using tiny, robotic tools and small, abdominal [incisions]. Adapting and attaching a recording and streaming system to that original setup was fairly easy.

McCrea: What was the Olympus system lacking?

Scaduto: The system didn't include streaming capabilities. Surgeons would have to log onto a server and download the video. The process was cumbersome, and it also created a number of security and file-size problems. That's why we went with a system that could automatically stream the content onto the Web for us.

McCrea: How was the new system rolled out?

Scaduto: We asked surgeons what they thought about recording the operations, and they were receptive to the idea. We launched it first in our operating rooms, where we immediately started using the imbedded streaming and recording capabilities. Over time we've dropped the Olympus recording system because our streaming video setup handles it for us.

McCrea: What criteria did you use when selecting a video system?

Scaduto: We wanted a solution that would be easy to manage, and one that would allow us to easily organize user groups into specific areas. Being able to search for content--and then organize it by user groups--is very important. We also needed to be able to control access to the content. We have to comply with HIPAA regulations regarding the safeguarding of patient identities and information, so the OR recordings are only viewable by the surgeons.

McCrea: How do you control access to the videos?

Scaduto: Right now, only a handful of surgeons have access to the OR recordings. Should they decide to share the content, they have to move it to a different catalog site and then authenticate the viewer.

McCrea: Have you run into challenges with this new setup?

Scaduto: Really just the fact that a contingent of the faculty wants to download videos to their own USB flash drives. We're trying to educate them that there are more secure options that outweigh the convenience of having a USB key in your pocket. As an institution, we're also trying to encourage safe computing practices, and the use of encryption tools. To that end, we'll be implementing an encryption solution this academic year, with the goal of providing a user-friendly environment that not only provides access to content, but that's also HIPAA-compliant and secure.

McCrea: What's on your IT agenda for the rest of the year?

Scaduto: We have a few projects underway. Our new student information system is in the planning stages, and we're also building a patient entertainment suite. Swank Motion Pictures is licensing the movies and shows to us, and we'll be streaming them into the patients' rooms using our VBrick system. Going forward, we plan to expand our use of streaming video even further to include the new children's hospital that we're designing.

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