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Development of an Indoor Location Tracking System for the Operating Room

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Development of an Indoor Location Tracking System for the Operating Room Development of an Indoor Location Tracking System for the Operating Room Gel Han FAKULTÄT FÜR INFORMATIK DER TECHNISCHEN UNIVERSITÄT MÜNCHEN FACHGEBIET AUGMENTED REALITY Development of an Indoor Location Tracking System for the Operating Room Gel Han Vollständiger Abdruck der von der Fakultät für Informatik der Technischen Universität München zur Erlangung des akademischen Grades eines Doktors der Naturwissenschaften (Dr. rer. nat.) genehmigten Dissertation. Vorsitzende(r): Prof. Dr. U. Baumgarten Prüfer der Dissertation: 1. Prof. G. J. Klinker, Ph.D. 2. Prof. Dr. H. Feussner Die Dissertation wurde am 14.12.2015 bei der Technischen Universität München eingereicht und durch die Fakultät für Informatik am 12.04.2016 angenommen. Abstract Location- and navigation systems are finding increasing use in areas such as logistics, medicine and secu- rity. These systems help exploit bottlenecks/weak points and analyze procedures and work flows. There are several technologies which, depending on the use case, can be applied to a location tracking system. For example, GPS is a technology which is used outdoors for navigation in cars. We look for a similar technology to GPS which should work indoors. Since this thesis was conducted in the medical technology company Trumpf Medical, the use case as well as environment was defined as the operating room and the adjacent corridors. This thesis evaluates op- tical, radio-based and acoustic technologies to develop a system for the use in the operating room. The purpose was to detect and tell if a mobile device was located inside or outside of a specific room. The user can then control medical devices located in the room such as OR tables or OR lights depending on their position. However, various requirements regarding healthcare facilities and the operating room make it difficult to select an appropriate technology. For instance, because of medical equipment, it is possible that no line of sight is given or that the environment (devices or people) changes which has a negative effect on the accuracy of the location tracking system. Interferences through already existing technologies are also a problem. After an evaluation and classification of several technologies, we focused on the radio-based ones. Furthermore, we also tested systems which were already available on the market and described first hand experiences and best practices. The goal was to develop a location tracking system, which tracks devices indoors with room level accuracy. Regarding radio-based technologies, we tested passive/active RFID, ZigBee, WiFi and Bluetooth. We looked at the advantages and disadvantages as well as the envi- ronmental requirements of each technology to see if they could be used in the OR. Based on the results, we developed a proximity-based location tracking system with Bluetooth Low Energy. With this system, we can achieve an accuracy of 1 to 3 meters. Depending on the environment and its conditions, the re- liability can improve or drop. There were several problems such as signal strength fluctuations or the correct antenna orientation of the modules to solve and deal with during the development phase. Some issues were optimized but there is still room for improvement. Besides guide lines on how to install and configure the system, we also developed an automatic test procedure with a robot to save both time and money. We describe three practical use cases with the location tracking system as well as the option to combine the existing system with another, additional technology. In the end, we show various appli- cations which can build on the developed system. They would first, improve the user experience and second, include new features to further enhance the system. v Zusammenfassung Lokalisierungs- und Navigationssysteme werden immer häufiger in Bereichen wie der Logistik, der Medi- zin oder der Sicherheitstechnik eingesetzt. Sie zeigen Schwachpunkte auf und helfen Prozesse sowie Arbeitsabläufe zu analysieren. Es gibt verschiedene Technologien, die je nach Art der Anwendung, als Lokalisierungssystem eingesetzt werden können. Für Anwendungen im Freien gibt es zum Beispiel das GPS, welches für die Navigation in Autos verantwortlich ist. Ähnlich zu dieser wird eine Technologie zur Anwendung innerhalb von Gebäuden gesucht. Da diese Arbeit in der Medizintechnik-Firma Trumpf Medical entstand, war der Einsatzort und Anwen- dungsfall auf den Operationsraum und umliegende Korridore festgelegt. Darauf basierend werden ver- schiedene optische, funkbasierte und akustische Technologien evaluiert, um ein adäquates Verfahren für den Einsatz im Operationsraum zu entwickeln. Dabei soll erkannt werden, ob sich ein mobiles Gerät innerhalb oder außerhalb eines vordefinierten Raumes befindet. In Folge dessen kann der Benutzer je nach Position bestimmte medizinische Geräte, wie OP-Tisch oder OP-Leuchte, steuern. Verschiedene Anforderungen, die speziell für den Anwendungsfall Krankenhaus und Operationsraum zutreffen, erschweren die Auswahl der geeigneten Technologie. Beispielsweise können sich medizinis- che Geräte im OP negativ auf die Sichtverbindung auswirken. Darüber hinaus kann es zu wiederholten Veränderungen der Umgebung durch Menschen oder Maschinen kommen, was ebenfalls die Genauigkeit der Lokalisierung beeinträchtigt. Interferenzen durch andere bestehende Technologien stellen eben- falls ein Problem dar. Durch eine Evaluation und Sichtung von verschiedenen Technologien wurde der Fokus auf funkbasierte Technologien gelegt. Zudem wurden auch bereits kommerziell vertriebene Sys- teme getestet und Anwendungsfälle sowie Erfahrungen aus erster Hand beschrieben. Das Ziel war es, ein System zu entwickeln, welches Geräte raumgenau innerhalb eines Gebäudes orten kann. Von den funkbasierten Technologien werden passives/aktives RFID, ZigBee, WiFi und Bluetooth für den Zweck der Lokalisierung getestet. Basierend auf räumlichen Anforderungen, der Infrastruktur und den Ergeb- nissen der Evaluation wurden anschließend Vor- sowie Nachteile der einzelnen Technologien erarbeitet, die daraufhin entsprechend den Einsatz und die Eignung im OP näher bestimmen. Im Anschluss an diese Auswertung wurde ein Lokalisierungssystem mittels Bluetooth Low Energy und der Abstandsmessung entwickelt. Mit diesem Lokalisierungssystem kann eine Genauigkeit von 1 bis 3 Metern erreicht wer- den. Dabei wirken sich die jeweiligen Umgebungsbedingungen positiv beziehungsweise negativ auf die Zuverlässigkeit aus. Während der Entwicklung galt es verschiedene Probleme zu lösen, zum Beispiel, Signalstärkeschwankungen oder die richtige Antennenorientierung der Module, die näher untersucht wurden. Zwar konnten im Rahmen der Entwicklung, Verbesserungen vorgenommen werden, Raum zur Optimierung bleibt jedoch weiterhin bestehen. Neben Anweisungen, wie das System am besten installiert und konfiguriert wird, wurde ein automatisiertes Testsystem mit einem Roboter entwickelt, welches dem Benutzer Arbeit und Zeit abnehmen soll. Es werden drei konkrete Anwendungsfälle des Lokalisierungssystems in der Praxis und die Erfahrungswerte daraus beschrieben. Auch die Möglichkeit, das bestehende System mit einer anderen, zusätzlichen Technologie zu kombinieren, wird betrachtet. Am Schluss zeigen wir verschiedene Anwendungen, die basierend auf dem System weiterentwickelt werden können. Diese dienen vor allem zur Verbesserung der User Experience und beinhalten zusätzlich fort- führende, neue Funktionen für das System. vii Acknowledgments / Danksagung Der größte Dank gilt meinen Eltern und meiner Schwester, die mich immer in guten als auch schwierigen Zeiten unterstützt und an mich geglaubt haben. Ohne die wiederholten und zeitaufwendigen Korrek- turen meiner Schwester, wäre diese Arbeit nur halb so gut. Ihr gilt ein ganz besonderer Dank, für all die konstruktiven Vorschläge und Rückmeldungen zu dieser Arbeit. Ganz besonders möchte ich mich auch bei Frau Prof. Gudrun Klinker bedanken, die immer ein offenes Ohr für meine Ideen und meinen Werdegang hatte. Sie war eine wichtige Stütze, die mich in den letzten 4 Jahren nicht nur begleitet sondern auch geleitet hat. Ebenfalls möchte ich mich bei Herrn Dr. Rudolf Marka bedanken, der einen großen Einfluss auf diese Arbeit hatte und auch zu meiner persönlichen En- twicklung beigetragen hat. Diese Arbeit ist durch unsere zahlreichen Meetings gewachsen und über die Zeit gereift. An dieser Stelle möchte ich mich bei den Studenten, die ich in den letzten 4 Jahren betreut habe, darunter Sonja Vogl, Susanne Meindl, Tilman Nölle und Umair Saleem, für die tolle Zusammenarbeit bedanken. Ich habe die Zeit mit den Studenten sehr geschätzt und werde diese sehr vermissen. Ich möchte mich bei Serhan Özhan, Klaus Thiessen, Hendrik Emerson, Christian Roth, Maike Forberg, Stefan Wiedmann und Joshua Riedel für ihr Feedback sowie Unterstützung bedanken. Zudem haben sie eine angenehme Team-Atmosphäre geschaffen, in der ich mich wohlgefühlt habe. Zuletzt danke ich all den Freunden und Kollegen, die diese Arbeit begleitet und mich in den letzten 4 Jahren unterstützt haben. ix I assure the single handed composition of this thesis only supported by declared resources. Ich versichere, dass ich diese Arbeit selbständig verfasst und nur die angegebenen Quellen und Hilfsmittel verwendet habe. München, den 14. Dezember 2015 Gel Han Contents 1 Introduction 1 2 Background and motivation3 2.1 Why RTLS are needed.......................................3 2.2 Investing into RTLS and its outcomes...............................5 3 Material and methods 7 3.1 General................................................7
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