Int J CARS DOI 10.1007/s11548-017-1589-2 ORIGINAL ARTICLE OR.NET: multi-perspective qualitative evaluation of an integrated operating room based on IEEE 11073 SDC M. Rockstroh 1 · S. Franke 1 · M. Hofer 2 · A. Will 3 · M. Kasparick 4 · B. Andersen 5 · T. Neumuth 1 Received: 13 January 2017 / Accepted: 10 April 2017 © CARS 2017 Abstract Purpose Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treatment, and care procedures. During the German flagship project OR.NET, more than 50 partners developed tech- nologies for an open integration of medical devices and IT systems in the operating room. The aim of the present work was to evaluate a large set of the proposed concepts from the perspectives of various stakeholders. Method The demonstration OR is focused on interventions from the head and neck surgery and was developed in close cooperation with surgeons and numerous colleagues of the project partners. The demonstration OR was qualitatively evaluated including technical as well as clinical aspects. In the evaluation, a questionnaire was used to obtain feed- back from hospital operators. The clinical implications were covered by structured interviews with surgeons, anesthesiol- ogists and OR staff. Results In the present work, we qualitatively evaluate a sub- set of the proposed concepts from the perspectives of various B M. Rockstroh max.rockstroh@medizin.uni-leipzig.de 1 Faculty of Medicine, Innovation Center Computer Assisted Surgery, Universität Leipzig, Semmelweisstr. 14, 04103 Leipzig, Germany 2 Department of ENT Surgery, University Hospital of Leipzig, Leipzig, Germany 3 Center for Information Technology, Schleswig-Holstein University Hospital, Luebeck, Germany 4 Faculty of Computer Science and Electrical Engineering Institute of Applied Microelectronics and Computer Engineering, University of Rostock, Rostock, Germany 5 Institute of Medical Informatics, Universität zu Lübeck, Lübeck, Germany stakeholders. The feedback of the clinicians indicates that there is a need for a flexible data and control integration. The hospital operators stress the need for tools to simplify risk management in openly integrated operating rooms. Conclusion The implementation of openly integrated oper- ating rooms will positively affect the surgeons, the anes- thesiologists, the surgical nursing staff, as well as the technical personnel and the hospital operators. The evalu- ation demonstrated the need for OR integration technologies and identified the missing tools to support risk management and approval as the main barriers for future installments. Keywords Integrated operating room · Intelligent OR · OR.NET · IEEE 11073 SDC Introduction Clinical working environments have become very complex imposing many different tasks in diagnosis, medical treat- ment, and care procedures, which must be dealt with by the hospital staff [1, 2]. The operating room is an especially criti- cal working environment [3–5]. The work of interdisciplinary teams is based on data from a large variety of sources, and highly specialized medical devices from various vendors are used to implement sophisticated surgical procedures. The technical complexity of operating room (OR) setups is still increasing [2, 6–10], and the technical equipment of ORs is yet a significant source of incidents and adverse events [9, 11]. The various opportunities and challenges of digital, inte- grated ORs have been identified more than a decade ago [6, 12, 13]. Especially the development of an integration infrastructure based on open standards emerged as a research field wherein several projects mainly addressed the general 123