Operating room remote monitoring

Abstract

OR computing system monitoring is described including self-monitoring and monitoring, with or without intervention, via a monitoring computing system. For a patient procedure in an OR, positions of one or more objects are tracked using sensors. Intra-operative data including pose information is communicated (e.g. in real time) to a monitoring computing system to present the intra-operative data including object positions in a GUI. Pose information may be sensor data with which to calculate a pose of an object or pre-calculated pose data. Intra-operative data may be a workflow state of the procedure to display workflow UI screens. A virtual view of the OR may be presented from pose information and geometric data for OR equipment. Working volumes of OR equipment including collision warning may be presented. OR equipment may include a localizer and/or a robot. Self-monitoring may evaluate progress in a procedure and trigger a request (e.g. to monitor).

We claim: 
     
         1 . A monitoring computing system to monitor a remotely located operating room containing an OR computing system configured to perform a computer-assisted procedure relative to a patient, tracking respective positions of one or more objects during the computer-assisted procedure in which sensor data, representing the respective positions of the one or more objects, is received from sensors coupled to the one or more objects, the monitoring computing system comprising:
 at least one processing unit   a data store comprising a memory or other storage;   a display device; and   a communication system to communicate with the OR computing system via a network;   wherein each of the data store, display device and communication system are coupled to the at least one processing unit; and   wherein the data store stores instructions which, when executed by the at least one processing unit, configure the monitoring computing system to:
 obtain geometrical data representing the one or more objects; 
 receive during a procedure from the OR computing system, relative to the computer-assisted procedure, intra-operative data including pose information; and 
 present in a GUI, by displaying via the display device, at least some of the intra-operative data including the respective positions of the one or more objects using the pose information and the geometrical data; and 
 wherein the pose information comprises one or both of sensor data with which to calculate a pose of an object and pose data representing the pose of the object as calculated by the OR computing system using the sensor data. 
   
     
     
         2 . The monitoring computing system of  claim 1 , wherein the pose information includes pose information for a reference associated with the patient and wherein the instructions configure the monitoring computing system to:
 receive anatomical registration data determined from a registration of the patient in the OR computing system; and   use the anatomical registration data and patient reference to present, in the GUI, at least one of: a position of the patient; and the respective positions of the one or more objects relative to the position of the patient.   
     
     
         3 . The monitoring computing system of any one of  claims 1  and  2  wherein the computer-assisted procedure comprises one of: performing a computer-assisted localization to track the one or more objects; and controlling a positioning of at least one of the one or more objects using a robot. 
     
     
         4 . The monitoring computing system of any one of  claims 1  and  2  wherein the sensor data comprises one or both of: camera measurements from a camera sensor of an optical localization system; and pose data calculated using the camera measurements. 
     
     
         5 . The monitoring computing system of any one of  claims 1  and  2  wherein at least one of the sensors generate sensor data comprising a motor encoder measurement of motors of a robot controlling the positioning of at least one of the one or more objects; and wherein the pose information comprises one or both of: the motor encoder measurement; and pose data calculated using the motor encoder measurement. 
     
     
         6 . The monitoring computing system of any one of  claims 1  to  5  wherein the one or more objects are selected from procedural tools and a part of the patient, preferably a bone of the patient. 
     
     
         7 . The monitoring computing system of any one of  claims 1  to  6 , wherein the instructions configure the monitoring computing system to receive pre-operative data for the patient to present in the GUI. 
     
     
         8 . The monitoring computing system of any one of  claims 1  to  7  comprising at least one of a video camera and a microphone to capture monitoring video and/or voice data and wherein the instructions configure the monitoring computing system to communicate the monitoring video and/or voice data to the OR computing system. 
     
     
         9 . The monitoring computing system of any one of  claims 1  to  8  wherein the instructions configure the monitoring computing system to:
 receive one of:
 a) a workflow state representing a progress in a workflow comprising UI screens for the computer-assisted procedure; and 
 b) a mirror of a display device of the OR computing system sharing the UI screens in accordance with the progress of the workflow from the monitoring computing system; and 
 
 present the UI screens of the workflow. 
 
     
     
         10 . The monitoring computing system of any one of  claims 1  to  9  wherein the instructions configure the monitoring computing system to receive input to define intervention data to control at least one operation of the OR computing system and communicate the intervention data to the OR computing system. 
     
     
         11 . The monitoring computing system of any one of  claims 1  to  10  wherein the geometrical data comprises 3D data models for rendering 3D objects in a user interface and the instructions configure the monitoring computing system to use the positional information and the respective data models to render a 3D view of at least the one or more objects in the GUI. 
     
     
         12 . The monitoring computing system of any one of  claims 1  to  11  wherein the instructions configure the monitoring computing system to determine positional state information for the one or more objects using the geometrical data and the pose information. 
     
     
         13 . The monitoring computing system of any one of  claims 1  to  12  wherein the OR computing system comprises or is coupled to components of one of a localization system and a robotic surgery system and wherein the instructions configure the monitoring computing system to access geometrical data representing at least one of the components to present a rendering of the at least one of the components in a virtual view of the OR. 
     
     
         14 . The monitoring computing system of  claim 13  wherein the instructions configure the monitoring computing system to provide a control selected from a pan control to pan the virtual view, a tilt control to tilt the virtual view a zoom control to zoom in and/or out the virtual view and a working volume control to display a working volume for at least one component of OR equipment in the virtual view. 
     
     
         15 . The monitoring computing system of any one of  claims 1  to  14  wherein the instructions configure the monitoring computing system to receive a message from the OR computing system to initiate monitoring by the monitoring computing system. 
     
     
         16 . A method to monitor a remotely located operating room containing an OR computing system configured to perform a computer-assisted procedure relative to a patient, tracking respective positions of one or more objects during the computer-assisted procedure in which sensor data, representing the respective positions of the one or more objects, is received from sensors coupled to the one or more objects, the method comprising:
 obtaining geometrical data representing the one or more objects;   receiving during a procedure from the OR computing system, relative to the computer-assisted procedure, intra-operative data including pose information; and   presenting in a GUI, by displaying via a display device, at least some of the intra-operative data including the respective positions of the one or more objects using the pose information and the geometrical data;   wherein the pose information comprises one or both of sensor data with which to calculate a pose of an object and pose data representing the pose of the object as calculated by the OR computing system using the sensor data.   
     
     
         17 . The method of  claim 16 , wherein the pose information includes pose information for a reference associated with the patient and wherein the instructions configure the monitoring computing system to:
 receive anatomical registration data determined from a registration of the patient in the OR computing system; and   use the anatomical registration data and patient reference to present, in the GUI, at least one of: a position of the patient; and the respective positions of the one or more objects relative to the position of the patient.   
     
     
         18 . The method of any one of  claims 16  and  17  wherein the computer-assisted procedure comprises one of: performing a computer-assisted localization to track the one or more objects; and controlling a positioning of at least one of the one or more objects using a robot. 
     
     
         19 . The method of any one  claims 16  and  17  wherein the sensor data comprises one or both of: camera measurements from a camera sensor of an optical localization system; and pose data calculated using the camera measurements. 
     
     
         20 . The method of any one of  claims 16  and  17  wherein at least one of the sensors generate sensor data comprising a motor encoder measurement of motors of a robot controlling the positioning of at least one of the one or more objects; and wherein the pose information comprises one or both of: the motor encoder measurement; and pose data calculated using the motor encoder measurement. 
     
     
         21 . The method of any one of  claims 16  to  20  wherein the one or more objects are selected from procedural tools and a part of the patient, preferably a bone of the patient. 
     
     
         22 . The method of any one of  claims 16  to  21 , comprising receiving pre-operative data for the patient to present in the GUI. 
     
     
         23 . The method of any one of  claims 16  to  22  comprising capture monitoring video and/or voice data from at least one of a video camera and a microphone communicating the monitoring video and/or voice data to the OR computing system. 
     
     
         24 . The method of any one of  claims 16  to  23  comprising receiving one of: a) a workflow state representing a progress in a workflow comprising UI screens for the computer-assisted procedure; and b) a mirror of a display device of the OR computing system sharing the UI screens in accordance with the progress of the workflow from the monitoring computing system; and presenting the UI screens of the workflow. 
     
     
         25 . The method of any one of  claims 16  to  24  comprising receiving input to define intervention data to control at least one operation of the OR computing system and communicating the intervention data to the OR computing system. 
     
     
         26 . The method of any one of  claims 16  to  25  wherein the geometrical data comprises 3D data models for rendering 3D objects in a user interface and the method comprises rendering a 3D view of at least the one or more objects in the GUI using the positional information and the respective data models. 
     
     
         27 . The method of any one of  claims 16  to  26  comprising determining positional state information for the one or more objects using the geometrical data and the pose information. 
     
     
         28 . The method of any one of  claims 16  to  27  wherein the OR computing system comprises or is coupled to components of one of a localization system and a robotic surgery system and wherein the method comprises accessing geometrical data representing at least one of the components to present a rendering of the at least one of the components in a virtual view of the OR. 
     
     
         29 . The method of  claim 28  comprising providing a control selected from a pan control to pan the virtual view, a tilt control to tilt the virtual view a zoom control to zoom in and/or out the virtual view and a working volume control to display a working volume for at least one component of OR equipment in the virtual view. 
     
     
         30 . The method of any one of  claims 16  to  29  comprising receiving a message from the OR computing system to initiate monitoring. 
     
     
         31 . An OR computing system comprising:
 at least one processing unit;   a data store comprising a memory or other storage; and   a communication system coupled to the at least one processing unit to couple the OR computing system to a communication network;   wherein the data store and communication system are coupled to the at least one processing unit; and   wherein the data store stores instructions which, when executed by the at least one processing unit, configure the OR computing system to:
 perform a computer-assisted procedure relative to a patient, tracking respective positions of one or more objects during the computer-assisted procedure in an operating room in which sensor data, representing the respective positions of the one or more objects within the operating room, is received from sensors associated with the one or more objects; and 
 during the computer-assisted procedure,
 communicate intra-operative data generated during the procedure including pose information to a monitoring computing system for monitoring the operating room, the monitoring computing system configured to receive and present the intra-operative data in a GUI comprising the respective positions of one or more of the objects; 
 
 wherein the pose information comprises one or both of:
 sensor data with which to calculate a pose of an object; and 
 pose data representing the pose of the object as calculated by the OR computing device using the sensor data. 
 
   
     
     
         32 . The OR computing system of  claim 31 , wherein the pose information includes pose information for a reference associated with the patient; and wherein the instructions configure the OR computing system to: register the patient to the OR computing system to define anatomical registration data; and communicate the anatomical registration data to the monitoring computing system to enable the monitoring computing system to present, in the GUI, at least one of: a position of the patient; and the respective positions of the one or more objects relative to the position of the patient. 
     
     
         33 . The OR computing system of one of  claim 31  and  claim 22  wherein the computer-assisted procedure comprises one of: a computer-assisted localization procedure to track the one or more objects; and a robotic procedure comprising controlling a positioning of at least one of the one or more objects using a robot. 
     
     
         34 . The OR computing system of  claim 33 , wherein, during the computer-assisted localization procedure, the sensors are components of an optical localization system at least one of which sensors is attached to the one or more objects. 
     
     
         35 . The OR computing system of  claim 33  wherein, during the robotic procedure, the sensors are coupled to the robot. 
     
     
         36 . The OR computing system of any one of  claims 31  to  35  wherein the intra-operative data comprises any of:
 pose information of a robotic manipulator; 
 measured forces of a robotic end effector; 
 measured speed or revolutions per minute (RPM) of a robotic end effector; 
 pose information from an optical sensor; 
 pose information of a medical imaging device; and 
 timestamp data. 
 
     
     
         37 . The OR computing system of any one of  claims 31  to  36  wherein one of the sensors comprises a localization camera and the sensor data includes a video feed of the localization camera. 
     
     
         38 . The OR computing system of any one of  claims 31  to  37  wherein at least one of the one or more objects are selected from procedural tools and a part of the patient, preferably, a bone of the patient. 
     
     
         39 . The OR computing system of any one of  claims 31  to  38 , wherein the instructions configure the OR computing system to communicate pre-operative data for the patient to the monitoring computing system for use to present in the GUI. 
     
     
         40 . The OR computing system of any one of  claims 31  to  39  comprising at least one of a video camera and a microphone to capture OR video and/or voice data and wherein the instructions configure the OR computing system to communicate the OR video and/or voice data to the monitoring computing system. 
     
     
         41 . The OR computing system of any one of  claims 31  to  40  wherein the instructions configure the OR computing system to receive and utilize monitoring data generated by the monitoring computing system. 
     
     
         42 . The OR computing system of  claim 41  wherein the monitoring data is selected from intervention data to control the OR computing system; and audio data and/or video data. 
     
     
         43 . The OR computing system of any one of  claims 31  to  42  wherein the instructions configure the OR computing system to:
 to use a workflow comprising UI screens to perform the computer-assisted procedure; and 
 one of:
 a) maintain a workflow state representing a progress in the workflow; and communicate the workflow state to the monitoring computing system; 
 and 
 b) mirror a display device of the OR computing system to share the UI screens in accordance with the progress of the workflow to the monitoring computing system; 
 
 to enable the monitoring computing system to present the UI screens of the workflow. 
 
     
     
         44 . The OR computing system of any one of  claims 31  to  43  wherein the instructions configure the OR computing system to self-monitor a progression of the computer-assisted procedure and, responsive to the progression, communication a message to the monitoring computing system to invoke a remote monitoring of the OR computing system. 
     
     
         45 . The OR computing system of any one of  claims 31  to  44  wherein the OR computing system determines component pose information for components of the OR computing system and/or other OR equipment and communicates the component pose information to the monitoring computing system to enable a display of a virtual view showing a layout of the OR. 
     
     
         46 . A method comprising:
 performing a computer-assisted procedure by an OR computing system relative to a patient, tracking respective positions of one or more objects during the computer-assisted procedure in an operating room in which sensor data, representing the respective positions of the one or more objects within the operating room, is received by the OR computing system from sensors associated with the one or more objects; and   during the computer-assisted procedure, communicating intra-operative data generated during the procedure including pose information to a monitoring computing system for monitoring the operating room, the monitoring computing system configured to receive and present the intra-operative data in a GUI comprising the respective positions of one or more of the objects;   wherein the pose information comprises one or both of:
 sensor data with which to calculate a pose of an object; and 
 pose data representing the pose of the object as calculated by the OR computing device using the sensor data. 
   
     
     
         47 . The method of  claim 46 , comprising determining pose information for a reference associated with the patient; registering the patient to the OR computing system to define anatomical registration data; and communicating the anatomical registration data to the monitoring computing system to enable the monitoring computing system to present, in the GUI, at least one of: a position of the patient; and the respective positions of the one or more objects relative to the position of the patient. 
     
     
         48 . The method of one of  claims 46  and  47  wherein the computer-assisted procedure comprises one of: a computer-assisted localization procedure to track the one or more objects; and a robotic procedure comprising controlling a positioning of at least one of the one or more objects using a robot. 
     
     
         49 . The method of  claim 48 , wherein, during the computer-assisted localization procedure, the sensors are components of an optical localization system at least one of which sensors is attached to the one or more objects. 
     
     
         50 . The method of  claim 48  wherein, during the robotic procedure, the sensors are coupled to the robot. 
     
     
         51 . The method of any one of  claims 46  to  50  wherein the intra-operative data comprises any of:
 pose information of a robotic manipulator; 
 measured forces of a robotic end effector; 
 measured speed or revolutions per minute (RPM) of a robotic end effector; 
 pose information from an optical sensor; 
 pose information of a medical imaging device; and 
 timestamp data. 
 
     
     
         52 . The method of any one of  claims 46  to  51  wherein one of the sensors comprises a localization camera and the sensor data includes a video feed of the localization camera. 
     
     
         53 . The method of any one of  claims 46  to  52  wherein at least one of the one or more objects are selected from procedural tools and a part of the patient, preferably a bone of the patient. 
     
     
         54 . The method of any one of  claims 46  to  53 , comprising communicating pre-operative data for the patient to the monitoring computing system for use to present in the GUI. 
     
     
         55 . The method of any one of  claims 46  to  54  comprising capturing OR video and/or voice data from at least one of a video camera and a microphone and communicating the OR video and/or voice data to the monitoring computing system. 
     
     
         56 . The method of any one of  claims 46  to  55  wherein the instructions configure the OR computing system to receive and utilize monitoring data generated by the monitoring computing system. 
     
     
         57 . The method of  claim 56  wherein the monitoring data is selected from intervention data to control the OR computing system; and audio data and/or video data. 
     
     
         58 . The method of any one of  claims 46  to  57  comprising using a workflow comprising UI screens to perform the computer-assisted procedure; and, one of: a) maintaining a workflow state representing a progress in the workflow; and communicate the workflow state to the monitoring computing system; and b) mirroring a display device of the OR computing system to share the UI screens in accordance with the progress of the workflow to the monitoring computing system; to enable the monitoring computing system to present the UI screens of the workflow. 
     
     
         59 . The method of any one of  claims 46  to  58  comprising self-monitoring a progression of the computer-assisted procedure and, responsive to the progression, communicating a message to the monitoring computing system to invoke a remote monitoring of the OR computing system. 
     
     
         60 . The method of any one of  claims 46  to  59  comprising determining component pose information for components of the OR computing system and/or other OR equipment and communicating the component pose information to the monitoring computing system to enable a display of a virtual view showing a layout of the OR. 
     
     
         61 . An OR computing system comprising:
 at least one processing unit;   a data store comprising a memory or other storage; and   a communication system to communicate with the OR computing system via a network;   wherein each of the data store, display device and communication system are coupled to the at least one processing unit; and   wherein the data store stores instructions which, when executed by the at least one processing unit, configure the OR computing system to:
 perform a computer-assisted procedure, tracking respective positions of one or more objects during the computer-assisted procedure in an operating room, generating pose data representing the respective positions of the one or more objects in a reference space within the operating room; 
 store log data with which to monitor a progress of the computer-assisted procedure; 
 monitor the progress of the computer-assisted procedure using the log data; 
 determine a measure of progress responsive to the monitoring; and 
 responsive to the measure of progress, communicate a message identifying the measure of progress and optionally including at least some of the log data to a remotely located monitoring computing system to monitor the OR computing system. 
   
     
     
         62 . The OR computing system of  claim 61  comprising a camera and wherein the instructions configure the OR computing system to receive images from the camera and store images as log data. 
     
     
         63 . The OR computing system of any one of  claims 61  and  62  wherein the instructions configure the OR computing system to perform the computer-assisted procedure using a workflow including UI screens. 
     
     
         64 . The OR computing system of  claim 63  wherein the instructions configure the OR computing system to store as log data a state of the workflow and to communicate the state of the workflow to the monitoring computing system. 
     
     
         65 . The OR computing system of any one of  claims 63  and  64  wherein the measure of progress is a failure to advance the state of the workflow from one state to a next state or a repetition of one state of the workflow. 
     
     
         66 . The OR computing system of any one of  claims 63  and  64  wherein the measure of progress is responsive to an expiry of a threshold period of time to advance the state of the workflow from one state to a next state. 
     
     
         67 . The OR computing system of any one of  claims 61  to  66  wherein the instructions comprise rules to analyse the log data and generate the measure of progress. 
     
     
         68 . The OR computing system of  claim 67  wherein the rules determine a severity and communicate the message responsive to the severity. 
     
     
         69 . The OR computing system of any one of  claims 61  to  68  wherein the instructions configure the OR computing system to:
 communicate the message during the computer-assisted procedure; 
 receive monitoring data from the monitoring computing system during the computer-assisted procedure; and 
 utilize the monitoring data from the monitoring computing system via the OR computing system. 
 
     
     
         70 . The OR computing system of  claim 69  wherein the monitoring data from the monitoring computing system is one or both of: intervention data to at least partially control the OR computing system; and audio and/or video data to present via an audio and/or display device. 
     
     
         71 . The OR computing system of any one of  claims 61  to  70  coupled to a microphone and/or video camera and wherein the instructions configure the OR computing system to communicate OR audio and/or video data from the operating room to the monitoring computing system. 
     
     
         72 . The OR computing system of any one of  claims 61  to  71  comprising sending to the monitoring computing system additional data from at least one of the log data or intra-operative data generated by the OR computing system. 
     
     
         73 . The OR computing system of  claim 72  wherein the additional data comprises any of: camera image data, pose data determined from the camera image data, measurement data determined from the pose data, screenshot data, workflow state data, data representing a definition of one of the one or more objects, pre-operative patient data, and timestamp data for any of the intra-operative data. 
     
     
         74 . A method comprising:
 performing a computer-assisted procedure by an OR computing system, tracking respective positions of one or more objects during the computer-assisted procedure in an operating room, generating pose data representing the respective positions of the one or more objects in a reference space within the operating room;   storing, by the OR computing system, log data with which to monitor a progress of the computer-assisted procedure;   monitoring, the OR computing system, the progress of the computer-assisted procedure using the log data;   determining, the OR computing system, a measure of progress responsive to the monitoring; and   responsive to the measure of progress, communicating, by the OR computing system, a message identifying the measure of progress and optionally including at least some of the log data to a remotely located monitoring computing system to monitor the OR computing system.   
     
     
         75 . The method of  claim 74  comprising receiving images from a camera coupled to the OR computing system and storing images as log data. 
     
     
         76 . The method of any one of  claims 74  and  75  comprising performing the computer-assisted procedure using a workflow including UI screens. 
     
     
         77 . The method of  claim 76  comprising storing as log data a state of the workflow and communicating the state of the workflow to the monitoring computing system. 
     
     
         78 . The method of any one of  claims 76  and  77  wherein the measure of progress is a failure to advance the state of the workflow from one state to a next state or a repetition of one state of the workflow. 
     
     
         79 . The method of any one of  claims 76  and  77  wherein the measure of progress is responsive to an expiry of a threshold period of time to advance the state of the workflow from one state to a next state. 
     
     
         80 . The method of any one of  claims 74  to  79  wherein monitoring comprises using rules to analyse the log data and generate the measure of progress. 
     
     
         81 . The method of  claim 80  wherein the rules determine a severity and communicate the message responsive to the severity. 
     
     
         82 . The method of any one of  claims 74  to  81  comprising:
 communicating the message during the computer-assisted procedure; 
 receiving monitoring data from the monitoring computing system during the computer-assisted procedure; and 
 utilizing the monitoring data from the monitoring computing system via the OR computing system. 
 
     
     
         83 . The method of  claim 82  wherein the monitoring data from the monitoring computing system is one or both of: intervention data to at least partially control the OR computing system; and audio and/or video data to present via an audio and/or display device. 
     
     
         84 . The method of any one of  claims 74  to  83  comprising capturing from the operating room using a microphone and/or video camera and communicating the OR audio and/or video data to the monitoring computing system. 
     
     
         85 . The method of any one of  claims 74  to  84  comprising sending to the monitoring computing system additional data from at least one of the log data or intra-operative data generated by the OR computing system. 
     
     
         86 . The method of  claim 85  wherein the additional data comprises any of: camera image data, pose data determined from the camera image data, measurement data determined from the pose data, screenshot data, workflow state data, data representing a definition of one of the one or more objects, pre-operative patient data, and timestamp data for any of the intra-operative data. 
     
     
         87 . A monitoring computing system to monitor a remotely located operating room containing an OR computing system configured to perform a computer-assisted procedure relative to a patient, tracking respective positions of one or more objects during the computer-assisted procedure in which sensor data, representing the respective positions of the one or more objects, is received from sensors coupled to the one or more objects, the monitoring computing system comprising:
 at least one processing unit   a data store comprising a memory or other storage;   a display device; and   a communication system to communicate with the OR computing system via a network;   wherein each of the data store, display device and communication system are coupled to the at least one processing unit; and   wherein the data store stores instructions which, when executed by the at least one processing unit, configure the monitoring computing system to:
 receive from the OR computing system a message identifying a measure of progress of the computer-assisted procedure and optionally including at least some log data for the computer-assisted procedure stored by the OR computing system to initiate monitoring the OR computing system. 
   
     
     
         88 . The monitoring computing system of  claim 87  wherein the data store stores instructions which, when executed by the at least one processing unit, further configures the monitoring computing system to:
 obtain geometrical data representing the one or more objects; 
 receive, during the computer assisted procedure from the OR computing system, intra-operative data including pose information; and 
 present in a GUI, by displaying via the display device, at least some of the intra-operative data including the respective positions of the one or more objects using the pose information and the geometrical data. 
 
     
     
         89 . The monitoring computing system of any one of  claims 87  and  88  wherein the log data comprises images from a camera coupled to the OR computing system. 
     
     
         90 . The monitoring computing system of any one of  claims 87  and  89  wherein the OR computing system performs the computer-assisted procedure using a workflow including UI screens and wherein the monitoring computing system receives from the OR computing system a state of the workflow. 
     
     
         91 . The monitoring computing system of  claim 90  wherein the measure of progress is a failure to advance the state of the workflow from one state to a next state or a repetition of one state of the workflow. 
     
     
         92 . The monitoring computing system of  claim 90  wherein the measure of progress is responsive to an expiry of a threshold period of time to advance the state of the workflow from one state to a next state. 
     
     
         93 . The monitoring computing system of any one of  claims 87  to  92  wherein the monitoring of the progress is associated with a measure of severity and the message is communicated responsive to the severity. 
     
     
         94 . The monitoring computing system of any one of  claims 87  to  93  wherein the instructions configure the monitoring computing system to:
 receive the message during the computer-assisted procedure; and 
 define monitoring data and communicate the monitoring data to the OR computing system during the computer-assisted procedure. 
 
     
     
         95 . The monitoring computing system of  claim 94  wherein the monitoring data is one or both of: intervention data to at least partially control the OR computing system; and audio and/or video data to present via an audio and/or display device. 
     
     
         96 . The monitoring computing system of any one of  claims 87  to  95  coupled to a microphone and/or video camera and wherein the instructions configure the monitoring computing system to communicate audio and/or video data from the monitoring computing system to the operating room. 
     
     
         97 . The monitoring computing system of any one of  claims 87  to  96  wherein the instructions configured the monitoring computing system to receive from the OR computing system additional data from at least one of the log data or intra-operative data generated by the OR computing system. 
     
     
         98 . The monitoring computing system of  claim 97  wherein the additional data comprises any of: camera image data, pose data determined from the camera image data, measurement data determined from the pose data, screenshot data, workflow state data, data representing a definition of one of the one or more objects, pre-operative patient data, and timestamp data for any of the intra-operative data. 
     
     
         99 . A method to monitor a remotely located operating room containing an OR computing system configured to perform a computer-assisted procedure relative to a patient including tracking respective positions of one or more objects during the computer-assisted procedure in which sensor data, representing the respective positions of the one or more objects, is received from sensors coupled to the one or more objects, the method comprising, by a processing unit of a monitoring computing system:
 receiving from the OR computing system a message identifying a measure of progress of the computer-assisted procedure and optionally including at least some log data for the computer-assisted procedure stored by the OR computing system to initiate monitoring the OR computing system.   
     
     
         100 . The method of  claim 99  further comprising:
 obtaining geometrical data representing the one or more objects; 
 receiving, during the computer-assisted procedure from the OR computing system, intra-operative data including pose information; and 
 presenting in a GUI, by displaying via a display device, at least some of the intra-operative data including the respective positions of the one or more objects using the pose information and the geometrical data. 
 
     
     
         101 . The method of any one of  claims 99  and  100  wherein the log data comprises images from a camera coupled to the OR computing system. 
     
     
         102 . The monitoring computing system of any one of  claims 99  and  101  wherein the OR computing system performs the computer-assisted procedure using a workflow including UI screens and wherein the method comprises receiving from the OR computing system a state of the workflow. 
     
     
         103 . The method of  claim 102  wherein the measure of progress is a failure to advance the state of the workflow from one state to a next state or a repetition of one state of the workflow. 
     
     
         104 . The method of  claim 102  wherein the measure of progress is responsive to an expiry of a threshold period of time to advance the state of the workflow from one state to a next state. 
     
     
         105 . The method of any one of  claims 99  to  104  wherein the monitoring of the progress is associated with a measure of severity and the message is communicated responsive to the severity. 
     
     
         106 . The method of any one of  claims 99  to  105  comprising:
 receiving the message during the computer-assisted procedure; and 
 defining monitoring data and communicating the monitoring data to the OR computing system during the computer-assisted procedure. 
 
     
     
         107 . The method of  claim 106  wherein the monitoring data is one or both of: intervention data to at least partially control the OR computing system; and audio and/or video data to present via an audio and/or display device. 
     
     
         108 . The method of any one of  claims 99  to  107  comprising receiving audio and/or video data from a microphone and/or video camera communicating the audio and/or video data to the operating room via the OR computing system. 
     
     
         109 . The method of any one of  claims 99  to  108  comprising receiving from the OR computing system additional data from at least one of the log data or intra-operative data generated by the OR computing system. 
     
     
         110 . The method of  claim 109  wherein the additional data comprises any of: camera image data, pose data determined from the camera image data, measurement data determined from the pose data, screenshot data, workflow state data, data representing a definition of one of the one or more objects, pre-operative patient data, and timestamp data for any of the intra-operative data.