A practical example of an integrated interoperable neuromonitoring system based on IEEE 11073 SDC and HL7

Purpose: With the ongoing work on the Health Level Seven (HL7) standards and the IEEE 11073 Serviceoriented Device Connectivity (SDC) family, the demand for open integration of medical devices in the operating room (OR) has become clear. Nevertheless, there are very few interoperable medical devices available to date. This work describes a practical example of connecting an intraoperative neuromonitoring (IONM) device with a radiofrequency (RF) surgical device based on SDC and with the hospital information system (HIS) based on HL7. Methods: Before starting the surgery, patient-related data must be entered into the neuromonitoring system. To minimize manual input, we integrated an automized patient data query based on HL7, which completes all other necessary data provided by the HIS after entering the patient identification number. During the surgery, while mapping neural structures in the situs using IONM, the parallel operation of RF devices for coagulation generates artifacts in the neuromonitoring signals, which makes a reliable interpretation of the IONM signals impossible. Therefore, we developed an IEEE 11073 SDC interface for the neuromonitoring device and implemented an SDC-based OR control panel. While placing the hand probe for mapping neural structures in the situs, the OR control panel suppresses the coagulation of the electrosurgical instrument and only reenables it, after the mapping has been terminated. After the surgery, the generated IONM report can be uploaded into the HIS using HL7. Therewith it is assigned automatically to the previously selected patient. Result: With the SDC- and HL7-enabled neuromonitoring system, we showed a practical use case of interoperable medical devices to optimize surgical workflow.