You use the word "integration," but I use the word "interoperability" to describe the ability to safely, securely and effectively exchange and use information among one or more devices, products or systems in the OR. With telecommunications, electronic medical records, video conferencing, voice activation, patient information and doctor preferences all on a one-touch console, integrating that data in the OR seems like a no-brainer.

The ability to share information across systems and platforms is the backbone of integrated ORs. An integrated OR means something different to everyone, but its goals are to reduce the burdens on the clinical team and to eliminate useless technology that doesn't support the workflow. Take an electronic board mounted above the whiteboard, for example. They both display the same information about the day's schedule. But if no one looks at the electronic boards, get rid of them.

Clinicians usually have conceptual ideas on what their perfect working environment would be. The ideal state for an anesthesia provider might be to look at a single screen that consolidates all the information displayed on 6 screens. A circulator might love to be able to voice-control data into an electronic environment. Some surgeons like to see integrated data on a dashboard so that they don't have to look at multiple screens. But really, it's all about bringing data to the clinicians to support their decision-making that allows for safer care.

The ability to share information across systems and platforms is the backbone of integrated ORs.

What's it take to turn those conceptual ideas into a successful OR integration outcomes? Here are 5 tips to consider:

1. Build your team.

At the very least, your team should include advanced practice nurses, anesthesiologists, surgeons and architects. But it should also include a fully engaged IT component and a chief financial officer or someone who is in the finance office.

In addition to your team, also talk to people who are not in the current OR environment. That could be somebody like a potential patient, a 15-year-old, or somebody from another industry. Have them describe what kind of OR experience that they would want to have. Once you build your team and have talked to outside sources for other opinions, then listen to what your team is saying. Make sure that clinicians are engaged and involved in the process and that OR integration isn't something that is just thrust upon them.

2. Establish outcome measurements.

What are your goals and what are you trying to achieve? To help find that out, you need to establish outcome measurements, with a starting point and then at intervals as you move toward achieving those goals. You can create different categories — based on your organization's goals — to measure outcomes, even putting a higher value on the ones that make sure there is satisfaction for the clinical team. Then measure those outcomes and adjust based on the feedback that you get.

Bringing in business analysts and looking at those measurable values, we've done that, and it's only gotten us so far. We need to have technology help us do the right thing all the time, and that requires integrated systems with interoperability at the core.

3. Get the complete picture.

Why is the interoperability of an integrated OR so important? Simply put, it's so you have access to all the information you need to manage the patient's profile in one centralized location. If you have all the patient's data vs. having only some of the patient's data, you have a better ability to make decisions for that patient. If we had one patient profile in the maze of systems we now have, that would be different. But we don't. We're re-registering patients and re-entering data in the disparate systems and that's frustrating.

4. Improve safety.

Knowing the patient by having all the details about that person is important for any care team. And having a unified look for that data through all the devices improves the patient's safety. Clinicians are knowledge workers, they use data elements to make decisions and they need a holistic view of the person they care for, not pieces that they have to puzzle together.

You want to know everything about the patient, including medical history and any medications they may be taking. By knowing the complete picture, you may make different decisions for that patient's care, like in managing their recovery. If you don't have all the information, how can you make the best decisions? The integrated OR gives you the best opportunity to make those decisions.

5. Find a vendor solution.

Multiple vendors have multiple solutions, yet it's the health system or the care team who coordinates that. Facilities are paying a lot of money for interfaces between multiple vendors or they have separate IT systems that need to be maintained and upgraded so that disparate systems can talk to each other.

They aren't going to be able to explore multiple vendors without a testing lab certification — like what the Center of Medical Interoperability, a non-profit research and development lab in Nashville, Tenn., is working on. Technology solutions should be based upon open-sourced reference architecture that can serve as a platform for trusted and secure data exchange. We don't yet have that in health care like other industries — finance, logistics, shipping, for example — that have data liquidity.

Technology should be able to talk to itself — one to many, many to many discussions through technology. But right now, it is the clinical and operations staffs, or the health system IT department, that are responsible for coordinating all the different systems. And that's not how it should be.

Be transparent

None of this can be done in a silo. The transparency of the measurements and outcomes must be known within the organization. There isn't a one-size-fits-all solution to OR integration. Planning sessions where everyone has an equal voice in creating the goals does work. Because if you have a lot of naysayers, it won't work. OSM