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PODCAST 176-1: Macquarie University Renovates Surgical Skills Lab

Show 178, Part 1

SVC Podcast – Show Notes – Show 178-1

In this edition of the SVC Podcast, Contributing Editor Bennett Liles talks with Iain Brew, the Clinical AV and IT Coordinator at Macquarie University in Sydney, Australia about the recent technical overhaul of their advanced Surgical Skills Lab. The facility had an outdated proprietary video distribution system and had become difficult and time consuming to use. Iain led the team of faculty members who accomplished the entire project in-house. He discusses the cabling, signal extension, iPad control and the tight time window in which they had to work.


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This is the SVC Podcast from Sound & Video Contractor Magazine with Iain Brew of Macquarie University. Show notes and equipment links for the podcast are on the web site of Sound & Video Contractor Magazine at

Sydney, Australia’s Macquarie University just finished a massive upgrade of the AV system in their surgical skills lab where older and new equipment had to work together. Clinical AV and IT Coordinator Iain Brew led a team of faculty members for the installation and did an award-winning job. He takes us inside the project, next on the SVC Podcast.

Iain, it’s a real treat to have you with us on the SVC Podcast coming to us from Macquarie University in Sydney, Australia. The more I read about this massive AV tech upgrade in your surgical skills lab there, the more fascinating it got especially when I learned that it was all done in-house by the same faculty members who are using the lab. It sounds like you’ve got some very special people there, so tell us about Macquarie University.

Sure. Well, thanks for having me on your podcast. So I’m Iain. I’m the Clinical AV and IT coordinator for the Faculty of Medicine and Health Sciences at Macquarie University. We’re quite a young university. We were founded in 1964. We’re located in Macquarie Park, which is sort of in the northern part of Sydney. Some quick facts about us: we’ve got over 40,000 students and we also have our very own private hospital on our campus, which is quite a rare thing. As I said I work for the Faculty of Medicine and Health Sciences and just to help support, amongst other things, our surgical skills lab. I guess one way to think of the surgical skills lab is having 10 operating theaters in one massive room. And we use that space with our medical community and students to explore things like human anatomy and demonstrate surgical skills and techniques. So, for example, in the last few years we’ve trained over 1,500 physicians from all around the world in that space. The space itself has quite a few challenges. So, for example, we can have up to 60 people in a relatively conservative-sized space. So in terms of AV it’s really important that we have some clarity for audio and also the ability to see clear pictures wherever you are in the lab. [Timestamp: 2:21]

This was a very big project for the surgical skills lab to replace the existing old technology video system. Before jumping into the deep end of the pool with this, had you done any previous AV projects or installations at the university?

This is the largest thing I’ve done with the university. In the past I’ve done a few other projects. We had, in 2010, a digital signage pilot and I got involved with that and helped design a large 3 x 3 video wall for our new library at the time. And I used some video over IP products back then which was quite exciting. Moving on from the success of that installation I was engaged to design what we call Studio 750 because it was located in Office 750 in our Business and Economics Department. That was a self-service media studio for academics. So media and video content and multimedia is becoming more and more important in our education, but in terms of generating that content there’s only a handful of professional media people on the campus that can do it. So we wanted to empower our academics to be able to do it themselves. So I built this space for them that uses an iPad controller and that went very well. And so when I moved across into medicine I did a small meeting room upgrade. And that inspired some confidence which then allowed me to do a small control and audio upgrade of our simulation lab, which inspired further confidence, which then opened the doors to allow me to do a complete refresh of a larger space. [Timestamp: 3:49]

And so faculty are training students in a very realistic medical environment but the existing video system didn’t seem to be working as well as you needed it to. What was the problem with the previous AV system in the lab?

The previous system was installed when the building was originally built in 2010 and unfortunately hadn’t been touched since. So it’s a proprietary system that never quite worked the way anyone wanted it to work. So for example, there’s very limited routing and control capability. So as I mentioned, it’s sort of 10 operating theaters in one big room so each operating theater – or as we call them pendants that hand from the ceiling – has a surgical-grade, full high-definition monitor, inputs and a speaker. And that’s replicated 10 times. However, there’s a teaching station and that could only route S-video to the other displays. That was it. That was the limit of our routing capability previously. So we would have a situation where the teacher or the demonstrator would be showing a technique on a model or something along those lines and then want to show all the students or scholars in the class. So our poor lab coordinators would have to go around to each and every display and change the input by hand. Then when the demonstration was finished go back and do it all again to go back to local inputs. So that wasn’t great. And in terms of inputs there was analog routing throughout the entire facility, so there was no sort of unified signal format. So every display had S-video, DVI via fiber, VGA and SDI and control so there was just cables everywhere. We pulled out two cubic meters of cabling and there’s still plenty left in the roof. Along those lines in terms of cabling we often had with newer computers and high-definition sources, which weren’t as popular back in 2010. We had a lot of EDID issues, things not syncing properly or syncing at weird resolutions or not high resolutions. Even though we had a high-definition display we could never get a high-definition picture out on it. And due to the cost of the system and the cost of the proprietary control system, we would have to go and get a dedicated programmer out if we wanted to make a change or improvement. And that was quite a prohibitive cost. So as a result, like I said before, things didn’t get upgraded, problems didn’t get solved, and it just slowly broke down over time, especially because we don’t own the source code for the system. We’re not allowed to have access to that. We don’t own the rights to it. So we though right, it’s time for a change. Let’s do something better. [Timestamp: 6:11]

That would really complicate things if you can go out and buy something of a different make and model but not be able to program the system to control it or make it work.

That’s right. And it was quite an expensive system as well, so it was quite disappointing that we were sort of left in a situation where we could just jump in and make a change ourselves. But it’s one of those systems where you need to have accreditation and years of training before you’re even allowed to be let loose on those systems. So it just doesn’t quite work the way we work anymore. [Timestamp: 6:36]

Yeah and I can imagine how the S-video looked running around through all of those high current systems putting out induction fields and it was far from the best in showing the high detail that they need to have in the lab.

That’s right. So for S-video, we have a lot of medical equipment which has quite a lot of output options on it. So they were using the S-video, which is probably the lowest-quality output available in those devices. It works, and we do get a reasonably decent picture, but you put a picture from that next to a high-definition output on the screen there’s just no comparing them. S-video was soft. We didn’t really have much interference, which was quite a surprise for me when I first started working in the space. The signals themselves were fairly decent quality. However, the cabling was really top-notch, Belden good stuff. So I’m not surprised we didn’t have that much interference. But it was more the actual picture quality itself – soft, lack-of-detail. For what we’re doing that’s not really going to cut it. [Timestamp: 7:32]

I was looking at some of the images in detail and it looks like you had an NEC projector on the ceiling for the big view in the room. Was that new or a part of the existing system?

That projector was existing. It replaced a projectiondesign F12 back when the building was built. And it wasn’t quite cutting it at the time because it’s a very bright space. It’s full of fluorescent lighting and also there’s 10 medical lights. And one entire side of our lab is just natural light coming in from windows. So it’s an incredibly bright space. So they replaced it with the NEC PA-550 projector. So we have 5,000 lumens, 1280 x 800. Originally had a whole ton of connections feeding into it for all different signal types in the lab, however now we’ve just replaced it with one single CAT network cable with a video over IP receiver which just feeds a full HD signal in via HDMI no matter what our input is. So it’s really cleaned up the roof space. [Timestamp: 8:26]

It’s remarkable that you were able to use that much existing equipment and blend it with the new high resolution video distribution. But the most remarkable thing about it to me was the fact that you didn’t call in an AV contractor for this. The entire project was handled by faculty members who will be using the new setup.

That’s right. So when I joined the faculty last year in 2016, I did a full sort of audit of the system – every nut and screw and bolt and every piece of equipment – and looked through it. I talked to all our faculty stakeholders. So our Director of the Lab Associate, Professor Richard Appleyard, our Surgical Skills Coordinator, Dr. Janos Tomka, and amongst other people students, teaching staff, professional staff and I formed sort of a refresh plan for our faculty. And so the first cab off the rank was our surgical school. That’s where we identified the strongest need for improvement. So I designed all the systems and sort of engaged with different companies to look at different products, attended tradeshows. Just called people up and like, “Hey, I look at your product. Can you send one out to me for a week?” And it was quite great that companies would respond to that. There was a bit of surprise that I’m not an integration company, but never mind. Once the project got some budget and got some legs we bought all the equipment ourselves and like I said, we all pitched in so we were up ladders pulling old cabling out of pendants and designing new wall input panels and things like that with our hospital facilities team. So that saved a lot of money as well, but it means that I think we take a lot of pride in the work we’ve done because we did most of it ourselves. So it’s something we’re very excited about. [Timestamp: 10:03]

It would seem that the faculty members, since they installed all of this, would have a big start on how to operate everything. They can control all of these video sources and distribution on an iPad Pro tablet?

I’m using a project from a Russian company called iRidium Mobile. I’ve been very impressed with their software. I’ve used other products in the past, but though they were useful, but just not very powerful. This iRidium software I feel is as good or even better than the other big players in the market such as AMX or Crestron. So for our installation in this lab I’m using iPad Pro 12.9 inch, which we have wall mounted onto a panel of wood. Something I’ve done a little bit differently is instead of using Wi-Fi for the iPad we’re actually using an Ethernet so that way I’ve got a very secure connection back to the control systems. One of the concerns about Wi-Fi for me is if it drops out or the iPad loses a connection then our entire lab stops working. So at least by using an Ethernet adapter, which was a new thing for me to find that the iPads can actually support it. In terms of the software we’re using Version 3 of the software. It’s the latest version. The way it works is there’s a Windows program and it’s a what-you-see-is-what-you-get type interface. So you create pages and popups. On those pages you can drag graphics from the program yourself. For us, I us Photoshop to make all my buttons and headings and titles and control things mainly just so that it would be on our new brand so it has the same colors and look and feel as the university. And then on the right-hand side of the interface you have all your devices, commands, syntax and tokens, which you use for logic and things like that. So it’s all drag-and-drop and you can also get under the hood because really under the hood the whole thing is just JavaScript. So if you want to do something a bit more detailed or a bit more complicated you can just get under the hood, write some JavaScript and you can do all sorts of amazing things with the software. It can be deployed to not only iPads, but you can also deploy to any IOS device, any Android device, and any Windows device. So I can build one control system and roll it out to multiple different devices without having to change a thing, which is quite good. But for now we’re just using iPad. [Timestamp: 12:20]

Getting all of this in and working right was a lot to do and you only had something like six weeks to get the job finished?

Our surgical skills lab is one of the most heavily-used labs in the southern hemisphere, actually, for all the programs we do, so there’s not a lot of downtime. So there’s a lot of preplanning, a lot of pre-work and testing prior the build. But the actual build, it’s a date that is probably ingrained into my memory forever now, Monday, 19th of December 2016 is when we started pulling roof tiles out and ripping old pieces of equipment out. And then six weeks later, sort of mid-January this year, 2017, we were up and running. Of course there was a few little bugs or little things to sort out, but within a six-week period we went from the old lab to a completely new space. [Timestamp: 13:06]

You certainly did a great job on the wiring. I’ve seen some of the pictures and with all of that high tech gear all over that room, I barely see a wire anywhere.

I bring people into the lab and I’m like half the work is in the roof and you can’t see it any more. (Laughs)

Yeah, most of the hard work you did is completely out of sight and that’s probably the way it should be. But all of those moving arms and swiveling platforms, that must have been a real job threading cable through all that.

That was a challenge because we’ve never done that before. We were kind of figuring it out as we go along. Luckily we have a biomechanical engineer who was very helpful in figuring things out for us. The first one we did, it took about four hours for us and three people to try and wrap the cable through these impossible small, little channels and little elbows and armatures throughout the whole system. But we became quite good at it in the end, so yeah. [Timestamp: 13:57]

And I take it you got fairly good support from the equipment companies like Gefen and the others.

That’s right. So for the sort of the heart of our system is, as I mentioned, the control systems are iRidium Mobile and it’s the one I’ve been using for probably about a year now on other projects, like I mentioned the previous upgrades I’ve done for the faculty. And I had some great support from Jackie Roos at JAMWARE, which is located in New Zealand next door to Australia, who is our distributor for iRidium back in Russia. So lots of emails and questions and, “Can I do this?” and “How do I do that?” and things, but she was fantastic. Our video system is all over IP so I feel that’s the way the AV industry is moving now. Everything is going on IP rather than dedicated analog or digital cables. So I selected the Gefen video over IP, which is quite new and I worked very closely with Rod Sommerich here in Sydney, Australia and he gave us incredibly great support. So sort of June and July last year he provided loan equipment and came out for a few days and answered questions and went over my plans and helped me design things – and helped with the networking side of things. And did absolutely fantastic. So I really recommend to people looking for video over IP products definitely give Gefen a go. [Timestamp: 15:14]

Well, it’s been interesting getting the details on this project, Iain and we’ll talk more about this one in Part 2. It’s Iain Brew, Clinical AV and IT Coordinator at Macquarie University in Sydney, Australia. Complete re-do of the Surgical Skills Lab and all done within a very tight time frame. Thanks for being with us.

My pleasure.

Thanks joining us on the SVC Podcast. Show notes and equipment links are on the website of Sound & Video Contractor Magazine at Next week Iain will tell us about the sound system in the Macquarie University surgical skills lab and the challenges of making all of the existing AV equipment talk to the new gear. Coming up next time on the SVC Podcast.

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