title: A multimedia electronic patient record (ePR) system for image-assisted minimally invasive spinal surgery.
abstract: OBJECTIVE
  This paper presents the concept of bridging the gap between diagnostic images and image-assisted surgical treatment through the development of a one-stop multimedia electronic patient record (ePR) system that manages and distributes the real-time multimodality imaging and informatics data that assists the surgeon during all clinical phases of the operation from planning Intra-Op to post-care follow-up. We present the concept of this multimedia ePR for surgery by first focusing on image-assisted minimally invasive spinal surgery as a clinical application.
  
  
  METHODS
  Three clinical phases of minimally invasive spinal surgery workflow in Pre-Op, Intra-Op, and Post-Op are discussed. The ePR architecture was developed based on the three-phased workflow, which includes the Pre-Op, Intra-Op, and Post-Op modules and four components comprising of the input integration unit, fault-tolerant gateway server, fault-tolerant ePR server, and the visualization and display. A prototype was built and deployed to a minimally invasive spinal surgery clinical site with user training and support for daily use.
  
  
  CONCLUSIONS
  A step-by-step approach was introduced to develop a multimedia ePR system for imaging-assisted minimally invasive spinal surgery that includes images, clinical forms, waveforms, and textual data for planning the surgery, two real-time imaging techniques (digital fluoroscopic, DF) and endoscope video images (Endo), and more than half a dozen live vital signs of the patient during surgery. Clinical implementation experiences and challenges were also discussed.
authors.affiliation: IPILab, Department of Radiology, Keck School of Medicine, University of Southern California, 1450 San Pablo Street, Suite DEI 2100, Los Angeles, CA 90033, USA. documet@usc.edu
authors.forename: Jorge
authors.initials: J
authors.lastname: Documet
authors.forename: Anh
authors.initials: A
authors.lastname: Le
authors.forename: Brent
authors.initials: B
authors.lastname: Liu
authors.forename: John
authors.initials: J
authors.lastname: Chiu
authors.forename: H K
authors.initials: HK
authors.lastname: Huang
mesh_terms: D057286:Electronic Health Records; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D033183:Interdisciplinary Communication; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D015641:Radiography, Interventional; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D018511:Systems Integration; D017749:Total Quality Management