Information Technology Reference
In-Depth Information
2 Spine Surgery Planning Platform Architecture
The Biomedical Imaging Resource (BIR) at Mayo Clinic has developed a clinical
imaging software framework designed to provide powerful image visualization/
analysis tools in an intuitive, easy-to-use interface [
12
]. Built upon a comprehen-
sive, mature imaging toolkit called AVW [
13
], individual task-driven modules can
be developed and easily added to the base software. The underlying architecture is
based upon two concepts very familiar to physicians
—
Cases and Workflows. Each
case is associated with a unique patient and a speci
c set of routine clinical tasks, or
a workflow. This project uses a Spine Surgery Planning module developed to run
within the newly developed clinician-centric application framework.
Designed by a team consisting of imaging/visualization scientists, software
developers/engineers, and clinicians/surgeons, the goal at the outset was to develop
tools that are powerful, yet very simple to use. Clinicians have limited time to spend
learning new, complex software applications. Consequently, great care should be
taken in designing advanced clinical tools to ensure widespread acceptance. The
most effective way to develop such an application is to work closely with the end-
user and include the targeted clinician, or
in the entire design
process. Before a line of code was written, our collaborating orthopedic surgeon
met with the development team to discuss the problems with the current methods
and began outlining the requirements for the new surgical planning tools. For spine
surgery, 3D visualization and manipulation is at the core of the new tools. Tem-
plating of implants in 2D has been a technique utilized in orthopedics for decades
so it made sense to implement a new, advanced templating procedure that incor-
porates 3D imaging. Early design meetings, when the interface was
“
clinical champion
”
first scribbled
onto a whiteboard, included our clinical champion. After each teration of devel-
opment, the clinical end-user reviewed the latest version with members of the
development team and provided a list of recommended changes to be made to the
tools. Given the busy schedule of most surgeons,
finding time for repeated reviews
can be extremely challenging but their input is essential to the development of tools
that will be used by fellow surgeons. To successfully develop clinical tools in a
timely manner, the team needs to be persistent as well as
flexible. Design reviews
do not take precedence over much in the working day of a surgeon so postponed
meetings are routine. Reviewing the latest version on a laptop in the hospital
cafeteria between surgical cases may turn out to be one
fl
s best opportunity to meet
with a clinical collaborator in a several week span. In the end, the tools developed
are sure to be usable by and useful to the intended clinical users, given their active
involvement in the development process.
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