30.04.18

Award-winning multi-campus 4K hospital project breaks new ground in Vienna

4K operating theatre in jones AV's InAVation-award winning multi-campus project in Vienna

Charlotte Ashley discovers the story behind an installation for two hospitals which evolved into multi-campus project connecting sites 400 metres apart, leading to a fourth consecutive victory for Jones AV at the 2018 InAVation Awards.

In early September 2016, the Jones AV team received a phone call from long-term  partner  Arthrex  with  a  request to  join  its  largest  project  to  date  and upgrade all theatres for a private hospital group in Vienna – the catch being they had just two weeks to complete the system design and first  fix  install.  The  last-minute  nature  of  the request from the client to design and wire the system before ceilings would be closed was no surprise  to  the  integrator,  but  what  started  as a  project  to  deliver  two  4K  operating  theatres would evolve into a feat of system integration spanning multiple locations.

“The AV install could under no circumstances impact  on  the  final  build  schedule  so  planning started straight away on two 4K theatres at the Heart  of  Christ  Hospital  and  three  days  later we visited the building site in Vienna and work commenced  within  a  week,”  says  Ingo  Aicher, managing  director  at  UK-based  Jones  AV. Delivering two integrated theatres based on a Barco Nexxis variant video over IP system integrated with Arthrex’s 4K endoscope (with fibre optic 4K video output) was fairly standard work for the integrator, but in reality, the project had just begun.

“Things  then  started  to  become  interesting, because  the  customer  ordered  the  complete overhaul  of  their  three  day-surgery  operating theatres,” explains Aicher. “This may seem fairly unspectacular,  however,  these  theatres  were  to be  linked  up  to  the  two  theatres  we  had  just finished,  an  auditorium  and  an  anatomical teaching  theatre.”    Although well versed in using fibre optics to connect the campus sites via HD-SDI over fibre, this project was to be all video over IP. “Given that Barco Nexxis is based on uncompressed 4K it produces such data loads, sharing across a normal IT network was completely out of bounds,” states Aicher.

He adds: “To add to the complications, Nexxis is based on multimode fibre, which handles  a maximum of 300 meters distance. With the ORs more  than  400  metres  apart  (and  500  metres plus for wiring), it was out of the question to build  one  centralised  system,”  says  Aicher.  The two deployed systems with switch fabric in the main wing were furthermore already in operation and could not be co-located. Both centres also had to be connected via the Arthrex endoscopy management platform linking the matrix video routing interface that controls Nexxis.

“We came up with the idea to build a system in the day surgery and somehow connect the switch backbone from the day surgery to the backbone of  the  main  surgery  theatres  system  with  an uplink  to  the  main  server  communications room.” It was then a case of finding a product that could accommodate backbone connections on 40GB QSFP, with multimode only capable of handling 120 metres. “Countless calls with the product experts from the manufacturers always came to the same conclusion: this is not possible.” The integrator says it explored every option for connecting the buildings – not only needing to overcome the distance limitations, but build  a 160Gb/s backbone to facilitate the multicast for such a system to function. The answer appeared to come in the form of a ring topology between switches  using  4  x  40GB  QSFPS  to  cross  the three 48-port high bandwidth extreme network – but obtaining it would mean travelling to the other side of the world.

“Everyone said not to do it, but it was technically feasible so we figured it had to be doable.”

“We dug deep into technology mecca that is Shenzen,” says  Aicher.  “Endless emails and drawings later, we found what we  needed:  a single  mode/multimode  QSFP  hybrid.  A small device at a steep price to save the day.” Jones AV acquired 12 despite many saying they were “crazy” to push ahead with a system untested by any of the manufacturers. The stakes were even higher to deliver due to the three day surgery ORs’  past  status  as  the  integration  reference site  for  local  region  for  Olympus  Medical Systems. “Everyone said not to do it, but it was technically feasible so we figured it had to be doable,” recalls Aicher.

Work began in the summer holidays, and with no fibre connection between the buildings and the client continuing to add to the order, the ‘to-do’ list was extensive, but having inhouse demo OR facilities ‘Das Bank’ helped the integrator to test around limited access along the way. “We were to install 4K medical cameras in the rooms, the 4K endoscopes and 4K surgical monitors and some in-wall 4K monitors with Corian covers and anti-glare coated gorilla-style glass.”  A visitor gallery with bi-directional audio and video and switchable glass, adjacent to one of the theatres was then requested, in addition to replacing the ceiling  supply  units  for  free-moving medical devices which are permanently connected to gas, electrics, network and AV (without trailing cables).

Multiple Viennese heatwaves and  six-week  turnaround meant  the  pressure  was  on for  Jones  AV,  who  set  about installing  inter-area  fibres  in single  and  multimode  and dismantling  and  gutting  the Olympus  operating  theatres one  at  a  time,  due  to  their rotation  –  all  while  projects in  Munich  and  Oslo  took place  too.  Then it was time for the  real  test:  the  system configuration.

“With the system connected and  all  the  hardware  seeming to  be  working,  the  problem was  that  when  we  tried  to share sources across the switch backbone  we  were  greeted  by the error message saying the maximum bandwidth of the backbone for inter OR connection reached,” says Aicher. Two weeks of testing later, the team discovered a basic switch configuration submenu with backbone sharing bandwidth  value  set  to zero. “We changed it to 160 in a last desperate attempt  and  it  suddenly  opened  the  backbone and  system  was  firing  4K  in  all  directions.”  By fate, the system showed its ability to share any source to any destination in any of the locations across  the  unique  uncompressed  4K  video  over IP  network  on  the  day  the  day  surgery’s  head surgeon returned for the handover. With the client “overjoyed” with the result, work then began on the next operating theatre to be connected.

Following the handover, Jones AV, Arthrex and Vinzenz Group IT staff agreed to use the new city-wide fibre connectivity to span the network distance across all four sites for uncompressed 4K video sharing to a fifth location in what will continue to be a boundary-pushing project for the medical world.

Jones  AV  picked  up  a  fourth  consecutive InAVation  Award  this  year  in  recognition  of its work for the Vinzenz Gruppe hospitals and incorporating three projects into one expansive installation.

“Not  only  is  it  really  flattering  to  win  the award again, it’s also helped us tremendously as people look at us and realise that we really know what we’re doing – it’s a badge we wear with pride,” says Aicher.

 

Tech-Spec

Apart Audio speakers and CHAMP-2 amplifiers

Arthrex Synergy.net endoscope management platform and Synergy matrix routing

Audio Technica ES945 omnidirectional microphone and System 10 wireless system

Barco Nexxis encoders & decoders and 32-in 4K medical monitors

Blackmagic SDI conversion equipment

B-Tech large display mounts

Extreme network switches

Kramer DVI splitter and cabling

Leader Optec fibre optics cabling and MTP breakout

LG 49-, 55- and 65-in 4K monitors

Neutrik opticalCON Duo/Quad, MTP sockets and rugged fibre cables

Simeon Medical ceiling supply units and 4K surgical cameras

Sumitomo fusion splicers

tvOne CORIOmaster micro