RESUMEN
Surgeons have to deal with many devices from different vendors within the operating room during surgery. Independent communication standards are necessary for the system integration of these devices. For implantations, three new extensions of the Digital Imaging and Communications in Medicine (DICOM) standard make use of a common communication standard that may optimise one of the surgeon's presently very time-consuming daily tasks. The paper provides a brief description of these DICOM Supplements and gives recommendations to their application in practice based on workflows that are proposed to be covered by the new standard extension. Two of the workflows are described in detail and separated into phases that are supported by the new data structures. Examples for the application of the standard within these phases give an impression of the potential usage. Even if the presented workflows are from different domains, we identified a generic core that may benefit from the surgical DICOM Supplements. In some steps of the workflows, the surgical DICOM Supplements are able to replace or optimise conventional methods. Standardisation can only be a means for integration and interoperability. Thus, it can be used as the basis for new applications and system architectures. The influence on current applications and communication processes is limited. Additionally, the supplements provide the basis for further applications, such as the support of surgical navigation systems. Given the support of all involved stakeholders, it is possible to provide a benefit for surgeons and patients.
Asunto(s)
Artroplastia de Reemplazo de Cadera , Implantes Dentales , Prótesis de Cadera , Cirugía Asistida por Computador/métodos , Cirugía Bucal , Diagnóstico por Imagen , Humanos , Planificación de Atención al Paciente , Sistemas de Información Radiológica , Programas InformáticosRESUMEN
PURPOSE: Today's operating room is equipped with different devices supporting the surgeon. Due to the lack of common interfaces between devices, an integrated support of the surgical workflow is missing. In the field of implantation, a smooth exchange of preoperatively planned data between devices is of great interest. Additionally, the availability of standardized preoperative data would facilitate the documentation, especially with regard to Electronic Health Records. METHODS: To analyze whether DICOM Structured Reporting can be the basis for a standardized digital human- and machine-readable implantation plan, we derived all requirements for such a document. Therefore, we examined the conventional implantation plan and future applications of the digital plan. RESULTS: In this paper, we propose to use the mechanisms introduced by DICOM Structured Reporting as storage and communication infrastructure for implantation plans in the surgical domain. DICOM Structured Reporting complies with all requirements of our analysis. Additionally, we introduce a first draft of a standardized implantation plan structure. CONCLUSIONS: A standardized digital implantation plan based on the DICOM Structured Report has the potential to overcome current integration problems in the OR and to facilitate new applications.