A Return to the Operating Room
Capturing Surgical Content in the Post-COVID Era
Originally Broadcast: July 21, 2022 | 2 PM ET
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COVID necessitated the use of virtual technology to connect physicians and continue the sharing of valuable medical education & insights - while this remote network continues to flourish, there has been a growing appetite for surgical demonstration content amongst physicians to complement the plethora of didactic programs.
Getting back to the OR to capture this surgical based content has become more challenging than ever - even prior to the pandemic, these events were not without their strict protocols and nuanced techniques to maintain patient safety at all times.
Topics covered will include:
Safely planning and entering this sterile environment
To stream or not to stream?
Not all procedures are made the same
Expert Q&A Panel
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Mike Ciaburri VP, New Business Development
Scott Clelland Director, New Business Development Hello and welcome to today's webcast. Its continuation of a multi. Part series. All things health care and live events. Today's topic will be covering a return to the operating room where we'll be talking over all the things you need to know about. Getting back into the O. R. To capture content. Clinical content uh in the post Covid world will be going over some best practices and some tips and tricks that broadcast med uses to capture all of our clinical content. Whether we're doing boots on the ground or virtual recording content or remote controlling content as well. A little bit of housekeeping. Before we start, you'll notice, like I mentioned, this is a multi part series. This is actually the fifth webcast in the series. So check out below. There's links to our previous webcast. Also we'll be doing a question and answer session in this program. So you'll see. Ask a question button. Feel free to send over some questions for us. We will be making sure that we'll get to everybody's questions throughout the program. If we don't have a chance to get two years before time's up, we'll be reaching out to you directly to make sure any of your questions and concerns are answered in a timely fashion. The other item that we want to mention is that there will be polling going on throughout the program. We invite you to answer those polling questions and we may actually reference them during the call itself. The other final comment of housekeeping. Uh is that there's gonna be an additional webcast coming out around our U. S. News and world report best practices for our hospital clients about reputation building for our hospitals. So feel free to register for that if there's any interest in joining that webcast and we hope to see you there today. I'm joined by my colleague Scott McClellan, the director of business development here at Broadcast Med. He actually has a ton of wealth of knowledge in the production as he was actually part of our production team for almost seven years prior to joining the business development team, scott, You wanna introduce yourself? Thanks Mike, glad to be back with you today as we continue this series as your folks at home know prior to the pandemic in dressed in virtual content was just not part of the vernacular, you know, everything was in person, whether it was medical conferences, trade show events, association events and even a lot of the surgical training, it's very common that a lot of us will never have watched that surgical demonstration online prior to the pandemic. Now, I'm sure everybody knows what Zuma's have spent many hours a week in virtual teleconferences, Skype events, team events and just has become part of the new normal. And while we've produced a lot of didactic symposia based programs during the pandemic, one thing that we are seeing a great need for again, a great appetite for from our physician audience has been surgical content. And that is something that has been a challenge to a lot of our clients, partners and prospects as we, you know, continue to tread carefully as we hopefully make our way out of the pandemic. So today we'd like to give you some tips and tricks that we've learned over the many, many years that we've been doing this. And the first and most paramount is safety mike. You want to kick us off by talking about our philosophy and safety? Yes scott. Um, you know, safety is obviously the number one factor when we're going into the, you know, the O. R. Um, you know, broadcast meds mission statement is to engage, educate and inspire physicians and you know, going out there, we could be worried about, you know, kind of making sure that you're getting that money shot or the best angle possible for that surgery. But really at the end of the day, we really want to be a extension of the positions team. We want to make sure that we're not standing getting in any ways of, you know, the patient safety because at the end of the day the patient does come first, the patient safety is paramount to anything that we're doing. We really want to make sure that that is the number one priority when we're going into the operating room to make sure that we're not interfering in any which way um, to the patient safety and outcome of the overall surgery. So we want to be that extension of the physicians team and you know almost treated as if it was a loved one on the table, your mother, your father, your your brother or sister on that table doing what we can to make sure that that surgery goes as smoothly as possible. Exactly mike all the while still capturing the footage and walking away with what our client or what the hospital wants or what the surgeon wants to you know, showcase to demonstrate the clinical advantages. And the reason that we are able to do that and you know, other successful parties out there are able to do that is through understanding the safety and the protocols that go into a surgical production. I've often heard horror stories about you know hospitals or device companies hiring just a local crew that's been shooting a music video one day, a car commercial the day before and then coming into an operating room with a very similar approach and ensure they might have nice equipment and understand, you know videography on the whole but you really need to understand the nuances of being in a sterile environment, not touching anything blue, not getting in the way of the O. R. Nurseries or anybody that is assisting the surgeon that's more important than check your focus and you know anything that should just be foundational of the production. And too often we hear stories of inexperienced people going in there and you know unfortunately causing a disaster and the last place in the world, you you do want to cause any sort of harm. So I think, you know, making sure you find a vetted crew vetted agency that's that's been doing something of this caliber for a while. Has built up a reputation, has built up trust by hospitals, industry partners and anybody in that space so that, you know, that you don't have to worry about patient safety in ruining your reputation by proxy by sending the wrong people or an inexperienced crew into an area that's completely sterile and high priority for surgery. I definitely could agree with you there scott. Um, I do know that we've had clients literally get the pull the plug pulled on, you know, surgical footage or surgical content by bringing in an experienced crew. We've actually had to come back to broadcast, met after leveraging a different agency or a different vendor for that. You know, that one horror story that I know of that we recently encountered with one of our clients, They got the night before the 11th hour of the program. Uh, they had the plug pulled by the hospital because the crew that they brought in just was not experienced enough to um, not asking the right questions and whatnot. So just really making sure that you're getting that crew before going into the the operating room and knowing what you're doing, you can really be a big help and you know, not stop you dead in your tracks for sure. And that comes down to the pre production. The pre production is almost more important than the production itself because it's not just an environment that you can walk in like a studio space or a manufacturing area where you're you're filming interviews for other sectors of the industry. There's hoops to jump through and there's certain parameters that you need to meet before you can even step foot in the hospital. And in addition to finding a crew that has experience and you know, a resume of doing events of this caliber, you also need to make sure that you're aware of the nuances for each facility and it tends to be the bigger the facility in the hospital. The more protocols that are that you have to meet. So that's why everybody in our production team and crews that we work with our credential through vendor mate simpler rep tracks, secure all of those agencies and make sure that you're up to date with shots. I know that that's been a hot button topic over, you know, the last couple of years in particular vaccines to do or not to do. Um in this environment, it's not political. You have to have certain shots, You have to have certain blood work done, you have to understand, you know, certain protocols before you step foot in the O. R. From a company standpoint, you also have to have certain insurances liability, any sort of waivers there and that process can take anywhere from you know a matter of hours, two weeks before you have the credential and needed to step foot in there. So it's not something to take lightly as you plan. And and then the planning really is a key base scott. You can't say it enough, especially if you were gonna talk about streaming later on directly from the operating room, especially if you ever want to tap into that I. T. Support um you know you definitely wanna start the planning, that's another factory, you said it best there that the pre production side is almost more important than the actual surgery itself that you're capturing because of all the logistical hurdles. Again you don't want to show up to the day of and making you know you left one box unchecked and it can kind of take down the entire house of cards there. So again that pre production phase and we'll get into streaming later on uh you know I. T. All the different uh requirements of the hospital or the facility will ask you of. So you're making sure that you're doing that. And again doing that prep work before you go out there can really ensure a successful shoot and you know, capturing that content goes as smoothly as possible. Exactly mike and this is a type of production where you really only get one shot. It is very much akin to live tv. You can't ask the surgeon, oh can can you make that incision again or can can you remove that part again? You only have one shot and even before you get that one lateral shot you only have one shot to make sure that you can go into the hospital and into the operating room without any sort of hindrance. And that is by having a you know, rigid pre production schedule and as you said, my making sure you leave no box unchecked. This isn't like filming a music video or even even an interview or something else, a didactic, a symposium in the healthcare space, you um you know, show up and oh I forgot a cable take to grab a glass of water, you know, I'll be right back or if if someone you know says the wrong thing you can you can do a retake of it or somebody's wearing the wrong clothes, no harm, no foul dress, more professional the next time in this sort of environment you don't get that, you know, chance. And one of the things that we have seen in the virtual Leader is there's a, you know, a lot more agencies, production crews popping up out of necessity, you know, Covid has affected the creative world greatly and there's a lot of these agencies out there that claim they can do it and they've never set foot in the hospital, never mind an operating room in their lives. So I can't stress enough how important it is to vet the team that you're gonna be working with and to make sure that them and yourself for doing your due diligence before you step foot in the hospital because you only get one chance to do this and one chance for your reputation, you, you know, make a mess in an operating room, You're never getting in any hospital again. It's, it's definitely a bad look to have. Yes scott. I love how you say that. You know, um you know, there's no take backs. This isn't the board game operation, there's the stakes are much higher this time around. Uh in terms of, you know, capturing that content, patient safety. But we've talked about pre production. We've talked about all the planning that goes into the actual production day itself, making sure you're getting a vetted crew, communicating with the facility hospital, you're gonna be filming at getting again all the credentials needed for that. Let's talk about the production day itself. What's the day look like when you're actually at the facility starting to record. Yeah, great point mike, once you've dealt with the extensive pre production and have all your ducks in a row, I think the next thing you remember and it goes back to that old business saying that you want to be the first one into work and the last one to leave. That's probably going to be the case when you're recording a procedure most times were recording something we like to try and schedule it and work with the nurse manager to film the first procedure of the day. That way you can get in way ahead of time and make sure everything's set up. And one of the things that you're gonna want to do is build an extra time again. This isn't just setting up for an interview Type shoot. You know angle one shot 1. Um you're gonna want to make sure that you can safely navigate the minimal crew that you're allowed into the room to get the shots without getting in the way of the crew there. And then you'll probably have to wipe down your equipment with sterile whites, hospital grade white. So you're going to want to build an extra time for that. You may have to drape your equipment especially if it's getting closer to the sterile field. So make sure you're not running out of time because the last thing that you want is to be up against the clock. And that O. R. Team are waiting to wheel a patient into the room and you're still messing around the camera equipment again. Once you're you're there you're going to be recording often back to back cases in the same way you often can't break down the equipment because you know block utilization dictates that the these institutions are trying to get back to back cases quicker than ever. So a lot of the time you're gonna have to plan to be on your feet for a long day and make sure you're respectful of the staff trying to turn around the room, clean it in between cases while keeping the, you know, equipment set up in a way, you're going to be able to capture that. And then at the end of the day you're gonna want a clean down all your equipment and pack out once everybody else is cleared out of the room. Don't be trying to, you know, dismantle camera equipment, take down a job, pull up cables when you know, a patient still being sutured. I've heard of that happening before, Be respectful, you're maybe gonna have to wait an extra hour, but patient safety is always paramount. So make sure you build in that extra time. Don't cut yourself short and don't be impatient with. You know, the people that are there to do their jobs also. Yeah. Thanks scott. I think that's a really good overview of what to expect when you are actually capturing that content in the operating room itself. Um, the one thing I think that we've kind of not covered quite yet is you know, how the physicians actually want to see this content presented to them. Um, traditionally, you know, live surgical content, there's that high wire act. Some of the physicians are concerned about that, but just try to understand when is it appropriate to live stream a case and live presented versus on demand or Simon live where you're basically taking previously recorded content and REBROADCASTING it out with maybe a narration, live narration or live Q and A. You kind of want to talk about how some of our clients kind of tackle those sort of questions again, whether to stream it live, whether to, you know, keep it for an on demand or chapped arise it or slice and dice it up to whatever their their specific needs are or again, having a uh, you know, the previously recorded footage re broadcast live with a physician um member, whether it be the performing surgeon or just another expert talking to the material. You kinda want to talk about how our clients tackle those things. Yeah, that's that's a really good point mike. I would say, you know, 5, 10 years ago. Even when there wasn't that much live surgical footage out there and it was kind of like a super bowl level broadcast or event, it was always live from the, you know, operating room patient in the table. You only get one shot. There's all that planning and that's still as often the case that that we're doing. But as I mentioned before, there's a lot more restrictions in the covid while the appetite remains the same, if not more increased for, you know, these surgical demonstrations. One of the things I will say is there's no real right or wrong answer. I guess. It just depends on your institution and how comfortable you feel with capture and content. A lot of the times that we are producing live surgical demonstration that will be in tandem with an association or a society event. Say for example double O. A. S. One of our device clients has a large booth. They've spent a lot of money there and they want a stand out from you know their competitors that they're sharing the exhibit hall floor from a lot of the times they'll still do a live patient. You know two p.m. There's a total knee surgery happening and they'll try and invite an audience of prospects of physicians walk in the hall to you know, showcase this live surgery in real time and take moderated feeds that is like a high level high wire act that we will often do to make people stand out from the booth and often times with those cases you want a live patient so that the folks the physicians that are in the the exhibit hall can talk in real time with the surgeon moderator that's you know performing the procedure in the operating room. That definitely makes people stand out. There's a lot of planning that goes into it because not only do you need to take care of the I. T. Specifications which we'll get into a second for the hospital and all the planning that we've mentioned before. But you have to do the same at the exhibit hall and with the society to make sure you have a good connection because it's bidirectional you know you're having a moderator there, you're having surgeons there that walking the floor speak live to you know this surgeon who's in the hospital possibly hundreds if not thousands of miles away. We did one where we had the surgeon in bordeaux France performing our shoulder procedure and that was getting beamed in an event in Manhattan and they were speaking in real time between both locations. So that's something where you would probably want to consider a live patient. But more often than not recently we've seen folks still keep a live model but pre record multiple cases and who better and mention some of the specifics of that than her very own kristen chill borg right from the operating room Kristen you want to take it away and tell us a little about that. Thanks scott. As you can see I am here in the O. R. Today and it's taken quite a few steps of planning before even getting here with the nurse manager or the our director and the I. T. Team to plan just to even think about live streaming later. We're capturing about four cases today and that is a shoulder a couple of knees and a hip and the beauty of that is we're getting as much content as possible and it's more cost effective for our client and we are adding a lot of content to their content library. The beauty of that is we can then later take all of that content edit it down, get it through regulatory get it approved and then have four webcasts later where physician and can join live answer questions and do a whole Q. And A. And engage an audience at their own time later. And that way we don't have to come back to the hospital four or 5 times and be here and disrupt the hospital and all of that. But it's super convenient cost effective and works out really well for both us and the hospital and the client. Thanks chris and uh you know appreciate you jumping in here while you're in the operating room uh to join us on this live webcast here scott. You and Kristen have both brought up I. T. As sort of one of you know the boxes that needs to be checked especially if you're talking about streaming a surgery out of the operating room at a hospital facility. What are some of the hurdles and conversations that you need to have and how soon prior to you know actually the day of of the surgical shoot. Do you want to start those conversations with the hospital I. T. Teams and maybe talk about some of the snags that you come across or any sort of the hurdles you ever had to jump across to get this across the finish line and get into the operating room the day of um you know as you're dealing with these I. T. Teams you want to kind of take a swing at that. Yeah for sure mike. And it's honestly often the first thing that we tackle when we know we're going to be streaming something live from an operating room even before the cases are stacked up. Because often you know we'll check the credential and status of the hospital. As we mentioned before we like to work with the nurse manager. Oh our director to see how the cases are stacking up what time we can get in. But often surgeons don't make their patient schedules to a couple of weeks out and sometimes even a few days out so that they know how their cases are stacking up. If we've been planning for this weeks and months in advance we can't just wait to find the patients scheduled to work with I. T. So often that's the first call that we're having speaking to the I. T. And network teams at the hospital making sure they understand what we're trying to do. Making sure that the network that we're going to be on. Any of the provisions that they're setting up for us. Any of the protocols that they're setting up for our poor is going to be separate from anywhere that contains P. H. I. And often hospitals have multiple circuits so we'll be on that circuit and we'll still be able to safely broadcast without you know touching anything that's patient related, which is, you know that the number one thing that we we have to focus on, you know outside of the patient that's on the table, all of that sensitive data that you know, as as part of the hospital's network. Sometimes this is very straightforward. You know, the network team are like that's fine for 56 on the wall of O. R. Eight you're going to plug into that. Sometimes it's multiple calls because they have to, you know, get a new network installed in there. We have to go and do an on site visit to test ahead of time. Um, so it really just depends. So that's why you can never be too early in planning that. And the ironic thing is obviously, you know, Kristen had just mentioned capturing a bunch of cases that she didn't need to stream but in order to to stream to us today from the hospital, she still had to make some of those provisions. So luckily it's a hospital that we've worked in in the past and streamed a live case out of. So it was just a case of plugging back in. So Kristen was able to talk to us there. Yeah, thanks. Got you know, I think you and Kristen have really nailed it that a lot of the heavy lifting on these, you know surgical cases when you're capturing content the O. R. Does take place prior to actually stepping foot in the operating room again, making sure you've checked all of those different boxes, had the conversations you need to have uh did the proper planning makes the day of, you know, I don't want to call it a walk in the park, but definitely makes it as seamless and easy as possible for the traditional producer, whoever's there boots on the ground. The one actually capturing that content. Uh, the other thing you want to kind of talk about to when you are planning these events, you know, scott you made a reference. It's a Super Bowl event traditionally when we're doing a live case. Um you know, live emphasizes there's somebody watching on the other end. So the one thing you want to do, make sure that, you know, as we talk about planning starting as early as possible. You know, if you're doing these live programs, you might want to start thinking about who you want on the other end, watching this, the engagement that you want them to have, you know, making sure that you're set up for question and answer. But don't forget about that audience. So we do recommend, you know, for a live event such as this, you start promoting it building up that audience, generating that buzz that you're looking for at the end of the day again, whether you're doing it purely 100% live or even ramping up to a, you know, tape to live with that Q. And A. Maybe getting that surgeon on the line to answer any question and answers. The one thing you do want to talk about is make sure is just making sure that you are marketing this and again giving yourself enough lead up to make sure that people can make the appropriate time to be available for these programs. Again, Best practice and we have some webcasts that you might want to check out again. There should be links below this video to actually access previously webcast where we talk about driving an audience but you want to start that about Six weeks prior to the live of so kind of work backwards 4-6 weeks is where we recommend the more time you give yourself, the better you'll have again driving that audiences, people need to be reminded getting in that cadence of a weekly cadence of getting in front of them and don't forget obviously the day of and the day before you want to make sure you're hitting these audience members, these um physicians, you're trying to get on the line, they're very busy. So get those reminders out there, get that build up that promotion, hit them from multiple different angles as well. You know, possibly email possibly getting organic posts on, you know, channels such as social media, maybe some paid pay per click or you know, promotional avenues on again, such places such as linkedin or other social media avenues that you're kind of engaging with your physician audience and again, the resources are available with you below if you want to have a chance to look at some of our previous webcasts. And then also the broadcast med team is always happy to kind of help support any of those conversations about driving the physician audience to any of your live events along with producing those events as well. Um, you know, the one thing I wanted to talk before we get into Q and a scott is, you know, tackling different cases and you know, it's, we have a saying no two cases are ever the same. No to live events are ever the same. You know, how do you go about say dealing with an orthopedic case one day and possibly a cardiovascular case the next or a neuro neuro surgery the next day. So, you know, kind of talking through the different cases that we might see and how we tackle those case by case. Yeah. Mike like you say no to procedures are created the same. So that's what goes in the planning of anything that we're doing and again, emphasizes the point and solid pre production. One of the things that I'd like to kind of reiterate that I mentioned before that this isn't shooting a music video or a car commercial or some, you know, short forum where you can have multiple setups, multiple takes the operating room is a very fast paced strict environment. So once you identify the type of procedure, whether it be orthopedic, minimally invasive, you know, whatever type of specialty you're recording, you're gonna have to think ahead and get creative where you're gonna place the cameras ahead of time for the best shots because a lot of the time, once you get set up and locked into that, you know, set up for your cameras, you're not going to be able to move. As I mentioned, it's so fast paced, there's a lot going on. Patient safety is paramount. So you're going to make sure that you work with the staff ahead of time to make sure you get your placement right. Another thing, regardless of the type of procedure. Again, whether it's cardiology orthopedics O. B. G. Y N. You're gonna want a um make sure that you're you're prepared for your your placement. Unlike a lot of the Tv shows that you see an operating room isn't some grand atrium where you only have a star surgeon who can look down the lens and you know, give a Hollywood smile as they're talking away about the procedure and they're doing this kind of in a self contained environment where you have lots of room and lots of different angles you can see here that there's a lot of different bodies and that that make this procedure a success. And you can't just be like move out the way I need to get this angle you need to get creative in order to get the shots that you need. And often camera on a tripod where a lateral view isn't going to cut it. That's why we often use very specialized jobs to get up and over the surgical field. So that if there is a lot of bodies, nurseries, surgical text, surgeon's assistant, any residents or fellows that are getting surgical training, they can still be as successful as they are put patient safety first and we can still get creative in the angles that we're getting here. So with that jib shot, you can you can see here, um, in in this example of a knee surgery, we were able to get a shot that you wouldn't have traditionally been able to get had it been a tripod on sticks. Because in the number of people in the operating room and you can also see here that we're bringing in a surgical field of robotic uh feed an addition, the view of the surgical field. So there's a lot of different things going on and we're able to bring them on screen at the same time. And that goes with that that pre production planning. Now, that being said, don't ever discount the beauty of a wide shot because often with these procedures, you're gonna have to see like the flexion in the knee, the overall results, the final show or the introduction where the surgeons talking down the lens. So that might only be used for 5% of the procedure. But if you are able to get a second camera in there for those you know, examples such as deflection that was just shown, make sure to do it and do it in a safe manner where you can get that. Yeah, scott, thanks. And you know, one thing that you kept mentioning um you know, is the jib and it might be perfect timing right now. I know we have chris and Kristin out in the field currently for that orthopedic shot, let's cut to them in a second. You know, kind of describe what the jib is for some of the production novices possibly watching this program to explain why it's so necessary for some of the, you know, angles that we need special, specifically an orthopedic for some of those overhead shots when we're trying to capture the incision or where the procedure is actually taking place. So we kind of talked about the jib itself, Kristen and chris want to take it away. Thanks mike for those who are unfamiliar with production when they hear jib, they might think of something on a sailboat where and then when they see something like this, it's it's basically a crane arm that's counter weighted and it's got a motorized head and the ability to control the camera, they might say why do we need such a piece of equipment like this in the O. R. Well, the reason why is we want to we want to keep the camera up above the sterile field to also and also to be able to get also almost a surgeon's eye view you know see right over the shoulder of a surgeon from a safe distance before we ever bring this into the O. R. It all gets wiped down with sterile wipes and then for added protection and safety for the patient. We will we will have the the O. R. Staff drape a C arm drape a sterile c arm drape over and so everything is self contained, everything is sterile were even up above the sterile field but because of the control that we have on the camera and the lenses we can get really surgeon's eye view and great visualization on anatomy on procedure from a lot of different angles because of the way that we have control over the over the camera with the motorized head. And a lot of this comes down to scouting locations, talking with the staff and good pre production practices because a lot of ours this this oh are here happens to have great high ceilings which gives us a lot of flexibility in terms of getting great visualization. You know and it's also a procedure based in terms of what angles work best for visualization. But another thing our producers and our production staff to work with is you know in terms of the actual environment and and to really even with a low ceiling with a jib like this, we can we can get some really great shots and capture some really great content. Yes scott you can really see the importance of a jib in making sure you get the, you know, proper shot for those open procedures, the incisions that we're looking for. But we are seeing a shift with robotic assisted procedures, minimally invasive. You know, it takes a little bit of a different approach when you're handling those different types of, you know, cases when you're having those at hand. As opposed to some of the ones that we had mentioned before, like the orthopedic where you need that overhead shot, you know, how are we doing that? Where we're where we need scopes, we need, you know, equipment in the O. R. To pull feeds from, from video perspective, how does you know, a crew kind of handle those different cases at hand? Yeah. Like that's a very worthwhile point there because that's a trend that we've been seeing in general over the last few years, decades, that there has been a shift to minimally invasive surgery when possible a lot of the clients and partners that we're working with our, you know, more focused on what's been done inside the body rather than what's been done incision Aly for these, you know, more traditional open style procedures. So take a vascular venus based approach, for example. Um and the cardiology heart and vascular realm, a lot of what we're doing there Has multiple monitors. You know you have this whole matrix of monitors whether it's flora's capi ultrasound. You know I've all on the screen at the same time and that's really the focal point of the surgery and it's constantly changing because you know these procedures maybe are 45 minutes long. You know the minimize the amount of time that a patient has an open wound so you can kind of set your watch but a lot of the time the 45 hours long and there's a lot of discovery phase. So the surgeons constantly shifting between the I. V. S. The fluoroscope E you know whatever view that they have on this matrix monitor or sometimes they're looking at multiple viewers at once. So you can see in the examples here the importance of being able to pull multiple feeds and still sync that up with a short of the O. R. That may not need to be jib focused. But a lot of the time you're still seeing the nuances of what the surgeons are doing with their hand placement. If they're working with catheters are really sensitive devices you're still gonna want to see that at the same time that you're seeing this. So the amount of preparation is the same you may not have you know the real estate issues that you would with a jab or an open procedure but you also have the the added challenge. You haven't pulled feeds from multiple devices safely. So that's also something that you're gonna have to prepare for leading up to these events, finding out what types of devices. Because not all devices are created the same. There's different outputs, there's different settings. So you need to be prepared ahead of that and make sure you can test it if possible, so that you can get nice clean feeds of all these devices sync up with shots of the surgical team working. So that would be our advice their way minimally invasive surgeries. Yeah. Thanks scott. Um, and I know that, you know, we all like to wish or think that we're out of Covid. But there are some, you know, lingering ramifications and one of them, you know, some hospitals are still limiting. Um, you know, essential people in the o r only essential staff. So there are some hurdles from, you know, boots on the ground getting people in the operating room to this day. How are, you know, our client's house broadcast met, you know, using some of our best practice to overcome some of those hurdles that are still in place. And, you know, for the foreseeable future may still remain in place with all the different variations and waves of Covid that still could be coming. Unfortunately. Um, you know, you want to talk about that. That's a very valid concern had mike. And unfortunately, you know, regardless of the experience of the crew and how vetted we are in the hopes that we jump through, there are still some institutions that you know, won't let non essential personnel in. And that includes video staff, you know, even some reps or having a hard time getting in certain parts of the country or you know, the world. So we are have a portable broadcasting cut that, you know, we've mentioned before them. You can click on the view previous webcast to get a deeper dive into that. I won't ramble on too much. But basically it's a studio in a box that is a cost effective way to capture a multitude of different content, whether it be didactic symposia based talking heads or surgical. We've kind of retailed that to be completely remotely controlled in that sense. We would identify, you know, hospital device company with the key, the key opinion leader, a high volume surgeon and essentially install this satellite version of the portable broadcasting kit in a dedicated operating room or area of the hospital, for example, or our friends at Sentara, we installed one in our cardiology department. Once it's set up there, you know, we we make the appropriate calls and that pre production that I mentioned before. That's all important. We get that set up once it's set up, it's kind of a set and forget it model and act squatter's rights and it's there for that surgeon in that institution. They basically tell us, okay, broadcast med next friday, we're going to be doing a tavern procedure at two p.m. And we don't need any boots on the ground. We don't need any traveling production. We just need to know the procedure the time. If we're streaming it live or you know, if we're just capturing cases either way, we're ready to do either situation and we'll remotely get into that equipment. We have remote control cameras, pan, tilt zoom, we can take, you know, different shots, we can take different feeds. We can have all that set up wireless audio, picture and picture to be able to get the same elevated production that a client would come to expect from a broadcast med production. The only thing I always say is just to remember that your microphone has a fresh set of batteries. That's all the surgeon needs to remember and then we'll take care of the rest. And there is other solutions that do exist for that. You know, that there's these hybrid Uars and these other types of camera devices that can be bought for hundreds of thousands of dollars and installed and those function more like surgical equipment than they do this kind of studio solution. It's portable and cost effective. And the beauty of doing it with us is we don't charge an hourly rate to record. We don't charge you to pull your files. So just something to bear in mind when you're considering this and considering your budget, this entire example, I mentioned before for this tab, you can see here that not only were we able to run it completely remotely. Um, one of the internal levy guys still, you know, had some time and wanted to be an extra camera shot and were never designed to take the place of hospital levy were designed to extend their bandwidth because a lot of the times they're spread really thin and they have to focus on the BBC, the, you know, consumer being the patient and creating patient content rather than being able to film surgical procedures. So we'll let them integrate with your equipment. There, there's no stepping on toes were designed to, you know, really strengthen the band with and this, you know, applies beyond the operating room and beyond restrictive areas. This can just be a cost effective solution that we can remotely control and be used for, you know, volume. You can see this example here that we did for our friends at cooper surgical, they streamed it live, but they've also did it on demand when we had multiple shots here integrating our portable broadcasting cat with, you know, a cadaver labs cameras. We pulled in those multiple feeds, we pulled in feeds from the device, the robot that was in the room and we brought it all together with wireless audio and created a high level production. So it's a very long answer to say there is things that exist there, there's different costs, tears, but it's something that we have experienced from long before Covid and we expect to keep doing as clients are, you know, controlling costs and trying to get over these prohibitive times. Yes scott. We never know you to be won on the brief side of answering some of the questions there. But you know, to reiterate, you know, the P. B. K. One of the things I will say that was a God center in Covid, especially early days of the pandemic were those robotic cameras, you know, being able to leverage equipment to your point, very high quality. Um, without having to put physical boots on the ground. We got it set up by the hospital staff. We designed it to be user friendly. Was actually designed pre Covid to have. Um, you know, be used by our clients themselves who might not be the most savvy when it comes to production. Audiovisual. So it's really a simple color coded cords and cables to be plugged into a laptop that all fired up the software that we needed and allowed us to really not have to put boots on the ground and still get that appetite for that. You know, the content that our physicians were looking for at the end of the day are live surgical content. Again, just without getting those boots on the ground and really bypassing a lot of those restrictions that we kind of talked about. Um, that there does wrap up our content scott. I think we got some question and answer. We can go into right away. Um we have an inbound inquiry from a julie um patient consent. How does your team handle hipAA concerns and filling out patient consent forms when dealing with a live patient uh scott. I know you have a ton of experience with both your hospital clients and back in your days as a producer. You know, how do we tackle that from a patient safety patient concern on the patient release forms? That's a fantastic question there julie. And you know, it just kind of goes back to that pre production thoroughness and having all your your ducks in a row. Um a lot of the times the hospital will have consent forums because you know, they have it as their standard practice and we'll insist when we're working with the nurse manager, know our directors that we get that done ahead of time. And normally the surgeon will take care of themselves during the pre op process if we're doing this on behalf of a device company or a third party. Normally they have to, you know get their that the documents signed for their company since we're acting as a subcontractor for them. So they'll have the pre vetting document that's approved by their legal and regulatory team and we can also help with that. You know, we've produced enough original content that we can, you know, provide some of your clients or you know future clients that are smaller and don't have these in place. We have templates we can adjust and cater for. So that is a great question and something that would be included as part of the pre production that normally larger institutions will have already. So sometimes it's up to you just to give them a little nudge and reminder. Thanks again julie. That was a really great question. We actually have another one on a similar vein about hipaa compliance with patients. How are you able to ensure that no HIPPA or ph i information is leaked or disclosed during a recording um, really goes back to, you know, some of that pre planning that we have mentioned. You know, we're working with the all the appropriate players, all the groups that were working with to ensure that none of this is, you know, any of it is even available even all the way down. You know, making sure that we're blacking out any um, you know, name recognition, any identifiable information when we're pulling feeds from the O. R. Operating rooms or machinery. Excuse me. Uh, you know, making sure that the patients, if they have any identifiable tattoos or markings are covered or not in shot all the way down to literally scrubbing whiteboards, making sure that, you know, if there's a schedule of patients that are listed by last name or any other, you know, identifiable metric. We are making sure that's that's out and not in the opening very, very, very diligent during the live process. Any of the prerecorded continents on for a later time. That does go through a rigorous editing phase where we are, you know, double checking, triple checking for any of those that you know, might have slipped through the cracks. But again, our team with our planning especially if we're doing anything live, we do do go through all the checks and balances to make sure that no ph I know hipaa sensitive data is leaked throughout that process again to make sure that this is all above board really comes back down to that planning phase that I had mentioned before. Um scott any other comments or you know, kind of feedback on that topic as well. No mike I think you nailed it there and it is really nice to see so many people asking questions that are around patient safety because again, that is what always comes first. We do have a question here from a from a surgeon themselves asking um, I record all of my procedures, you know, just kind of interpret this using the built in scopes and hybrid all our cameras. I'm assuming that's what this means. How can they then get that footage ready for live delivery? That's a great question. Thanks for passing that on to me scott. That's where I think post production and editing comes. But we really talked about all of the ramp up to actually capturing the content, capturing the content itself. You know, don't discount continents already in existence. You know, don't go and reinvent the wheel if your physicians, your K. O. L. Have content and you honestly be shocked and surprised at how many doctors are sitting on a legitimate treasure trove of content on their shelves collecting dust and hard drives or in, you know, accounts somewhere in the internet nether realms. Um you know, that's really where editing can really come into play. We kind of talked about capturing the content and to get down for, you know, a you know, live airing of that content or a live narration. Do the same thing, doesn't matter when it was recorded, as long as it's relevant and engaging. Um there's there's an audience for it. So really identifying that content, leveraging editing resources, whether you're leveraging a company like Broadcast Med, internal A. B team or even a self, you know, self record tool of sorts out there. Um you know, there's no problem with shining it up. And then again, really having that same surgeon and one that recorded it, you know, edit down one or 2345 cases depending on how long they are, what the content or subject matter is and having them available literally just hit play for the 35 minute 45 minute program and bring that physician back on for the last 15 minutes, come back on, answer your peers questions, have any of those challenging questions that come through, but don't discount that content that already exists. Just again because um, you know, there's an appetite for live content engaging content because it doesn't already exist, doesn't mean that it's not new and fresh and engaging for our physician audience. Um, but that's, that's the one thing I would have to say on that topic again, don't discount content already existing, leveraging editing services to make it new and then bringing on that live component. So the physicians that are watching the physicians, audience members can bounce that question off the expert of the surgeon at hand. Anything else you want to add to that scott? I think you hit the nail on the head there mike. One of the things that we really noticed during our audits when we're onboarding new clients, whether they be device or hospital is a lot of the times, they're just not aware how much existing content already exists for. You know, the top performance surgeons there, coal's their high volume surgeons. So that's something to check on, you know, as mike says, don't try and reinvent the wheel or give yourselves additional costs if it's already being recorded. Now, some of those recordings, you know, the overhead light cameras and the feeds that you're getting for device might not be, you know, of good enough quality to merit spending a lot of money and you know, to showcase an innovative procedure that only your hospital is doing. but you know, a lot of the time that you'll be surprised with how good they are and then any of those ones that you need to elevate can always be supplemented so make sure to check in with those high volume surgeons. Alright, thanks scott. We have time for just one more question here before we wrap and uh I just want to remind everybody at home who you know, there are some questions we don't have a chance to get to because we ran over on time today, we will be reaching out and answering any of your questions individually to make sure that all your questions and concerns are answering a timely fashion. So keep an eye out if you didn't hear your question asked today and scott, the last question that we have here is what had, what is your experience with physicians comfort level of doing a live case. We've definitely had a mix of doctors that are more comfortable in front of the camera. Um, scott you want to kind of take that one. I, I know that the initial swing I would take is, you know, it's really just kind of want to judge the physician's comfort level when they are in front of the camera. Some are, you know more charismatic than others, but I know you have a lot of experience in this field, you definitely want to kind of take a swing at it. Yeah, for sure mike and a lot of time we'll we'll find that out ahead of time, you know that the marketing team either at the device company or hospitals will normally tell us if the surgeons on the shyer side or a surgeons, you know, a celebrity in front of the camera and that is partly one of the reasons why we chose to do the pre record approach. The surgeon doesn't have to narrate, they can be in the zone while they do the procedure and then they can record the track afterwards. We can edit it down from an hour, 20 minutes. Reconnect with the surgeon, send out a microphone and have them, you know, do that track and then also talk to it live. Another thing that, you know, with those shy surgeons or surgeons that you know, we're comfortable speaking but needed a better prompt. Oftentimes would get one of their colleagues if they were available to be the moderator um, and they could be in the same room when a wireless microphone and asking questions or even explaining why surgeon was doing a particular technique. We've also seen this, you know, on behalf of the device companies that will work with some of these wrecks are just as in tune with the devices and the approaches as the surgeons themselves. So having them in the room to moderate and be these additional, you know, voice of expertise during the procedure is something that we've seen. So figuring that out as part of your pre production and setting up the type of production you want accordingly is something else that we've seen? All great answers scott and I just want to say thank you to you for joining me today as well as kristen and chris out in the field um for all of you at home, thank you again for joining us and we do hope you join us next time uh next month when we're gonna be talking about U. S. News and World Report and hospital reputation and how to improve that. Especially now um with rankings coming out in the next week, we really hope that you'll be able to join us and thank you all again and hope to see you all soon, have a great rest of your night.