The operating room is among the most complex spaces in the hospital. While surgery has long been the subject of innovation — think surgical robotics and laparoscopy — the OR’s orchestration has not always been treated with the same level of concern for precision and productivity.
Meanwhile, today’s OR is, perhaps, the most financially relevant part of the entire healthcare ecosystem, accounting for more revenue and cost than anywhere else. While attention is paid to the various component parts of the perioperative value chain — scheduling, staffing, turnovers, supplies — the visibility needed to monitor and track the larger OR workflow has long been overlooked, making it difficult for anyone to see when, where, or why delays happen.
In recent years, OR status camera technology has emerged as the silent sentinel of the surgical suite. Software and hardware offerings from companies including Stryker, Karl Storz, Surgical Safety Technologies (SST), Artisight, Proximie, and Apella capture and broadcast a range of video views directly from the operating room to the charge desk and beyond. And, in addition to the closed-circuit video of legacy offerings, some solutions have incorporated ambient AI and data analytics to identify objects in the OR, passively document events, provide insights, and make predictions.
Understanding the status camera landscape is essential to hospitals modernizing their OR operations and looking to optimize their perioperative workflows. This post outlines the basics of a few leading OR status camera vendors, with an overview of each, along with their core strengths and weaknesses.
What are OR status cameras?
OR status cameras are fixed-position video systems installed in operating rooms to give charge nurses, perioperative managers, and other stakeholders visibility into the surgical environment.
Initially, the use case hypothesis for the hardware was that cameras in the OR could serve a dual purpose for intraoperative/surgical insights and operational objectives. However, over time, the consensus has emerged that separate systems with differentiated approaches to both infrastructure integration and software capabilities are required to drive results.
The core use cases for OR status cameras include:
- Enabling remote visibility into activity across multiple ORs
- Observing operating room surgery-readiness
- Confirming room occupancy and patient presence
- Tracking case start and stop events and procedural milestones
- Monitoring turnover progress
- Validating clinical compliance
- Supporting surgical quality initiatives
- Capturing sensor data that can be used in documentation, analytics, and dashboards
While we’d estimate less than half of U.S. operating rooms are equipped with basic status cameras today, a new generation of platforms is emerging, adding AI, EHR integration, and cloud-native architecture to the mix.
Stryker
Founded: 1941
HQ: Kalamazoo, MI
Known best for: A hardware-first approach to surgical status with limited focus on OR intelligence
Stryker has long been a leader in the overarching medical equipment space with emphasis on tools for specific surgery and surgeon types. This is a reflection of its origins, when it was founded by an orthopedic surgeon 85 years ago to improve on the limitations of that period’s devices. Its wide range of products includes not only surgical and perioperative tools — Stryker invented the wheeled hospital bed — but also intracorporeal implants, training resources, and services.
Status cameras from Stryker are among the most commonly found in ORs today, typically single, durable HD cameras fixed on the surgical table but situated in the corner of the room (sometimes with remote pan-tilt-zoom functionality). Their systems are designed to integrate with existing OR infrastructure, much of which is also manufactured by Stryker, and communication systems like Vocera, which was acquired by Stryker in 2022.
Although it is a late-mover on OR tracking and automation (and its innovation cycles have slowed), Stryker has recently begun to offer capabilities like wheels-in and wheels-out detection and RFID-based turnover monitoring. Stryker also introduced a partnership with NewCompliance in 2021 to integrate with the ACTiQ platform and draw efficiency metrics from status camera feeds for the Dash iQ Surgical Dashboard.
Strengths
- Hardware Maturity: Stryker offers an extremely broad, mature set of devices and hardware with a focus on reliability, carrying over to its video and imaging equipment.
- Track Record: Hospitals are already familiar with Stryker’s OR and surgical equipment and have longstanding relationships and trust in its cameras.
- Flexibility & Integration: A single camera offers multiple viewing options in multiple formats. And focus on hardware positions Stryker’s status system as an extension of other products already installed in hospitals.
Weaknesses
- Limited AI: Until recently, Stryker’s software offered no analytics or AI capabilities, so object and event detection were not part of its OR camera solutions.
- Not Actionable: Stryker cameras are designed for status visibility rather than workflow automation, predictions to improve outcomes, or change-oriented insights.
- No EHR Ops Integration: Despite Epic’s and Oracle - Cerner’s data workloads, Stryker’s intercorporeal video integration with EHRs is not for scheduling or forecasting.
- Short Timeframe: The data from Stryker cameras is not integrated with the EHR and is not unlocked for use beyond live view, like scheduling or longitudinal trend analysis.
Karl Storz
Founded: 1945
HQ: Tuttlingen, Germany
Known best for: Systems integration and minimally invasive surgical scopes, expanding over time to include a fixed camera view of surgery
Karl Storz was founded in Europe shortly after Stryker’s launch. Unlike Stryker, however, the company’s focus has evolved towards becoming the leader in rigid endoscopy. Karl Storz has remained family-owned in Germany for more than three-quarters of a century.
Karl Storz’s offering is similar to Stryker's, and Storz’s typically bundles status cameras as part of systems integration packages, namely their OR1 workflow solution. Between Stryker and Karl Storz, approximately 80% of the surgical status camera market belongs to two legacy vendors. Widespread but low-margin integrations across systems and sources creates strategic IT dependencies, which have historically made the market resistant to switching.
As recently as 2015, Karl Storz expanded its focus to target process improvement in the OR. Its SCENARA product is a turnover management solution (TOMS) that introduced color-coded room status indicators, countdown timers, RFID tracking, status change updates, and basic turnover statistics. More recently, Karl Storz has partnered with Artisight on its Pathway.AI offering to track a limited variety of perioperative workflows in the OR.
Strengths
- Endoscopy Leadership: Karl Storz has been an innovator and a principal in minimally invasive surgical scopes, contributing to its head start in other imaging hardware.
- Breadth & Reach: An expansive focus helps Karl Storz’s reach and steady expansion across the entire IT value chain, including both ORs and patient rooms.
- Packaging & Integration: By leveraging its expertise in systems integration, Karl Storz has been able to bundle offerings and entrench hospitals with a platform strategy.
Weaknesses
- Status Limitation: Historically, OR1 offerings have emphasized basic surgical visibility, with little variety or advancement in use cases for status cameras beyond monitoring.
- IT Over Outcomes: Despite aggressive marketing efforts to promote new AI products, Karl Storz has few examples of efficiency benchmarks from cameras in the OR.
- Slowed Innovation: The pace of new OR product development has slowed and increasingly relies on acquisition and partnerships with a long timeline to results.
- Solutions Support: A history of short-lived partnerships (e.g., InTouch Health, LiveData, Syus), has resulted in confusion or unsupported tech as the ecosystem changes.
Surgical Safety Technologies (SST) OR Black Box
Founded: 2014
HQ: New York, NY and Toronto, ON
Known best for: Sensors that record audio and video from the operating room during procedures to reduce risk and improve surgical outcomes
SST was founded by a surgeon as OR Black Box to enable clinicians to review audiovisual logs of their cases, observing and avoiding the otherwise unseen safety issues that threaten patient wellbeing. The Black Box platform, named after aviation flight recorders, introduced the multi-camera array in the OR, including microphones and sensor kits, to create a 360° view of the surgery.
With a focus on case review, surgical coaching, and adverse event analysis, SST is a leader in retrospective surgical video. OR Black Box was among the first platforms to deploy artificial intelligence to asynchronously analyze and highlight errors from past procedures. Today, the product line has expanded to include trauma centers and simulation centers in addition to ORs, with an emphasis on generating data from recordings to drive operational improvement and best practices through analysis, training, and research.
Strengths
- Continuous Improvement: SST’s retrospective video review can be used to evaluate performance in any part of the hospital, particularly for re-training and credentialing.
- Early Mover: The OR Black Box was an early multi-camera solution, giving teams a broad view of surgical performance and safety, including intracorporeal video.
- Quality Assurance: With a large library of archival audio and video, clinicians and managers alike can review and analyze any amount of hospital “game tape” for issues.
Weaknesses
- Async Only: Like the flight recorder for which it’s named, the OR Black Box specializes in log diagnostics, not live video, where many issues can be addressed or prevented.
- No Integrations: SST’s solutions are primarily stand-alone, with no connections to other systems that can easily make use of the performance data captured by its sensors.
- Rigid Technology: OR Black Box captures large volumes of sensor data in on-prem servers, not the cloud. After high costs to build out, the platform is difficult to upgrade.
Artisight
Founded: 2015
HQ: Chicago, IL
Known best for: Patient activity monitoring with AI-enhanced cameras and virtual care across inpatient settings
Artisight’s core offering powers virtual patient rooms, where nurses and care team members can broadcast in and out via a video conference-like technology. Like many ambient technologies designed for the patient room, Artisight uses cameras with artificial intelligence to automatically generate documentation, especially from audio capture.
During the past two years, Artisight has entered the OR monitoring space via a co-marketing agreement with Karl Storz, focused on the Pathway.AI solution. The platform promises support for perioperative status tracking, but OR deployments remain limited.
Strengths
- Broad Deployment: Artisight has championed a variety of inpatient use cases across a wide array of places and contexts, including nurse call and communications centers.
- Computer Vision: Machine learning to enable object and event detection is meant to deliver basic automations to perioperative workflows.
- Strategic Partnerships: High-profile integrations with technologies from Epic Systems, Karl Storz, Microsoft, Meditech, Oracle Cerner, and Nvidia are a key Artisight claim.
Weaknesses
- Little Proof: Artisight has been slow to deploy its OR status camera solution. Even in long-standing spotlight hospitals, very few measurable results have been shared.
- Lagging Development: Despite claims, Artisight has made slow progress in its OR computer vision. Its algorithms identify only up to four events, with latent reporting.
- Divided Focus: As Artisight makes forays into the OR, the vast majority of its solutions are for non-surgical contexts — patient rooms where telepresence can lead.
Proximie
Founded: 2016
HQ: London, UK
Known best for: Collaboration among and education for surgical teams using lightweight video and a unified data integration layer
Proximie was founded by a surgeon focused on improving remote connectivity among surgical teams, especially across Europe. Its main platform resembles telepresence for clinical contexts, enabling live-streaming of surgeries and remote guidance, primarily targeted at medical training, device sales training, and peer-to-peer consultation.
Unlike the other solutions listed here, Proximie’s approach to hardware is more impermanent, with sensors and cameras that are not fixed on the wall and are not part of the hospital’s room infrastructure. While not a traditional status camera platform, some health systems use Proximie’s feeds for procedural visibility. However, its primary use case is long-form video for surgical collaboration, not room readiness or turnover management.
Strengths
- Simple Installation: Proximie’s proprietary remote collaboration hardware is meant to be mobile and plug-and-play so that it can accommodate any context.
- Global Footprint: Founded and based in the EU, Proximie’s sales and marketing strategy is more international than some other OR camera vendors.
- Remote Care: As technology has evolved along with the demand for more virtual solutions, Proximie offers a platform aligned to a more distributed healthcare context.
Weaknesses
- Different Purpose: Despite some adoption for perioperative tracking, the cameras and software in Proximie’s product line are primarily meant for training, not status monitoring.
- Data Limitations: Proximie offers very limited AI capabilities and does not integrate with the EHR, extending a possible information problem into a product quality issue.
- User Misalignment: While Proximie’s remote collaboration and education use cases are ideal for clinicians, the design has limited daily value for charge nurses or OR managers.
Apella
Founded: 2019
HQ: San Francisco, CA
Known best for: OR transformation using ambient AI-enhanced data streams for busy hospitals focused on efficiency, optimization, and automation across the entire perioperative cycle
Apella is the most recent entrant in the status camera category, but it has emerged as a leader in driving outcomes like less overtime, higher case volume, and better cross-functional coordination for top health systems. Apella benefits from being the only player that was originally founded to offer status cameras and computer vision software specifically for the operating room.
Apella’s ambient AI both integrates with the EHR, with write-back capabilities for Epic Systems, and generates not only more perioperative data, but also passively detects and precisely documents up to 14 events in real time. As a result, surgical teams not only get a live view across all ORs at once, but also actionable predictions for more efficient workflows and longitudinal analytics for ongoing process improvement and team management.
Strengths
- Novel Data: Apella captures and documents more complete and granular event data directly to the EHR, enabling the most precise forecasts throughout the day.
- Advanced Analytics: Apella is the first to predict and right-size opportunities to add-on cases so that more volume can safely be added and ORs can be more productive.
- Capacity Optimization: More precise case duration data also creates an advantage for schedulers trying to improve resource utilization through the block schedule.
Weaknesses
- Newest Entrant: As a newer offering, Apella is still gaining market and brand visibility compared to the incumbent OR status camera solutions.
- Initial Setup: Capturing unique and accurate data requires some on-site infrastructure installation, systems integration, and model training.
- Broader Scope: Apella draws on real-time data for OR schedule optimization and process insights in a single platform, not only managing day-of OR efficiency.
As the category evolves, hospitals are no longer satisfied with a simple video feed. They need systems that deliver real-time data, integrate with and automatically document events in the EHR, and enable true end-to-end OR optimization, including scheduling and staffing forecasts, across the perioperative suite.
Looking for a deeper dive into OR status cameras? Are you evaluating tools for your RFP process? Reach out to explore how Apella fits into this landscape and how better OR intelligence can enhance your existing investments.
And check out our case study on How Houston Methodist Increased Case Volume While Decreasing Overtime and drove a 10% increase in surgical revenue while simultaneously reducing staffing costs.