In February 2019, Northwell Health became the first healthcare system in the U.S. to deploy OR Black Box® technology, which records audio, video, and physiological data from operating rooms to improve surgical safety and performance. Developed by Surgical Safety Technologies, this system captures detailed insights into laparoscopic surgeries, such as urologic and colon procedures, by synchronizing data from the surgical field, staff communications, and patient vitals. The technology aims to enhance team collaboration, identify system issues, and evaluate surgical techniques, with a focus on improving outcomes and teaching. It also helps analyze adverse events by examining how unexpected situations, like patient anatomy variations, are managed in real time.

Northwell's use of the OR Black Box has revealed valuable insights into OR dynamics, including distractions caused by staff movement in and out of the room, and the role of communication in managing complications. The system is designed to maintain privacy by de-identifying data and focusing on systemic issues rather than individual performance. While still in its early stages, the initiative has shown promise in fostering a data-driven approach to improving surgical practices, and Northwell is considering expanding the technology across its hospitals. Other U.S. health systems are also adopting OR Black Box technology to enhance patient safety and surgical outcomes.