Vol. 7 •Issue 8 • Page 57
Taking Audio Visual to the Next Level
A Texas hospital implements audio visual technology to meet its educational and research needs.
Baylor Jack and Jane Hamilton Heart and Vascular Hospital on the Baylor University Medical Center campus in Dallas opened last summer. Hamilton Hospital, a 176,000 square-foot facility, which is affiliated with the Baylor Health Care System, includes a 34-bed nursing unit, surgical suites, pre-op and post-op recovery areas, a 16-bed surgery care unit, a nine-bed interventional recovery unit, heart and vascular physician practices, and a research and education center for staff and family members. The new hospital also moved forward with its use of audio visual technology.
AV technology is particularly useful for facilities such as Hamilton Hospital because of its fit in medical research settings and its ability to transmit what’s going on in a surgical suite to students in the classroom. Because Baylor Health Care System’s other surgical suites did not have observation areas, there was no space for medical students to observe surgery. But now, with the new facility and new AV technology, groups of students can watch what’s taking place in the surgical suite directly in the classroom.
The AV technology allows for procedures to be delivered to a classroom and supplement visual education with additional knowledge from medical books and the like, delivered electronically.
The system provides a communication and presentation format that supports the physician’s educational needs based on clinical procedures in the surgical suites, cath labs or electrophysiology labs. The system also supports educational conferences throughout the entire Baylor Health Care System and other off-site facilities using multimedia, video teleconferencing and computer presentation tools.
Understanding health care
Lynn Gibson, vice president of applications at the hospital, said the organization had searched for AV companies that could meet its educational needs. However, many of them only had experience in the general business community and were not familiar with the workings of health care. The hospital partnered with Audio Visual Innovations, Inc. (AVI) of Tampa, Fla., and AVI outfitted the new hospital.
Donna Wolbe, senior account manager at AVI, had worked with the Heart and Vascular Institute at Baylor University Medical Center for a number of years. She said the project implemented an intercommunications system for use on a portable presentation cart. The idea was to allow surgeons to directly communicate what was going on in the surgery suite to the classrooms and meeting rooms within the hospital. “We also connected other areas of the campus via fiber; we’re now able to send information over high-speed T1 lines to other facilities that want to receive the information,” Wolbe said.
The system’s mobile presentation cart, designed by AVI, houses all the equipment needed to communicate from any of Hamilton Hospitals’ 26 procedure rooms. The attending physician/surgeon controls the images and information being sent to the classrooms or auditorium.
The mobile carts are designed to provide video camera capabilities, so physicians can zoom, provide audio and video feeds and deliver it all to the central media room, which then distributes it to the respective classrooms.
In August 2001, Baylor signed a contract with AVI. The project began last January and was finished in June 2002.
The auditorium is designed as the switching node, so if there is going to be a class in the auditorium and instruction needs to come from one of the ORs, it goes through the auditorium, said Joseph Thomas, senior systems engineer at AVI. “Those rooms can also be switched to act as extensions to the auditorium and present information interactively to the classrooms. In each of these venues there are standalone teaching capabilities with full audio visual and conferencing capabilities that can be tied directly into the operating rooms and conference rooms.”
What physicians wanted
Gibson said the physicians involved in the AV project wanted a system that allowed them the freedom to present information to students and family, “which is why a movable cart was constructed. The technology needed to be something that could be brought into a surgical suite: It had to be unobtrusive, it had to be usable with a minimum of staffing and the image from the surgical environment had to be clear.”
The technology — while new to the Baylor Health Care System — had been used by some surgeons in other settings.
Bob Myers, media services director at Bayor University Medical Center, said he was able to incorporate T1 lines throughout the organization: “We utilize those lines in connecting to anybody, any health system or any business that has a compatible unit and can teleconference with us in real time.”
The hospital’s primary objective was to build a technology-advanced system that would complement and enhance its research focus. “The physicians at Baylor were already doing a lot of teaching and research and had a broad understanding of the information they wanted to expand,” Wolbe said. “They wanted to be able to provide media and video conferencing (which was part of their overall strategic direction). Some doctors had seen the technology being used in other settings and they wanted a way to be able to do the same thing here.”
The project was successful because AV technology standards have improved for audio and video communications over the past few years, Gibson said. “Ten years ago, when Baylor tried to do AV, we had a difficult time making the point-to-point connections needed to run a vendor-based system,” he said. “Today, it is more of a standard capability and with the freedom provided in Internet tools, these systems have come a long way.”
Education and safety
Michael Taylor, CEO of the Baylor Jack and Jane Hamilton Heart and Vascular Hospital, said that from a strategic direction Baylor understands the importance of education and patient safety. “We believe we can better assess education and patient safety through positive outcomes and high satisfaction ratings.”
Taylor had to juggle two interests to make this possible: First, from his standpoint as a hospital administrator, he knew the technology was complex. And from the viewpoint of a consumer and user of technology, he knew that it had to be something that would be of interest to his constituents, as well. “During the demonstrations, I was impressed with the technology’s ability to take real-time photographs from textbooks or other printed sources and place them onto a presentation cart, and have them projected onto an image board a few feet away. Not only were the images readable, they were also the clearest photographs I had ever seen,” he said.
Meeting AV needs
Myers said that in the past when an educator needed media technology for a class, the media services department had to bring the technology into the classroom. “Everything he or she needs is now there. The educator just needs to ask someone to operate the equipment,” he noted.
Previously, Myers had to outfit the classroom with whatever technology was needed (e.g., projectors, video equipment, overhead projector). “We often encountered confusion because an instructor may have asked for an overhead projector, when in fact what he wanted was a projector that mounted overhead and projected images of what he was doing below,” Myers said. “This system’s design has taken a lot of the guesswork out of equipment requests.”
One of the features of the technology, Gibson said, is that live procedures can be videotaped or linked to other applications. For example, an educator teaching a class can show the procedure and also supplement his or her training with a PowerPoint presentation to underline a particular lesson to the class. “Everyone benefits from this — including the students, the community where the hospital is located and the medical community — because we are now able to educate our staff and others across the United States. This means that medical staff elsewhere can be educated right from our facility, thereby improving health care in their communities,” Gibson said.
Programming the technology
The AVI team went through an exhaustive programming process to make sure they understood what the hospital wanted, identified internal clients and the organizational structure, and confirmed ownership of the program.
Patient safety is on every hospital administrator’s mind these days, Taylor added. “One of the biggest drivers toward patient safety and the reduction of errors is the result of people not intentionally doing something wrong. But not being able to fully assess processes can also impact patient safety,” he said. “When a tool has an educational benefit in an economic and real-time sense through an outcome that improves safety — and provides ease of access to education that enables the learner to gain a greater understanding of what we are trying to teach — then patient safety will certainly follow.
“The presentation cart is ideal in this environment because it can be moved around to any room, so if there is a new procedure underway, we can capture that information and use it in training other physicians, nurses or caregivers as to the value of doing that procedure,” Taylor said.
Myers commented, “We can’t wait for articles or textbooks to come out, so this is a way that we can share new information we’ve learned and educate others. That is what everyone was looking for before we installed the system — a real-time education process.”
The CIO’s involvement
Thomas reflected on what he learned during the AV implementation. “Audio visual, for a lot of people, still means an overhead projector. Obviously, we are talking about something totally different than that here.”
Thomas said that anytime a health care organization looks to expand or do a construction project, management should consider where AV technology could be implemented.
Wolbe pointed out, “AV will save the customer a lot of money and headaches if it is brought in from the beginning of the project; it’s not something that should be done as an afterthought. If all the planning is done without AV, then you have to retrofit AV systems instead of laying the infrastructure as you go.”
Certainly, an AV system can be retrofitted, “but on a project such as the one at Baylor, having input from everyone on the front end, and with the contractors and technical expertise working with them from the beginning, they will not only have a better system, but they will also have somebody to call upon when a service issue arises,” Wolbe said.
Whether AV technology is right for your organization depends on the educational value you can glean from it. “In larger facilities, such as Baylor, the audio visual technology was closely tied to the curriculum,” Thomas said. “It’s also tied to the commonality of applications that are installed. They are able to share the information. At smaller facilities, it may be a simple matter of somebody being able to get a second opinion from a doctor at the larger affiliated hospital.”
Mr. Mitchell is managing editor of ADVANCE for Health Information Executives.