Oct. 13, 2022 - In 2017, Crestron CEO Dan Feldstein (then COO) spoke about his dad's interest in a nonprofit called Orbis International. His father — Crestron founder George Feldstein — was an avid pilot and an aviation enthusiast. "On one visit to the annual airshow in Oshkosh, Wisconsin, he stumbled upon the Orbis Flying Eye Hospital," the younger Feldstein recalled. That encounter piqued George's interest — and inspired him to lead the effort to donate more than $300,000 worth of Crestron products to the organization.
The integration of that technology into a plane — specifically, a McDonnell Douglas MD-10 — is a massively complex undertaking involving cabling and heat mitigation in extremely tight spaces, power generation and conditioning in a wide variety of locales, weight reduction, and a host of other challenges. The Orbis integration team, led by Audio Visual Specialist Jangaiah Chalamala with chief consultant Lincoln King-Cliby, commercial market director for ControlWorks Consulting, LLC, recently wrapped up months of work to retrofit the entire hospital.
The Hospital as "Cargo"
A leader in the fight against avoidable blindness for four decades, Orbis is an international nonprofit that trains, mentors, and inspires eye care professionals in places with the greatest need so they can save and restore vision in their communities. Orbis operates the world's only Orbis Flying Eye Hospital, a fully accredited ophthalmic teaching hospital on board an MD-10 aircraft. The Orbis Flying Eye Hospital – a state-of-the-art teaching facility that is complete with an operating room, classroom, and recovery room – allows the Orbis Volunteer Faculty to travel the world sharing knowledge and developing the skills of local eye care teams. The Orbis Flying Eye Hospital has been airborne since the early '80s, bringing its teaching hospital to parts of the world with limited access to quality ophthalmic training. Their current plane, the third-generation Orbis Flying Eye Hospital — donated by FedEx — launched in 2016 and was specifically designed to make future tech upgrades easier.
The latest update wrapped up in early August of 2022, and the Orbis Flying Eye Hospital is conducting in-person trainings again after offering virtual trainings throughout 2020 and 2021. With the plane now returning to in-person programming, the virtual model Orbis developed is being used in conjunction with in-person training, a concept known as "blended learning," to ensure that participants can maximize the time with their mentors, continue their education after the plane leaves, and more.
"One of the cool things about Orbis is the hospital is all considered cargo," explains Lincoln King-Cliby, whose firm has integrated projects "from airplanes to zoos." "The various modules of the hospital were all built on cargo pallets," he says. There are several advantages to this approach: First and foremost, this ensures that the electrical systems in the hospital segment of the plane, from medical equipment to AV solutions, are completely separated from the aircraft's power infrastructure. "There's no chance for crosstalk or interference," he adds. Additionally, this means that the hospital modules and systems don't need to be certified by the FAA as part of the plane.
Furthermore, those modules essentially slide out of the fuselage for maintenance and updates. The plane recently underwent a maintenance check when the modules were removed, all while the Orbis Flying Eye Hospital was offering virtual training to comply with pandemic protocols. "It was time for regular maintenance anyway, so it was determined that this was the perfect opportunity to update the technology," says King-Cliby.
"We installed roughly 100 Cat cables in about two months," notes Jangaiah Chalamala, "and yes, the space is a little tight." Some of those dimensional issues were solved by the technological advances that have transpired since the plane was first outfitted. "The current generation of graphics engines such as the DM-DGE-200-C and the TSD-2220-B touch screens are quite a bit smaller than previous models," says King-Cliby.
Saving Fuel, Generating Power
But there's an even more important consideration than space: weight.
"The new gear allowed us to shed more than 100 pounds of weight from the aircraft," says King-Cliby. Less weight means less fuel will be burned in-flight, and every pound represents a cash saving that helps Orbis use more resources for its mission. "Every inch of space we can add and every pound of weight we can save — that's what the folks at Orbis love to hear about," he notes.
The Orbis Flying Eye Hospital now has better AV in the operating room and classroom. "We've now installed 4K displays," says Chalamala. Higher resolutions mean clearer images, and top-of-the-line picture quality is immeasurably helpful when one's demonstrating delicate surgical operations to a group of eye care professionals. Crestron DigitalMedia™ technology is at the heart of the hospital, according to King-Cliby. "We have DM ties to get video to and from the classroom because that's really where Orbis shines as a teaching hospital. You'll have someone in the operating room demonstrating a technique or discussing a patient, while you have students in the classroom with an interpreter acting as someone to help bridge those two worlds. They can ask the doctor questions about what they're seeing, and the doctor can answer in real time — that's all via the magic of DM."
Powering all of the devices when the plane's on the ground is another trick. King-Cliby describes the setup: "There are generators that siphon jet fuel from the wing to power everything, and then there's battery backup. The hospital systems are not used in flight at all. They get packed up, strapped down, and travel as cargo in the belly of the plane. And when they're on the ground, that space essentially turns into someone's office." This further means that the electrical system has to be extremely resilient. "Since the hospital is completely shut down in the air, it starts up from 'dark' when it's on the ground," he explains.
Power conditioning is another concern. "It is definitely a different world when you don't necessarily have a reliable earth ground for signal integrity, and you have a ton of radio frequency interference, too," says King-Cliby. Airports, of course, are hotbeds of signal traffic. The hospital also needs robust climate control since it often lands in a significant number of countries known for temperature extremes.
The Next Update
Orbis has on-staff aircraft mechanics, and Jangaiah Chalamala (and his partner in IT for the nonprofit, Wonder Bhaku) keep the plane and its systems in top working order — not to mention compliance. "There are standards for aircraft, but there are also global standards for hospitals," explains King-Cliby. When one considers both elements, the Orbis Flying Eye Hospital may be the most highly regulated plane in the world.