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A Brief Introduction to Medical Grade Monitors

Radiologists, surgeons, medical physicians, and information technology specialists routinely rely on medical monitors for diagnostic, surgery, and treatment purposes. In medical imaging diagnostics, the human is the “brain,” but the medical imaging monitor is the “eyes.”

Medical professionals require medical grade monitors for an accurate and consistent performance of the medical image display system. Too much is at stake in a system where sub-par technology or inaccurate calibration can result in misdiagnosis. So, adequate medical monitors are the key element of the medical image viewing platform powering modern hospitals.

There is a wide availability of IT solutions from consumer grade to high-end medical grade gray-scale or color monitors to meet the demands of any hospital department. However, not every solution can provide the quality of the medical image displayed on the monitor that would be adequate for diagnostic purposes. There is no one-size-fits-all solution for all medical imaging purposes. That is why decision-makers need to involve the IT department and members of the care team working with medical images when selecting medical monitors.

LCD Technologies Used in Modern Monitors

  • TN Panel: Twisted Nematic (TN) is the oldest and the most common panel type. It is also cheap because it is easy to manufacture – you can see them in low-end monitors and laptops. Its strongest point is the fast response time. When coupled with a LED backlighting, TN monitors are energy-efficient and provide high brightness. However, the color distortions at moderate to wide viewing angles results in low quality of the image, and low accuracy.
  • IPS Panel: In-Plane Switching monitors reproduce colors noticeably better than TN. IPS also offers better readability and color stability at extreme viewing angles. However, IPS panels have a lower light transmittance than Vertical Alignment monitors. With the advent of S-IPS (Super-IPS), the response time and contrast have improved. IPS also allows for color calibration.
  • VA Panel: Vertical Alignment (VA) is the technology that combines the advantages of the above two, offering better light and color transmittance. Yet, the contrast is poor at extreme viewing angles.
  • MVA Panel: Multi-Domain Vertical Alignment (MVA) is a combination of a VA panel and a compensation film. It offers excellent image quality at extreme viewing angles, and a fast response time surpassing that of the IPS monitors. MVA also offers better blacks and contrast than IPS or TN monitors. The color reproduction of an MVA monitor is better than that of the TN. MVA medical monitors combine high quality with affordable price – a perfect fit for clinical review purposes.
  • AFFS Panel: Advanced Fringe Field Switching (AFFS) offers superior performance, color reproduction and high luminosity, minimum color distortion at extreme viewing angles and great white/gray reproduction. AFFS is used in high-end panels in commercial aircraft displays mounted in cockpits. Later it evolved into HFFS (High-Transmittance Fringe Field Switching) and AFFS+ with enhanced readability on outdoor environments. The most expensive type.

The choice of panel is crucial. It determines whether the monitor is:

  • good at reproducing colors (for the ultimate accuracy of your diagnostic images)
  • responsive and fast (very important if the medical monitor is used during surgeries)

Of note are the calibration capabilities of the monitor. Calibration allows you to use professional graphics monitors for diagnostic interpretation if basic calibration and set up guidelines are followed. Higher resolution monitors do not necessarily translate into superior diagnostic quality if calibration and set up guidelines are not followed. Irrespective of the monitor type, it must be regularly checked for calibration conformance using a centralized monitoring system.

Types of Medical Monitors

When selecting medical monitors, you need to have a clear idea of your intended use and requirements that stem from it. You can not buy the same monitors for all your departments. A healthcare facility needs a reasonable combination of medical monitors that meet the specific requirements of each department.

Depending on the intended use, the medical monitors differ in properties. The differences in properties – and prices – are significant.

Surgery Room – Surgical Grade Medical Monitor

Used by surgeons, these medical monitors require fast response time as surgeons rely on them to view movements of the instruments and the state of the tissue during surgery. Perfect readability at extreme viewing angles is a must, so an antiglare film is needed.

The surgical grade medical monitors call for 300-500 nits brightness. Other critical requirements stem from the sterile environment in the operating rooms and the number of peripherals and devices that must be connected to the monitor.

Hence, surgical grade medical monitors must have an antimicrobial coating to prevent the spread of germs in the OR. IP65 rating (waterproof casing, sealed bezels) is also a must-have feature, as these monitors must be able to withstand:

  • CDC-mandated disinfection with liquid chemical solutions
  • accidental spills and splashes (medication, blood)

Additionally, surgical grade medical monitors must support multiple video modes, such as picture-in-picture, and dual screen mode. To connect various peripherals such as cameras and other vitals tracking that the surgeon needs on one screen, surgical grade medical monitors require a selection of ports that would accommodate the required devices (HDMI, DP, DVI-I, SDI, Composite, RS323, USB).

Radiology – Diagnostic-Grade Medical Monitor

Radiologists need the highest possible color reproduction, and contrast alongside DICOM (Digital Imaging and Communications in Medicine standard) certification, especially the grayscale build as these are used to review X-Ray images. The requirements for these monitors are most stringent. They must reproduce color in its smallest variations, true blacks, and grays. Diagnostic-grade medical monitors require excellent image uniformity and high brightness to reproduce images at 800+ nits.

Clinical Review – Medical Touchscreen Monitor

Many medical specialists need a secondary display for PACS quality control or modality viewing. The primary monitors are used by medical practitioners to interpret images for billing and reports that other doctors use to make the healthcare decisions. The secondary monitors are multipurpose and are used for more than just viewing medical images. Secondary medical monitors serve for patient edutainment purposes, office work, review by surgeons and clinicians, PACS quality assurance and image acquisition.

Even though primary monitors are at the forefront, secondary monitors can not be consumer grade because the consistent quality and efficiency of the imaging chain rely on:

  • quality of image acquisition
  • efficiency of the IT solution used for secondary display purposes
  • interpretation quality assurance
  • reliable and accurate reproducibility of a medical image at each stage (primary and secondary medical monitor)

Physicians relying on medical monitors for clinical review require a touch screen that is not only accurate and medical-grade, but also multipurpose and can be used for electronic documentation, EHR, patient edutainment. The touchscreen is ideal as it eliminates the need for peripherals (keyboard, mouse) and is ergonomic for settings where you need to limit the wire clutter to ensure patient safety.

The clinical review monitor does not call for a DICOM certification. Instead, it needs the antimicrobial coating to cap the spread of germs, and waterproof bezels to withstand disinfection with liquid solutions.

In many cases, clinical review monitors call for the antiglare coating to enhance viewing from extreme angles and in different lighting conditions.

Final Words

Medical practitioners must be working with medical grade monitors – no less. When screening vendors, take into account the following criteria:

  • Panel type: image quality, color stability at different viewing angles, response time, calibration options, quality assurance. Consider if there is a need for an anti-glare coating.
  • Touchscreen/no touchscreen: to use with or without keyboard and mouse if there is a requirement to remove wire clutter.
  • Certifications: DICOM, CDC, IP, 60601-1, etc.
  • Safety for near-patient use and use in sterile environments: antimicrobial coating, waterproof build.
  • Ports: ample selection of ports to connect required devices and peripherals.
  • Mounting: VESA, desktop, medical cart.

Cost considerations tend to guide monitor selection, but it is important to remember that medical grade monitors end up having a lower Total Cost of Ownership than consumer-grade ones due to low failure rate (less than 2% with Cybernet monitors), MIL-STD components, long lifecycle and 3-5-year warranty. In other words, they last significantly longer, and while they last – they give you the peace of mind as you rest assured of the reproducible quality and accuracy of your medical images.