The Healthcare Economic Environment The advances in medical technology in the last quarter of a century have produced extraordinary changes in the way medicine and surgery is practiced. Among the benefits accrued from the application of this new technology includes a greater understanding of health and disease; improved efficiency in health care delivery; improved outcomes; decreased invasiveness of many diagnostic and therapeutic procedures; and decreased mortality and morbidity associated with those procedures. We have witnessed these advances originating within academic institutions and industry, with gradual dissemination into general practice in community hospitals.These advances have not been without certain drawbacks and shortcomings including escalating healthcare costs and, inequitable extension of these technologies to societies. It has been challenging to cost-justify many of the new technological and system advances, associated interventional procedures and redesigning of healthcare infrastructures such as operating rooms. The development and dissemination of these technologies have become central issues in the debate over healthcare reform and healthcare finance.To move beyond conceptual demonstrations of new interventional systems and towards the systematic assessment of interventional settings, an understanding of the expected maturity levels at present and in the foreseeable future is needed. This paper focuses on one important aspect of medical technology advancement in the next quarter of a century: the development of the Digital Operating Room [1][2][3][4]. Digital Operating Room In this paper, a timetable for the development of the Digital Operating Room (DOR) over a 25 year period is examined, including (1) its development up to the present time as well as its continued development and implementation (Fig.