SDI, HDMI or IP, what technology is the most appropriate for your project?

October 2021

Most of video management (VM) solutions on the market allow you to "do the same thing" from a functional point of view: to route, to display, to record, to stream, to ensure a connection with the PACS.

However, not all VM designers and manufacturers choose the same technology on which to build their solution. How then to distinguish the VM solutions on the basis of a comparison between the different technologies?

What are the differences and the impacts of one technological choice over another? Which one to favor and in which case?

In the market today, we see a profusion of solutions that are based on IP technology. Does that mean it's the right one? Why is it interesting? What are the points you have to be careful about?

For us, as a manufacturer, the stakes are twofold:

·       We have to know how to meet an increasingly demanding level in terms of video management and image quality (constantly evolving, improving)

·       Be competitive and accessible in terms of price

In this article we will give you the keys to understand these different technologies, first by comparing them with each other and finally by looking more closely at IP technology. Let's go!

Part 1: Comparative table of the most common technologies

Access the french version of the table here.

In a nutshell, we realize from reading this table that there is no one-size-fits-all solution. Finding the right solution for your establishment, - namely one that will be consistent with the challenges of your establishment, reliable because it is suited to your infrastructure, easy to maintain because it is adjusted to your internal technical resources - this will require a technical and financial analysis of the situation.

Part 2: ZOOM on the IP technology

In just a few short years, this technology has successfully established itself in the medical video management market. Adopted and pushed by the great leaders, it has certain advantages:

-       It is independent of the type of video signal, then compatible with all the video signals present in the OR

-       It has great potential for scalability which is essentially based on adding or updating software and not the purchase and integration of additional hardware module

-       With only one link it carries video, audio and computer data at the same time. Hence the installation is greatly simplified.

Today with one or two exceptions, market players offer only one solution or are actively switching to a single video management solution: the IP solution.

In this part we will describe the three technologies developed and made available to integrators like ISIS.

A technology in itself is not a product. It is made up of different modules that integrators use to assemble their own video management solution. All the solutions on the market are made up in the same way: both software (API, user interface) and hardware (encoders, decoders, cables, switches, screens, etc.).

In most cases, the big leaders outsource the integration. ISIS is one of the only companies to do its own integration. The technological expertise held by ISIS brings significant added value for healthcare establishments. Particularly in terms of maintenance, technical support and product development responsiveness.

3 solutions on the IP market : Barco, Sony and SDVoE


Barco was the first manufacturer to commercialize this technology. This is a proprietary technology. Among its technical characteristics, this technology ensures perfect transmission of the image, without compression and therefore without loss of quality. It uses a 10 Gigabit network for optimum transmission speed and only works on a type of switch certified by Barco. They also offer monitors with built-in decoders for aesthetic and space savings. To keep their promise "without compression" and transmit 4K signals, they require two 10Gb optical fiber links. This results in the use of two switch ports for a single 4K signal *. There is therefore twice as much cable to pull. This forces their customers to take a larger switch size and therefore more expensive.


InFull-HD, decoders can display two streams simultaneously (dualview). 4K versions can display a maximum of 4 views (quadview). Their system does not allow devices such as cameras or monitors to be controlled via the same network link. They have a KVM (Keyboard Video Mouse) option that allows you to deport the cockpit. Only analog audio is supported. No possibility of audio embedded in video, (eg a video conference that outputs audio to the video signal). You can have multiview layout up to 8 sources, but with an additional hardware module (quite expensive IP processor), for hybrid rooms for example.

*Please note: 1 Full HD (1080p, 60Hz) image uses 3Gbit of bandwidth. 4K video uses about 4 times the bandwidth, or 12Gb: hence the need to pull twice as many links to ensure uncompressed video stream in 4K.


Sony developed proprietary technology after acquiring e-SATURNUS, a company specializing in IP video solutions for the medical sector. They developed their technology which they were the only ones to transform into a finished product. Not like BARCO which sells its modules to integrators. The idea behind was to be able to offer a turnkey solution to their client. Sony is not very transparent about the technology in focus. Based on our feedback, it seems they are using 1Gb inFull-HD and 10Gb in 4K. For Full HD, they therefore opted for high compression and therefore lower image quality.


SDVOE has brought the advantage of not being dependent on a single manufacturer. It’s a consortium. The founding members of the SDVoE Alliance are Christie, Sony, ZeeVee and NETGEAR, as well as many other contributors such as Altimium, Kramer, PureLink, DVIGear. These players are manufacturers with expertise in signal distribution, display manufacturing, IT infrastructure, chip design, and AV software. The integrator therefore has the choice of components (eg: switch) among dozens of partners to assemble his solution.

Regarding the technical characteristics, this technology is based, like Barco, on a 10Gb network with the difference that it only uses one network link for each signal including 4K.

There is 0 latency and a native possibility of multiview layout up to 16 sources (versus 4 sources max for Barco). It allows the control of several peripherals in RS232, IP and infrared as well as a USB 2.0 connection, for example an external hard drive for storage or a camera (not only keyboard / mouse like Barco). Audio management is complete. It is also possible to manage video walls. This turns out to be an advantage when you want to display the image on an 8K monitor.

The two benchmarks for comparing performance between technologies are image quality and display speed.

How not to lose image quality or display speed with a single 10Gb fiber (vs Barco which draws 2)? Well, SDVoE provides a compression ratio of 1.3: 1, which is extremely low and visually imperceptible to surgeons and validated for use in the operating room.

In addition, the alliance is regularly enriched with new suppliers, which gives customers more choice and guarantees the sustainability of their solutions.

To learn more about the advantages of SDVoE: click here. (FR : cliquez ici)

At ISIS, we have always made a point of working with non-captive solutions for both, us and our customers. This has enabled us to ensure them continuity in the range of products, maintenance of the machine park and improvement of existing products. Our IP solution has therefore been based on SDVoE technology since 2017.

SDVoE is only in its infancy and will continue to evolve and offer new features that are easy to upgrade as they are software-based, hardware independent.

To conclude...

The answer to our initial question "which technology to choose to equip your operating rooms?" requires careful consideration. It is not simply a question of following a technological trend, a lot of parameters (initial need, existing equipment, skills of the site's technical team, budget, maintenance, etc.) must be weighed and analyzed as can be seen on the comparative table. Indeed, it may happen that in a given market technological innovation leads to the disappearance of a technology, which has become obsolete and less efficient, in favor of a new one that is more advantageous. Ex: the CD-ROM replaced by USB. In our industry, we are still at a crossroad and are unable to predict what will happen in 5 or 10 years. In addition, IP technology, still relatively uncommon, remains expensive or even oversized compared to the essential needs of some sites.

At ISIS, we have chosen to master the three technologies and are the only ones on the market to offer such a large panel in order to best advise our customers and provide them with the solution that best meets their needs.

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