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