Set the scene: the project in one minute

• Tell me briefly which OR build, renovation, or technology refresh this conversation is about and the target go-live month.
• Walk me through the rooms included and which are highest priority for clinical activity and scheduling. Options: Single OR pilot, Partial suite (2-4 ORs), Full suite (5+ ORs), Ambulatory surgery center, Renovation with phased rooms, Other
• On a typical surgical day in the rooms under consideration, how many cases run and what is the case mix by specialty?
• Which one or two outcomes from this project would make your executive leadership call it an unqualified success? Options: Reduce setup time per case (minutes), Eliminate lost surgical recordings, Lower turnover time, Improve OR utilization/case throughput, Support surgeon recruitment/retention, Reduce staff overtime, Improve documentation quality, Other

Where time and friction actually leak in your OR day

• If each case today loses 10 to 20 minutes to device setup or manual switching, how does that shortfall show up in your capacity, staffing, or overtime costs?
• Describe the last time a case was delayed by equipment setup, what unfolded, and who had to respond to fix it.
• How many minutes do circulating nurses or techs spend on audiovisual and device setup in an average case? Options: Less than 5 minutes, 5 to 10 minutes, 10 to 20 minutes, 20 to 30 minutes, More than 30 minutes
• Which devices or data sources most often require manual switching, cabling, or separate recording steps during surgery? Options: Endoscope or camera, Surgical microscope, C-arm or mobile fluoro, Imaging workstation/PACS, Anesthesia monitors, External recording devices, Other
• Who on your team typically raises concerns about lost recordings or documentation gaps, and what do they describe as the consequences? Options: Surgeon, OR director, Perioperative administrator, Circulating nurse, Biomedical engineering, Periop IT, Quality/risk

Decision and daily operators: who drives what

• If the surgeon champion and the OR director disagree on acceptance criteria, which side usually controls the go/no-go decision? Options: OR director, Surgeon champion, Perioperative administrator, Biomedical engineering, Consensus of stakeholders, Other
• List the core stakeholders who must sign off before a pilot becomes billable work. Options: Chief of surgery, OR director, Perioperative administrator, Biomedical engineering manager, Periop IT director, Infection control, Facilities/construction, Procurement
• Who will serve as the day-to-day owner for clinical workflows during the pilot and after rollout? Options: OR director, Perioperative administrator, Surgeon champion, Clinical education lead, Biomedical engineering manager, Periop IT director, Other
• How quickly can each stakeholder typically make a decision when presented with pilot results, estimate in business days. Options: Less than 3 business days, 3 to 7 business days, 1 to 2 weeks, 2 to 4 weeks, More than 4 weeks
• Name the approval body or committee that typically creates the longest gating delay for projects like this. Options: Clinical governance, Capital/finance committee, IT security review, Infection control, Facilities, Procurement

The single metric that would make this unambiguous

• Pick the single measurable signal that, if achieved in the pilot, would make you sign off immediately. Options: Average setup time reduced by X minutes, Zero missed recordings in pilot period, Turnover time reduced by X minutes, Surgeon satisfaction above target, ROI achieved within Y months, Other
• Describe the target numbers for that metric, for example minutes saved, percent reduction, or the number of complete recordings per month.
• Explain how your team plans to collect and validate that data during the pilot, who will own measurement, and where it will be stored.
• List the baseline data points we should capture now so the pilot comparison is valid. Options: Average setup time, Turnover time, Number of missed recordings, Case mix by specialty, Staffing levels per case, Network bandwidth usage, Other
• Would proving that metric in a single OR be sufficient to move to purchase, and if so what threshold would trigger that decision? Options: Yes, single OR at defined threshold, No, need same result in multiple ORs, Depends on integration stability, Unsure

Red flags and real failures we need to know about

• Identify the single site or program risk that would stop the project immediately if it cannot be mitigated.
• Outline a past integration or install that ran into trouble, what failed, and how your team resolved it.
• Select which of these constraints exist today: network segmentation, limited access windows for construction, lack of API documentation, insufficient IT/biomed headcount. Options: Network segmentation/VLAN limits, Limited construction or access windows, No API documentation or vendor support, Insufficient IT or biomedical engineering headcount, Other
• Are there regulatory, privacy, or legal reviews that must complete before pilot devices can record or store surgical video? Options: Yes, privacy/security review required, Yes, legal or contract review required, Yes, IRB or clinical governance review, No reviews required, Unsure
• Name the person or role in IT or clinical engineering who can provide firewall rules, network diagrams, and user account provisioning within the pilot timeline. Options: Network engineer, Clinical engineering lead, Periop IT director, External managed services, To be assigned

Alternatives on the table and what would keep you with the current approach

• Explain what evidence would convince you to keep your current setup rather than change to a new integrated OR approach.
• Pick from the options below which alternatives you are actively evaluating today. Options: Incumbent vendor upgrade or support, Another external integration vendor, Homegrown solution by biomed/IT, Delay until construction completion, Cloud-only video service, Continue manual processes with no change, Other
• Estimate the run duration without issues that would make you consider reverting to the incumbent or pausing rollout. Options: Less than 1 week, 1 to 4 weeks, 1 to 3 months, 3 to 6 months, Unsure
• Has anyone internally proposed solving this without an outside vendor, and what resource commitments did they outline? Options: Yes, with detailed plan and headcount, Yes, high level only, No internal proposal yet, Unsure
• Please name the vendor features or contract terms that must be in place to sign a deal. Options: Onsite support hours and response SLA, Data ownership and retention terms, Interoperability with PACS/EMR, Training and clinical workflow validation, Warranty and spare parts, Fixed pricing for pilot, Other

Can we actually install when and where you need it?

• Suppose network or physical access windows are not available during your scheduled installation window, can the project still meet your target go-live? Options: Yes with adjusted schedule, Yes with weekend or off-hours work, No, access windows are critical, Unsure
• Identify which rooms already have required ceiling mounts, power drops, and rack space versus those that will need construction work.
• Provide the contact and allowed hours for installers in active surgical suites.
• Detail the network services and endpoints that must integrate with this system, for example PACS, OR scheduling, identity provider, or storage targets. Options: PACS/image archive, EMR/documentation system, OR scheduling system, Identity provider (AD/LDAP), Network storage/NAS, Vendor cloud endpoints, Other
• Do you have existing network diagrams, VLAN details, and a named IT owner who can provision firewall rules during the pilot? Options: Yes, diagrams and named owner, Diagrams exist but no owner assigned, No diagrams available, Unsure
• Summarize the data retention policy and access controls that govern surgical video at your facility.

The pilot that proves workflows or stops the project

• Specify the immediate next step leadership will take if the pilot fails to meet the agreed acceptance criteria. Options: Extend pilot and re-test, Require fixes before any acceptance, Pause project and reconvene governance, Escalate to vendor and IT leadership, Unsure
• Define the exact acceptance tests you expect during the pilot, from integration points to clinician workflow tasks.
• Provide the clinician roles and the expected number of pilot procedures per week you plan to observe.
• State the role or person responsible for signing off when each acceptance test passes. Options: OR director, Surgeon champion, Perioperative administrator, Biomedical engineering manager, Periop IT director, Clinical education lead
• Given a scenario where the pilot meets the metric but reveals an unforeseen integration bug, indicate whether you would extend the pilot timeline or require fixes before acceptance. Options: Extend the pilot while fixes are implemented, Require fixes before acceptance, Escalate for a rapid fix and continue testing, Pause and reassess scope

If everything checks out, what's the fastest path to a signed pilot?

• Assuming the pilot proves your key metric, what would stop you from agreeing to a pilot contract the same week?
• What internal procurement steps and time windows must align for you to start the pilot within 4 weeks?
• Give the reviewers who will need to see the pilot SOW and estimate the typical review time for each.
• State the top three obstacles that would need vendor help to clear for you to start within 4 weeks.
• Would you be willing to commit a named OR, clinician time, and network access for a two-week pilot if the seller provided a fixed-scope SOW? Options: Yes, commit all, Yes, with adjustments, No, not without executive approval, Unsure
• Give the name and contact of the person who should receive the draft SOW and pilot schedule after this call.

• Integrated OR Experience

• Confirm the current state and its cost
• You confirm the demonstrated workflow removes the manual input switching and reduces setup time to the stated target.
• Provide inventory of all OR video and imaging sources, including make/model and expected default routing for the pilot room.
• You confirm the demonstrated recording flow reliably captures and stores procedure video according to the acceptance criteria.
• Map your typical OR workflow and source list
• Deliver a tailored Pilot Acceptance Criteria draft capturing recording retention, setup time target, and integration responsibilities before the pilot kickoff.
• Proof walkthrough using your context
• You agree on the pilot acceptance criteria, measurement approach, and next steps to validate integrations in one room.
• Schedule the pilot week and name the clinical lead and IT/biomed owner for pilot validation.
• Validate the future state and acceptance metrics
• Agree next evidence and pilot scope

• Integrated OR Experience
• Solution Experience Deck
• Integrated OR Solution Brief

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• Install Integrated Surgical Display Array
• Deploy Video Routing Matrix and Signal Switching
• Install Room Control Panels and Sterile Interfaces
• Integrate Surgical Cameras, Endoscopes, and Microscopes
• Deploy In‑Room Recording and Documentation Capture
• Provision Centralized OR Video Archive and Storage
• Connect Imaging Modalities (C‑arm, Fluoro, PACS)
• Integrate Medical Device Control Interfaces
• Configure OR‑to‑EMR Documentation Export
• Install Network and AV Infrastructure (cabling, switches)
• Commission and Validate Signal Routing During Live Cases
• Pilot Room Installation and Clinician Go‑Live Support
• Phased Multi‑Room Rollout and System Commissioning
• Financing and Capital Equipment Lease Setup
• Onsite Technical Training for Surgical and AV Staff

Install Integrated Surgical Display Array

• List the OR room numbers or descriptions where the integrated surgical display array should be installed.
• Estimate how many surgical displays are required per room (e.g., ceiling-mounted surgeon display, scrub-team displays, anesthesiology view). Options: 1 display, 2 displays, 3 displays, 4+ displays, Unsure - need assessment
• Specify the native video inputs each display must accept from your equipment (examples: 3G-SDI, HDMI 2.0, DisplayPort, IP/RTP). Options: 3G-SDI, HDMI 2.0, DisplayPort, IP (RTP/RTSP/NDI), Other

Deploy Video Routing Matrix and Signal Switching

• Provide the desired deployment topology for routing (central headend matrix for the suite, per-room matrix, or hybrid). Options: Central headend matrix, Per-room matrix, Hybrid (headend + local switching), Unsure - recommend assessment
• Estimate the maximum number of simultaneous video sources that must be routed in peak cases per matrix (count endoscopes, cameras, fluoroscopy, microscope outputs). Options: Up to 8, 9-16, 17-32, 33+
• Identify the physical connector and signal type requirements for the matrix (for example, percent of sources that are SDI vs HDMI vs IP streams). Options: Mostly 3G-SDI, Mostly HDMI, Mixed SDI/HDMI, Primarily IP streams, Other

Install Room Control Panels and Sterile Interfaces

• Describe the sterile-field control surfaces you require in each room (examples: ceiling-mounted sterile touchscreen, bedside panel, foot pedal, voice control). Options: Sterile touchscreen, Bedside panel (non-sterile), Foot pedal, Voice control, Other
• Specify the number of room control panels or sterile interfaces per OR and their preferred mounting locations (ceiling boom, wall, mobile cart). Options: 1 panel, 2 panels, 3+ panels, Mobile cart only
• Indicate which control protocols the panels must support to talk to devices and the headend (examples: RS-232, IP/REST, USB HID, serial API). Options: RS-232/serial, IP/REST, USB HID, Proprietary vendor API, Other

Integrate Surgical Cameras, Endoscopes, and Microscopes

• List the camera and imaging device families and approximate model counts per room that must be integrated (laparoscopic stacks, arthroscopy, surgical microscopes).
• State the native output formats and control interfaces for those devices (examples: HDMI 1080p, 3G-SDI, USB 3.0, vendor SDK for remote control). Options: 3G-SDI, HDMI (1080p/4K), USB 3.0/UVC, IP stream (RTSP/NDI), Vendor SDK/API
• Indicate whether pan/tilt/zoom, focus, or overlay control from the sterile-field interface is required for any microscope or surgical camera models. Options: Yes, PTZ control required, No, video only (no remote control), Limited control (zoom only)

Deploy In‑Room Recording and Documentation Capture

• Describe the recording trigger methods you require in the OR (examples: auto-start from device, manual start from sterile panel, foot pedal, OR scheduler integration). Options: Auto from device signal, Manual from sterile panel, Foot pedal start/stop, Scheduler/EMR trigger, Combination
• Specify acceptable recording formats and codecs for clinical review and medicolegal archives (examples: H.264 MP4, H.265, lossless AVI). Options: H.264 (MP4), H.265 (MP4), Lossless/Uncompressed, DICOM video, Other
• List the metadata fields that must be captured with each recording for linkage to the case (examples: MRN, procedure code, operator, OR room, timestamps).

Provision Centralized OR Video Archive and Storage

• Identify the archive ingest and access interfaces you require (examples: DICOM store to PACS, SMB/NFS file drop, secure cloud S3 with API). Options: DICOM C-STORE, SMB/NFS share, Secure cloud S3/API, Proprietary archive API
• Estimate annual storage needs per OR for recorded surgical video (terabytes per OR per year) or provide sample case sizes. Options: Under 1 TB/OR/yr, 1-5 TB/OR/yr, 5-20 TB/OR/yr, 20+ TB/OR/yr, Unsure - need sizing study
• Specify retention policy and access-control requirements for archived video (examples: 30 days, 1 year, 7 years; role-based access, audit logging). Options: 30 days, 1 year, 7 years, Permanent, Custom - provide policy
• What acceptance evidence will validate archive integrity and retrieval (for example checksum verification plus successful retrieval of test cases)? Options: Checksum verification + test retrieval, Successful retrieval of 3 representative cases, Audit log review, Other

Connect Imaging Modalities (C‑arm, Fluoro, PACS)

• List the imaging modalities to connect (for example mobile C-arm model, fixed OR fluoroscope, intraoperative CT) and approximate counts.
• Specify required DICOM services and behaviors for each modality connection (examples: C-STORE, Modality Worklist, Query/Retrieve, store to PACS). Options: C-STORE, Modality Worklist (MWL), Query/Retrieve, Other
• State the maximum acceptable first-image transfer latency to PACS or viewer during intraoperative imaging (examples: under 5 seconds, 5-15 seconds). Options: Under 5 seconds, 5-15 seconds, 15-30 seconds, No SLA - best effort

Integrate Medical Device Control Interfaces

• Identify the medical devices requiring integration for monitoring or control (examples: insufflator, electrosurgical unit, anesthesia machine, patient monitor).
• Describe the integration level needed with each device type: monitoring only (read-only), remote command (limited set), or full remote control. Options: Monitoring only (read-only), Limited remote commands, Full remote control, No integration required
• List required device protocols and connection points (examples: RS-232 serial, vendor API, IEEE 11073, USB). Options: RS-232/serial, Vendor API/SDK, IEEE 11073, USB, Other

Configure OR‑to‑EMR Documentation Export

• Specify the mechanism your EMR accepts for case documentation and media linking (examples: HL7 ORU, FHIR Procedure resource, secure file drop with metadata). Options: HL7 ORU, FHIR (Procedure/DocumentReference), Secure file drop (SMB/SFTP), Other
• Select the documentation elements that must be exported to the EMR for each case (examples: recording link, anesthesia record, procedure timestamps, surgeon note). Options: Recording link, Anesthesia record snippet, Procedure timestamps, Surgeon/operator note, Other
• Describe how patient identifiers will be matched prior to export (examples: modality worklist MRN mapping, manual entry, integration with ADT). Options: Modality Worklist (MWL), Manual confirmation at case start, ADT interface, Other

Install Network and AV Infrastructure (cabling, switches)

• Describe the cabling and physical layer currently available in the ORs (for example Cat6a copper, singlemode/multimode fiber, existing coax SDI). Options: Cat6a copper, Fiber backbone present, Existing SDI coax, Mixed/Unknown - need survey
• State the preferred network segmentation for AV and medical devices (examples: dedicated AV/medical VLAN, shared clinical VLAN, separate management VLAN). Options: Dedicated AV/medical VLAN, Shared clinical VLAN, Separate management VLAN, Unsure - need recommendation
• Indicate switch requirements per equipment room or IDF: number of PoE ports, SFP/copper density, and preferred switch redundancy.

Commission and Validate Signal Routing During Live Cases

• Identify which clinical procedures and specialties will be used for live-case routing validation (examples: laparoscopic cholecystectomy, orthopedic arthroscopy, ENT microcases).
• Name the onsite clinical roles who must provide validation sign-off during live-case commissioning and how their availability will be coordinated. Options: Surgeon champion, OR nurse educator, Clinical engineering rep, Other
• What acceptance criteria will confirm successful routing and clinician workflow during live-case validation (for example, clinician sign-off, playback of recorded streams, zero manual input switching across X cases)? Options: Clinician workflow sign-off, Playback of recorded streams for 3 consecutive cases, Zero manual input switching across 2 consecutive cases, Other

Pilot Room Installation and Clinician Go‑Live Support

• Designate the pilot room by number or description and indicate whether it will be an active OR or mock/adjacent room for initial testing. Options: Active OR (live cases), Mock OR / adjacent training room, Mobile cart pilot, Unsure - need recommendation
• Specify the go-live coverage required for the pilot (hours of onsite support, remote support, number of cases to cover). Options: Weekday business hours only, 24/7 during pilot days, Evenings/weekends by request, Remote support only
• What evidence will validate pilot success for clinicians and operations (examples: average setup time reduction, >95% recording success rate, clinician satisfaction score)? Options: Setup time reduced by ≥10 minutes, Recording success >95% across 10 consecutive cases, Clinician satisfaction ≥4/5 on survey, Other

Phased Multi‑Room Rollout and System Commissioning

• State the total number of rooms planned for rollout and the desired cadence (rooms per week or month). Options: 1 room at a time, 2-3 rooms per month, 4+ rooms per month, All rooms in a single phase
• List the commissioning checklist items that must be completed before each room turnover (examples: signal verification, training completion, QA playback of recordings). Options: Signal verification, Staff training complete, QA playback of recordings, Network checks, All of the above
• Describe how downtime or OR schedule impacts will be coordinated for phased installs (examples: block scheduling, weekends, after-hours). Options: Block schedule coordination, After-hours/weekend installs, Rolling room closures with notification, Other

Financing and Capital Equipment Lease Setup

• Select the preferred procurement approach for this purchase (capital purchase, operating lease, financing through third-party lessor). Options: Capital purchase, Operating lease, Third-party financing, Undecided - need options
• Indicate whether you require deployment milestones to be tied to payment milestones or lease draw schedules. Options: Yes - tie payments to milestones, No - standard payment schedule, Need discussion
• List internal approvals or documentation required to complete procurement (examples: PO, capital request packet, board approval window).

Onsite Technical Training for Surgical and AV Staff

• Select which staff groups require training sessions (examples: surgeons, scrub techs, circulating nurses, biomedical engineers, IT/network). Options: Surgeons, Scrub techs, Circulating nurses, Biomedical engineers, IT/network, All listed
• Choose training formats you prefer for each group (hands-on in mock OR, bedside proctoring during live cases, classroom, recorded modules). Options: Hands-on mock OR, Bedside proctoring (live cases), Classroom session, Recorded modules, Combination
• State whether you require competency sign-off records and what form they should take (examples: checklist sign-off, electronic competency in LMS, attestation). Options: Checklist sign-off, Electronic LMS record, Paper attestation, No competency sign-off required

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• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Purchase Agreement
• Software License & Subscription Agreement
• Service Level Agreement (SLA)
• Rollout Acceptance & Go/No-Go Signoff
• Maintenance & Support Agreement
• Warranty & Hardware Acceptance
• Change Order Agreement
• Data Processing Agreement (HIPAA BAA)

• Go-live Health Check (weeks 1-4 post go-live)
• First Outcomes Review (weeks 4-10)
• Acceptance Gate and Incumbent Wind-down (around day 90)
• Quarterly Success Review

• Schedule the next quarterly review and any interim checkpoints for high-risk items.
• Reconfirm Solution Scope success criteria and owners
• Update the acceptance gate readiness tracker and circulate to all owners.
• Restate acceptance criteria from Solution Scope
• Produce a documented pass or fail for each acceptance criterion recorded in Solution Scope and capture the named signatory where the engagement requires one.
• If any criteria fail, have a concrete remediation plan with owners and deadlines that will return the item to compliance.
• Confirm the legacy system is either decommissioned or formally retained read-only, and that data archiving or migration is complete.
• Circulate the formal acceptance record with the captured signatory and store it in the shared workspace.
• Schedule and track remediation tasks for any failed criteria with named owners and firm dates.
• Execute legacy system decommission checklist or confirm read-only retention and archive verification.
• Quarterly metrics review
• Validate that the key operational metrics remain at or above the targets recorded in Solution Scope and surface any negative trends early.
• Reduce the number of critical open issues and confirm ownership and timelines for remaining items.
• Agree the prioritized enhancement backlog and schedule for the coming quarter.
• Assign owners and deadlines for prioritized enhancements and publish the quarterly roadmap.
• Update the operations dashboard with the latest metrics and distribute to clinical and IT stakeholders.
• Schedule follow-up validation for remediated items within 7 days.
• Confirm which Solution Scope criteria are materially met at go-live and which require remediation.
• Have a clear list of critical issues with owners and target resolution dates.
• Verify clinician training status and note any immediate additional training needs.
• Open prioritized remediation tickets with named owners and target dates.
• Distribute a go-live health summary to the buyer's clinical and operations stakeholders.
• Present first-period metrics and trends
• Determine whether average equipment setup time and surgical video capture success rate are moving toward the targets recorded in Solution Scope.
• Assign corrective actions for each identified root cause with owners and clear due dates.
• Confirm the timeline and prerequisites for the Acceptance Gate meeting.
• Implement agreed integration or mapping changes and schedule verification tests.
• Schedule focused clinician training sessions for identified workflow pain points.
• Open issues and ticket burn-down
• Present outcome data against each criterion
• Root-cause analysis for any gaps
• Deployment and integration validation
• Document acceptance decisions and capture signatory
• Enhancement request prioritization
• Training completion and early adoption signals
• Clinician and OR staff feedback
• Agree remediation plan for any failed criteria
• Open issues and ticket triage
• Operational risks and maintenance windows
• Agree corrective actions and timeline to acceptance gate
• Agree immediate remediation actions
• Incumbent system wind-down and data archive confirmation
• Agree actions and owners for the next quarter