Doctors Without Borders

Nestled in the Salt Lake Valley, the new 1.5 million-square-foot Inter-mountain Medical Center (IMC) campus in Murray, Utah, is the largest and most advanced medical facility in the region. With 26 operating rooms and an education facility, there's nothing small about Intermountain Healthcare's new flagship. Every facet of the medical campus is state-of-the-art, and its high-tech AV system is no exception.
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Doctors Without Borders

Nestled in the Salt Lake Valley, the new 1.5 million-square-foot Inter-mountain Medical Center (IMC) campus in Murray, Utah, is the largest and most advanced medical facility in the region. With 26 operating rooms and an education facility, there's nothing small about Intermountain Healthcare's new flagship. Every facet of the medical campus is state-of-the-art, and its high-tech AV system is no exception.

The primary goal of IMC's Doty Family Education Center is to deliver a highly versatile and flexible training for doctors and staff. To this end, the center's AV systems–installed by systems integrator General Communications of Draper, Utah–interconnect in a full audiovideo matrix, allowing for audio and video sources to be routed to and from multiple rooms over Cat-6 cable (each room's AV system can also function as a stand-alone unit). Moreover, any room–eight classrooms, a boardroom, and a sub-dividable auditorium–can serve as an overflow for another, and when necessary multiple rooms can support multiple other rooms simultaneously. But the big trick was building in the flexibility the client required so that people could move throughout the facility and communicate seamlessly.In fact with so many wireless and fixed microphones involved, feedback and equalization issues inevitably arise, requiring General Communications to embed sophisticated programming of audio digital processing into the setup, which includes Biamp Audia Flex and Nexia systems throughout to manage audio signal processing, mixing, and routing.

CHALLENGE: Develop wireless microphone system that complements videoconferencing capabilities and enables communications between operating rooms and educational training spaces without restriction.

SOLUTION: Design integrated AV system that seamlessly routes audio and video signals from one room to another, providing an interactive, flexible teaching environment.

Nestled in the Salt Lake Valley, the new 1.5 million-square-foot Inter-mountain Medical Center (IMC) campus in Murray, Utah, is the largest and most advanced medical facility in the region. With 26 operating rooms and an education facility, there's nothing small about Intermountain Healthcare's new flagship. Every facet of the medical campus is state-of-the-art, and its high-tech AV system is no exception.

Seeing Is Believing

Although the sheer complexity of the AV system is transparent to the medical staff using it, the solution took some serious planning–18 months just in conceptualizing the flow, says Jeff Allred, public relations multimedia director at IMC. "You either have to make it complex at the beginning or the end," he says. "We chose to put it into the programming because we knew that our end-users would always [vary]. We couldn't rely on having dedicated people to operate a complicated system."

The design and installation took approximately 10 more months. A separate engineering company drew up the initial AV blueprint, but, according to Allred, "we wanted to do certain things that the original system just wasn't engineered to do."

General Communications came in to do some value engineering, as well as make changes, adjustments, and upgrades to fashion it exactly as the customer had envisioned. The original AV budget on the project was $620,000, however to get the system where the client wanted it, the final tally was almost $200,000 higher.

One of the cooler features General Communications added was the ability for wireless-microphone users to travel between rooms using the same mic and bodypack transmitter. In this system, mics are not restricted to a specific location. Although the company had completed similar installations before, it had never tackled wireless flexibility on this large a scale, says Colby Rytting, health care development manager at General Communications.

"Quite frankly, when we looked at the concept to begin with, we wondered if it could even be done," Rytting admits. "Normally, if you are wearing a mic that has a bodypack transmitter, it's going to communicate to just one wireless receiver in that particular room. In this case, we needed someone to be able to take any one of 10 wireless mics, walk into any of these spaces, and it would behave as though it was assigned to only that room."

With the help of the staff at Shure, a solution was designed that made wireless roaming possible. The systems integrator deployed 10 Shure SM48S microphone lapel microphones with ULX1 wireless bodypack transmitters to ensure each room could be covered through seamless switching without restriction. To make this functionality transparent to users, most of the complexity was built into the central control room behind the scenes.

In the control room, along with the central switching/routing system, are AV sources that can be routed to any of the AV systems, including the receivers for the 10 wireless mics. When a wireless microphone is checked out, the control room technician routes that microphone signal to the room it's being used in via the control room touch panel.

From there, according to Rytting, the challenge was building a wireless microphone antenna array that could pick up any microphone anywhere in the education center. The company didn't want to give too many details about its proprietary solution, except to say the array is distributed throughout the center and feeds the wireless receivers in the control room.

Staying In Control

From the control room, the full-time facilities manager can route any AV source from any of the classrooms, boardroom, or auditorium. The system can also transmit audio and video from 11 operating rooms in another building on campus to the Doty Education Center via fiber-optic cable and display it in any of the rooms. Participants in the auditorium can talk back to the operating room via local microphones.

"When you're establishing two-way audio microphone communication between the auditorium and the operating rooms, all of a sudden now you're dealing with the potential of an echo loop being generated between the two locations," says Rytting.

Rytting's team solved this problem using digital signal processing in the audio mixer/router. "You have to make sure you have all of your signal processing down pat so that you've got good clean audio communication going on between the two endpoints."

A view of the auditorium from the central control room where a full-time technician routes audio and video from eight classrooms, a boardroom, an auditorium, and 11 operating rooms in another building on campus via an extensive AMX control network.

In the operating rooms, the AV in up to four of the spaces can be routed simultaneously to any of the rooms in the education center. A Polycom VSX 8000 videoconferencing codec allows participants in the auditorium and the doctors in the ORs to talk with one another. Audiences in the classrooms and the boardroom can listen and watch the conference, but not participate in the two-way communication.

Describing a typical application of the overall system, Rytting explains, "Let's say you have neurosurgery going on in one of the operating rooms and a group of doctors and medical students in one of the auditoriums viewing the operation in real time," he says. "We can route the audio and the video from that operating room and display it in the auditorium. Using wireless microphones, they can talk back and forth to the OR, actually conversing with the surgeon while the surgery is going on."

Staying In Control

To hide the sophisticated solution from the end-user, the integrator designed simplified touch panels in the individual training spaces to ensure ease of use. "Because the educational facility doesn't shut down until 9 at night, when the full-time tech guy has long since gone home, the touch screens have to be simple enough for a nurse to operate," says Allred. "They need to be able to walk in, hit a button, and they're good to go. The integrator designed very simplified icon choices for them so they can run it without being intimidated. Then the more complex touch control panel is in the control room."

An extensive AMX control network serves as the brains of the entire system. AMX NXF card frames, which not only control the local AV systems but also enable automatic room combining of up to three rooms in two different sets, and AMX touch panels are used in the classrooms and the auditorium, while the boardroom is controlled using an AMX NI-4100.

The ability to combine rooms is key, according to Rytting. In doing so, the client can quickly configure two AV systems located in adjacent spaces so they behave as one system. For example, the two auditorium spaces in the Doty Center are separated by a retractable wall. When the wall is retracted, the AV systems in each auditorium space automatically combine into a single system that covers the entire combined space. This functionality is also available in the classrooms.

In the central control room, another AMX NI-4100 manages all intersystem routing as well as the specific AV systems in any of the spaces. All of the control processors are linked together over the campus' IP network with AMX's Room Management Suite, deployed to manage all systems and their attendant assets, including Sanyo projectors, Atlas loudspeakers, Da-Lite projection screens, and Stewart Filmscreen electriscreens.

According to Rytting, on a project with this level of AV sophistication, every last detail counts. "A lot of people can slap designs together, but it's the details that will kill you in the end if you're not paying close attention," he says. "If you're going to take a really complex design like this, you must be very granular with it, thinking it through down to the Nth degree and making sure every last bit of it works. In this case, that kind of attention to detail really paid off."

Ellen Parson is a Pro AV contributing editor and freelance writer based in Lee's Summit, Mo.

Full Equipment List

General Communications installed the following equipment at the Intermountain Medical Center System in Murray, Utah.

Amicus Boardroom

1 AMX NI-4100 controller
1 AMX PSN4.4 power supply
1 AMX NSS-RMSACL asset management client license
1 AMX NSS-RMSSCL scheduling client license
1 AMX NXC-NH hub card
1 AMX NXC-VOL4 volume card
1 AMX NXD-CV10 wall-mount touch panel
6 Atlas FA136T47 speaker
6 Atlas FA720-6 grille
1 Bitronics YV-TCS417M S-video cables
1 Chief CMA-440 ceiling adaptor
1 Chief RPM-U projector mount
200 Commscope 7504 plenum Cat-6 cable
1 Da-Lite 40973 low-voltage control
1 Da-Lite 92592 Advantage deluxe Electrol 50X67
165 Extron 22-103-03 plenum RGB cable
800 Extron 22-142-03 plenum skew free cable
1 Extron 60-300-02 AAP
1 Extron 60-373-1x RGB 460xi dual
1 Extron 60-375-0x RGB468xi
1 Extron 60-569-01 IN1508
2 Extron 60-604-20 RSB 123
1 Extron 60-637-21 MVX 84 VGA A
5 Extron 60-670-01 MTP R 15HD A
5 Extron 60-669-01 MTP T 15HD A
6 Extron 70-090-11 AAP blank
1 Extron 70-091-12 3 BNC
1 Extron 70-093-71 2 RCA
1 Extron 70-093-72 3 RCA
1 Extron 70-103-14 2 female XLR
1 Extron 70-404-11 VGA w/ BNC pigtails
1 GC Rack panels
1 JVC SR-MV50 US DVD/VCR
200 Liberty BNC connectors
1 Middle Atlantic S12SDG rack
1 Peavey IPA 752 amp
1 Peavey SMR 821A mixer
1 RDL PS-24A power supply
1 RDL STM-DA3 DA
1 Sanyo PLC-XU73 projector
1 Surgex SA20 TVSS
6 Universal Cable CMT-5FM-01 VGA-to-BNC
200 West Penn 25224B speaker cable
40 West Penn D252404 control cable
500 West Penn 25291B mic cable
1 power strip
2 VGA-to-VGA cable

West Auditorium

1 AMX AC-RK rack mount
1 AMX AXD-CV10 rouch panel
1 AMX NI-4100 controller
1 AMX NSS-RMSACL asset management client license
1 AMX NSS-RMSSCL scheduling client license
1 AMX NXC-COM2 RS-232 card
1 AMX NXC-NH hub card
2 AMX NXC-VOL4 volume card
1 AMX PSN6.5 power supply
6 Atlas 8CXT60 speaker
6 Atlas 164-8 grille
2 Atlas FA136T47 speaker
2 Atlas FA720-6 grille
500 Belden 1824A Component video cable, 3 RG59
2 Chief CMA-440 ceiling adaptor
2 Chief RPM-U projector mount
300 Commscope 7504 plenum Cat-6 cable
500 Extron 22-103-03 plenum RGB cable
800 Extron 22-142-03 plenum skew free cable
4 Extron 60-300-0x AAP 102
2 Extron 60-373-1x RGB 460xi dual
2 Extron 60-569-01 IN1508
2 Extron 60-597-1x CIA114
4 Extron 60-604-20 RSB 123
1 Extron 60-635-21 MVX 44 VGA A
1 Extron 60-637-21 MVX 84 VGA A
6 Extron 60-651-01 BUC 102
8 Extron 60-669-01 MTP T 15HD A
8 Extron 60-670-01 MTP R 15HD A
2 Extron 60-804-01 ASA 141
2 Extron 70-090-11 AAP blank
2 Extron 70-091-12 3 BNC
2 Extron 70-093-72 3 RCA
2 Extron 70-103-14 2 female XLR
2 Extron 70-109-1x One RCA, One Mini
2 Extron 70-404-1x VGA w/ BNC pigtails
2 Extron 70-431-1x Mini XLR 4 Pin
1 GC rack panels
1 Ivie IR-1 IRs (pair)
200 Liberty BNC connectors
1 Middle Atlantic RK20 rack
1 Peavey freq out processor
1 Peavey IPA 1502 amp
1 Peavey SMR 821A mixer
2 RDL PS-24A power supply
2 RDL STM-DA3 DA
2 Sanyo LNS-W02Z lens
1 Sanyo PLC-XF46N Projector
1 Sanyo PLC-XF60A projector
1 Stewart 104901 Luxus model A Electriscreen 9x12
1 Stewart 104903 Luxus model AB Electriscreen 12x16
1 Surgex SA20 TVSS
18 Universal Cable CMT-5FM-01 VGA-to-BNC
1000 West Penn 25224B speaker cable
2000 West Penn 25291B mic cable
200 West Penn 25814 video cable, RG59
400 West Penn D252404 control cable
1 power strip
10 VGA-to-VGA cable
2 K10P11D15-12 relays for foyer speakers (70 volt)

East Auditorium

1 AMX AXD-CV10 rouch panel
6 Atlas 164-8 grille
6 Atlas 8CXT60 speaker
13 Atlas DS2 table stand
2 Atlas FA136T47 speaker
2 Atlas FA720-6 grille
400 Belden 1824A Component video cable, 3 RG59
1 Chief CMA-440 ceiling adaptor
1 Chief RPM-U projector mount
200 Commscope 7504 plenum Cat-6 cable
700 Extron 22-103-03 plenum RGB cable
700 Extron 22-142-03 plenum skew free cable
3 Extron 60-300-0x AAP 102
1 Extron 60-373-1x RGB 460xi dual
1 Extron 60-569-01 IN1508
2 Extron 60-597-1x CIA114
2 Extron 60-604-20 RSB 123
1 Extron 60-637-21 MVX 84 VGA A
3 Extron 60-651-01 BUC 102
4 Extron 60-669-01 MTP T 15HD A
4 Extron 60-670-01 MTP R 15HD A
1 Extron 60-804-01 ASA 141
2 Extron 70-090-11 AAP blank
1 Extron 70-091-1x 3 BNC
1 Extron 70-093-7x 3 RCA
1 Extron 70-103-14 2 female XLR black
2 Extron 70-109-1x One RCA, One Mini
2 Extron 70-404-1x VGA w/ BNC pigtails
2 Extron 70-431-1x Mini XLR 4 pin
1 GC rack panels
100 Liberty BNC connectors
1 Middle Atlantic RK16 rack
1 Peavey freq out processor
1 Peavey IPA 1502 amp
1 Peavey SMR 821A mixer
5 ProCo CM-25 25-foot mic cord
1 RDL PS-24A power supply
1 Sanyo PLC-XF60A projector
1 Sanyo LNS-W02Z lens
1 Sanyo PLC-XF60A projector
2 Shure MX418D/S mic with desktop base
10 Shure SM48S mic
1 Stewart 104901 Luxus model A Electriscreen 9x12
1 Surgex SA20 TVSS
6 Universal Cable CMT-5FM-01 VGA-to-BNC
1000 West Penn 25224B speaker cable
2000 West Penn 25291B mic cable
300 West Penn 25814 video cable, RG59
300 West Penn D252404 control cable
1 power strip
9 VGA-to-VGA cable

AV Central

1 AMX AXB-232++ RS-232 box
1 AMX NI-4100 controller
1 AMX NSS-RMSSV RMS 3.0 software
1 AMX NSS-RMSACL asset management client license
1 AMX NSS-RMSSCL scheduling client license 1 AMX NXC-NH hub card
1 AMX PSN2.8 power supply
1 Anchor AN-1000X powered speaker
1 Biamp AudiaExpo input box
2 Biamp AudiaExpo output box
3 Biamp AudiaFlex DSP w/CobraNet
23 Biamp IP2 dual input module
2 Biamp Nexia TC DSP with teleconference
10 Biamp OP2e dual output module
2000 Commscope 7504 plenum Cat-6 cable
500 Extron 22-103-03 plenum RGB cable
6 Extron 60-301-0x AAP 104
1 Extron 60-469-02 Crosspoint 450 plus 3232 HV
1 Extron 60-476-01 VSC 500
1 Extron 60-487-01 SW 6V
2 Extron 60-506-01 P/2 DA2xi
1 Extron 60-569-01 IN1508
3 Extron 60-604-20 RSB 123
1 Extron 60-633-02 AAP 302
8 Extron 60-814-01 PS 123 power supply
7 Extron 70-090-1x AAP blank
6 Extron 70-090-x2 AAP double blank
1 Extron 70-091-12 3 BNC
1 Extron 70-093-71 2 RCA
1 Extron 70-093-72 3 RCA
19 Extron 70-103-14 2 female XLR black
2 Extron 70-135-02 RGB 580xi S AAP
1 GC rack panels
1 JVC SR-MV50 US DVD/VCR
400 Liberty BNC connectors
1 Middle Atlantic KO-AWFP2 door fan kit
1 Middle Atlantic MDV-DSK desk
1 Middle Atlantic MDV-R12 side cabinet
2 Middle Atlantic MW-4QFT-FC top fan kit
1 Middle Atlantic PD-620C-NS plugstrip
2 Middle Atlantic PDT-2X1020 plugstrip
1 Middle Atlantic SPN-24-312 side panel
2 Middle Atlantic SPN-44-312 side panel
1 Middle Atlantic WRK-24-32 rack
2 Middle Atlantic WRK-44-32 rack
1 NEC LCD195VX 19-inch monitor
4 NEC LCD 4610-BK 46-inch LCD monitor
6 Peavey SMR 821A mixer
2 Polycom PowerCam camera
1 Polycom VSX 8000 codec
2 Surgex SA20 TVSS
13 Universal Cable CMT-5FM-01 VGA-to-BNC
4 VMP PDM-W plasma mount
400 West Penn 25224B speaker cable
7000 West Penn 25291B mic cable
400 West Penn 25814 video cable, RG59
400 West Penn D252404 control cable
6 VGA-to-VGA cable
2 power strip

Small Meeting Rooms

2 AMX AC-RK rack mount
16 AMX NXC-COM2 RS-232 card
2 AMX NXC-IRS4 IR card
3 AMX NXC-ME260 master card
3 AMX NXC-NH hub card
8 AMX NXC-VOL4 volume card
8 AMX NXD-CV5 wall mount touch panel
3 AMX NXF card frame
3 AMX NSS-RMSACL asset management client license
3 AMX NSS-RMSSCL scheduling client license
1 AMX PSN4.4 power supply
2 AMX PSN6.5 power supply
32 Atlas FA136T47 speaker
32 Atlas FA720-6 grille
3 Atlas MS-10C mic floor stand
24 Bitronics YV-TCS417M S-Video cables
8 Chief CMA-440 ceiling adaptor
8 Chief RPM-U projector mount
550 Commscope 7504 plenum Cat-6 cable
3 Emtech EJ-8 adaptor box
550 Extron 22-103-03 plenum RGB cable
100 Extron 22-129-03 plenum S-Video cable
2000 Extron 22-142-03 plenum skew-free cable
8 Extron 60-300-02 AAP
8 Extron 60-569-01 IN1508
8 Extron 60-596-2x CIA111
6 Extron 60-604-20 RSB 123
8 Extron 60-669-01 MTP T 15HD A
16 Extron 60-670-01 MTP R 15HD A
8 Extron 60-769-01 MMX 32 VGA MTP
8 Extron 60-373-1x RGB 460xi Dual
8 Extron 70-091-12 3 BNC
8 Extron 70-093-71 2 RCA
8 Extron 70-103-14 2 female XLR
8 Extron 70-299-13 MAAP
1 GC rack panels
4 Ivie IR-1 IR's (pair)
8 JVC SR-MV50 US DVD/VCR
550 Liberty BNC connectors
8 Middle Atlantic S12SDG rack
8 Peavey IPA 752 amp
8 Peavey SMR 821A mixer
5 Pro Co CM-25 25-foot cord
8 RDL PS-24A power supply
8 RDL STM-DA3 DA
8 Sanyo PLC-XU73 projector
10 Sennheiser EW122G2 wireless bodypack system
2 Sennheiser EW145G2 wireless handheld system
5 Shure SM58-LC microphone
8 Surgex SA20 TVSS
48 Universal Cable CMT-5FM-01 VGA to BNC
800 West Penn 25224B speaker cable
500 West Penn D252404 control cable
5500 West Penn 25291B mic cable
8 power strips
16 VGA-to-VGA cables

Computer Training Rooms

8 Atlas FA136T47 speaker
8 Atlas FA720-6 grille
Chief CMA-440 ceiling adaptor
2 Chief RPM-U projector mount
80 Extron 22-103-03 plenum RGB cable
21 Extron 60-300-02 AAP frame
2 Extron 60-597-1x CIA114
1 Extron 70-103-14 2 female XLR
1 Extron 70-409-11 rocker switch
1 Middle Atlantic S12SDG rack
1 Peavey UMA752 amp
2 Sanyo PLC-XU73 projector
150 West Penn 25224B speaker cable
200 West Penn 25291B mic cable

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