Hardware

Key Considerations for Organizations Investing in Medical Displays

Displays used for reading medical images are held to higher standards than commercial computer monitors, and surgical displays must meet even stricter standards. If you’re in the market, here’s what you need to know.

Brian Eastwood

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Brian Eastwood is a freelance writer with more than 15 years of experience covering healthcare IT, healthcare delivery, enterprise IT, consumer technology, IT leadership and higher education.

Displays are just about everywhere in today’s healthcare settings, in locations as varied as waiting areas, exam rooms, nurse workstations, imaging centers and operating rooms.

However, not all displays are created equally. The technical standard for medical imaging recommends a luminance (brightness) of 350 candela per square meter (cd/m²) for diagnostic imaging, a luminance of 420 cd/m²for mammography and 250 cd/m²for all other monitors. In addition, displays used for diagnostic imaging and surgery are subject to U.S. Food and Drug Administration approval.

Commercial computer monitors typically range from 250 to 350 cd/m² and don’t need to be reviewed by the FDA. As a result, they are unlikely to meet a healthcare organization’s need for supporting patient care.

“There’s a difference between identifying an artifact versus muscle tissue in mammography,” says Tony Burford, senior engineer and senior account manager for medical displays with LG Electronics. “That’s the difference between diagnosis and misdiagnosis.”

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Meeting or exceeding the technical standard for luminance, which has been set by the American College of Radiology (ACR), is a critical consideration for healthcare organizations investing in medical displays. Several other factors come into play, and they may vary depending on whether a display is used in imaging or surgery.

Considerations for Imaging Display Implementation

Consistency. The technical standard also recommends that multiple monitors in a single workstation should have a difference in luminance of no more than 10 percent. That way, the view of an image remains consistent regardless of which monitor is used.

A large hospital network could have up to 200 workstations with diagnostic displays, Burford points out. Checking each display’s luminance manually is a time-intensive task — both for the technicians looking at each display at each facility and for the imaging teams whose workflow is impacted by a display “health check.”

To address this issue, organizations should turn to medical displays with built-in software to automatically generate reports on a regular basis to indicate whether a display continues to meet ACR standards, Burford says.

“You want to be able to maintain the displays remotely, without having to travel,” he says. “Because this is a large investment, you’ll want the reporting tools and compliance tools.”

Security. Some all-in-one computing stations include processors within the display, or they may connect to the internet. This is more than what’s necessary for imaging displays, which essentially serve as extensions of imaging workstations.

“It’s an endpoint,” Burford says, noting that the display does not store protected health information. “Ideally, there’s no memory in the display other than what’s used to generate standards compliance reporting, and there’s no ability to network the display.”

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Considerations for Surgical Display Implementation

Displays used in the operating room must meet an additional range of specifications. These include but are not limited to International Electrotechnical Commission standards for medical equipment safety, ingress protection (IP) ratings to protect against damage from solids or liquids, and electrical isolation requirements to prevent patients from being exposed to electrical currents. They also tend to come with higher color contrast (particularly for shades of blue) and increased luminance; LG’s surgical displays come in at 1,000 cd/m².

Along with these specifications, healthcare organizations should keep in mind these surgical display features:

Extensibility. While the imaging display has a single use and connects to a single workstation, the surgical display must connect to ultrasound devices, anesthesiology machines, physiological monitors, and (for certain procedures) gamma probes. The surgical display should be able to stream video from each of these sources simultaneously. “You’re going to a whole other level with the display: the imaging, the speed, the consistency and the number of devices you’re communicating with,” Burford says.

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Durability. A high IP rating means a display won’t be damaged by surgical instruments or low-pressure water jets, both commonly used in the operating room. Displays also need to be designed to withstand being moved (to the endoscopy department, for example), being hit by the large surgical lights or the boom (which houses support equipment and other audio-visual equipment) and being disinfected after each procedure.

Redundancy. Time is of the essence during surgery; a procedure can’t stop because a video feed goes down. Built-in fail-safe switchover capabilities will ensure that a display can switch from one input to another if the connection to one input goes down. This switchover should happen automatically, without anyone on the care team in the operating room having to interact with the display, Burford says.

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