The Surgical Intelligence Command Center: A 10-Point Framework for Connected Operating Rooms

The arrival of table-integrated robots, live computer-vision copilots, and cloud-connected telemetry has transformed the surgical theater from an isolated procedural room into a mission-critical digital computing environment. To navigate this complexity, clinical engineering teams and surgical directors are adopting the 10-Point Surgical Intelligence Framework.

The 10 Evaluation Invariants

1. Clinical Task Scope: Exact anatomical indication and boundary of software intervention.
2. Control Hierarchy: Strict distinction between tele-operation, semi-autonomous guidance, and active bone cutting.
3. Inference Latency: Sub-10ms glass-to-glass rendering on local edge accelerators (NVIDIA Holoscan).
4. Fail-Safe Fallback Modes: Immediate mechanical disengagement in the event of software failure or tracking loss.
5. Evidence & Provenance Logging: Cryptographically signed video and telemetry records for peer review and training.
6. Regulatory Authorization: Verification of exact FDA De Novo or 510(k) cleared intended uses.
7. Human-in-the-Loop Override: Mandatory surgeon confirmation for all procedural decisions.
8. EHR & PACS Interoperability: Seamless DICOM image integration and automated operative report generation.
9. Cybersecurity & Zero-Trust: Hospital network isolation preventing external telemetry tampering.
10. Total Cost of Ownership: Evaluation of capital expenditure vs. consumable instrument per-procedure fees.