Hospitals of the future: Multiple opportunities for AV as healthcare goes high-tech

Governments around EMEA are spending big on next-generation hospitals. Tim Kridel explores where AV fits into that nebulous future.

A lot of AV pros could be going to the hospital over the next decade. That’s actually a good thing.

Thank the growing number of EMEA government initiatives that provide billions to build “smart hospitals” and “hospitals of the future.” For example, Germany’s Hospital Future Act has a €4.3 billion fund, while the UK’s health infrastructure plan provides £2.8 billion (€3.3 billion).

“This plan is the biggest, boldest, hospital building programme in a generation,” former UK Secretary of State for Health and Social Care Matt Hancock says in the plan’s foreword. “We’re giving the green light to more than 40 new hospital projects across the country, six getting the go-ahead immediately, and over 30 that could be built over the next decade.”

Identifying the specific AV opportunities at this stage is challenging because these initiatives typically paint in broad strokes when it comes to describing the types of technologies they’ll fund. (An exception is Germany’s requirement that 15% go toward IT security.) Instead, they focus more on outcomes.

“They have a specific goal of making healthcare facilities more efficient, more comfortable and safer,” says Job Kamphuis, Siemens Smart Infrastructure global head for the healthcare market. “So it is not just investing in creating more facilities. These programmes provide a huge opportunity for companies who understand operational technology (OT), IT and medical technology and are also able to help to leverage this technology into real savings and other KPI improvements.”

Maximising efficiency and productivity — which could span everything from electronic health records to telehealth — would help generate a return on the multi-billion investments.

“The business case for smart hospitals is already very strong,” says a McKinsey & Company study. “Our experience suggests that in most OECD countries, implementing digital technologies in healthcare delivery could help realise cost savings of more than 10% of overall annual national healthcare expenditures.”


More video collaboration

Another common goal is using technology to enable collaboration between medical professionals and interaction with patients. Most of those use cases involve video, which sets up the opportunity for AV firms to provide VR headsets, videowalls and immersive CAVE systems.

“The ability to share more information is critical to the next stage of evolution of healthcare modalities,” says Sam McMaster, Hospital Services Limited (HSL) director of telehealth. “This will result in clinicians being able to access/consume patient data, have it reviewed by colleagues, add value through artificial intelligence (AI) support tools and share their expertise in diagnosing and treating patients from almost anywhere.”

Hospitals of the future: Multiple opportunities for AV as healthcare goes high-tech
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Some of these telehealth applications could get a boost from their use of smartphones and tablets instead of having to provide each patient with a specialised and thus expensive device.

“We had a trial of a remote stroke system in Belfast in 2019 where the consultant was able to undertake a clinical consultation — albeit a test not on a real patient — from a bus using an app on an iPhone, a 4G connection and a powerful suite of infrastructure services that we provide to drive the interaction,” McMaster says. “So, yes, there will be many more clinical-grade displays available in all sorts of places to give more clinicians access to real-time and archived patient data and for them to collaborate with colleagues to produce quicker and sometimes better outcomes for patients.”

Covid-19 experiences also are shaping hospitals for the future in ways that benefit pro AV.

“With Covid came the need for a lot of remote communications, for teaching, referring, assessment and homeworking in the healthcare [space],” says Ingo Aicher, Jones AV managing director. “This practically overnight requirement drove a lot of demand for new IT and AV solutions to be installed and delivered quickly.”


Going the distance

Some smart hospital applications don’t have an immediately obvious AV aspect but are potential opportunities nonetheless. Take drones, which are increasingly being used to transport medicine and medical equipment to remote locations such as rural communities.

A hospital that’s home to a large fleet will need a flight operations centre similar to the ones that the military uses to pilot its drones from hundreds or thousands of kilometres away. That’s a potential opportunity for AV firms with experience designing and installing operations centres for transportation departments, law enforcement agencies and telecom providers. 

Some potential smart hospital applications already exist but could be taken to another level as technology advances and funding becomes available. Take robotic surgical systems such as da Vinci. In the hospital of the future, a single surgeon might operate multiple systems — including ones at affiliated hospitals across town or across the country.

That scenario would increase productivity and access to care because surgeons and patients wouldn’t have to travel as much or at all. It also would require a variety of AV technologies, from displays to VR headsets.

“I can totally see myself sitting here at my desk, guiding three operations in three different locations,” Sricharan Chalikonda, a surgeon at the Cleveland Clinic in the US, told The Economist in 2017.

Two years later, doctors in China’s Sanya City performed a three-hour brain surgery on a patient in Beijing. “You barely feel that the patient is 3,000 kilometres away," one of the surgeons, Ling Zhipei, told China Global Television Network.


Reliable broadband is key

The Chinese surgery is noteworthy for another reason: The surgeons controlled the robot over a 5G mobile rather than a wired connection. “The 5G network has solved problems like video lag and remote-control delay experienced under the 4G network, ensuring a nearly real-time operation,” Ling said.

But some AV pros see mobile networks as the weak link when it comes to enabling smart hospital use cases that involve remote care, whether it’s robotic surgery or a telehealth visit in the patient’s home or at a rural clinic.

“5G promises a lot, but 3G is still not universal across the UK,” says HSL’s McMaster. “Can we really develop healthcare models that can only be delivered to those people who already have advantageous access to high-speed internet? Is this socially or morally acceptable?”

Technology advances have steadily shrunk some types of medical imaging equipment to the point that they now can be installed in the back of an ambulance. And in New Zealand, Victoria University developed a magnetic resonance imaging (MRI) scanner that can be transported by lorry, such as to a disaster site.

Those kinds of mobile and portable applications would drive the need for more displays and VR headsets at the hospital so physicians and nurses can review scans to prepare for incoming patients. They obviously can’t use fibre or copper, but they also can’t use a 5G mobile network that isn’t available where they are.

“Collaboration using VR headsets to connect from ambulances or static incidents in the field to hospital (or other peripatetic staff) is real,” McMaster says. “We are already doing this with the health services in Ireland. But the challenge is the availability of a suitable and consistent network service to keep the remote clinicians connected and to get real-time data from the patient. It will come, but by when?”


Help from above

Space technology could be the key to unlocking some of these next-gen use cases. For example, smart hospitals could use low earth orbit (LEO) satellites or drone-like high-altitude platform stations (HAPS) to connect with patient homes, rural clinics, ambulances and field hospitals.

“With technology advancing, and business models evolving, there is no single path to success,” says Rory J. Mulvey, Capgemini Engineering head of satellite communications and regional communication service providers. “LEO solutions are being tested today with promising results with much higher throughput speeds and ability to reach these areas. The investment required, though, is not insignificant. HAPS could provide another path forward to reach areas that are not reachable today.”

As part of the UK health infrastructure plan, the European Space Agency (ESA) and UK Space Agency (UKSA) are helping with “the first of a series of space-enabled hospitals.” [A vision of how they'll look at the top of the page and below]


Hospitals of the future: Multiple opportunities for AV as healthcare goes high-tech

“One person in charge of this future hospital project previously worked for the UKSA,” says Arnaut Runge, an ESA medical engineer. “They saw that there are plenty of activities that we’re doing that can really help facilitating [this vision].”

ESA and UKSA are evaluating a variety of proposed use cases from British companies. These could include satellite-connected telehealth or X-ray machines compact enough for portable use, and use technologies pioneered on missions to the International Space Station. The aforementioned drone fleets are an existing project developed to help the UK National Health Service cope with the pandemic.

“From a space perspective, we say: ‘This is feasible’ or ‘This is not feasible,’” Runge says. “We explain how space can play a role in different domains of the hospital, but we don’t define the topics ourselves. The call is pretty open.”


Putting hospitality in hospitals

AV firms are increasingly expanding into smart building applications, many of which are a good fit for smart hospitals.

“For the patient room, it is important to integrate HVAC, lighting and shading systems so that the patient can control the room environment to her/his liking,” says Siemens’ Kamphuis. “Having room controls at the bedside is in the top five of improving patient satisfaction.”

AV firms also could leverage their experience in the hospitality market. The July-August 2018 Inavate explored how hotel operators such as Marriott are considering direct-view LED on walls so guests can choose room themes, such as a virtual jungle. Hospitals of the future could use the same concept so patients can have wall-to-wall, floor-to-ceiling scenes that take their mind off of where they are.

That article also explored speech control in guest rooms, with Marriot as Amazon’s first customer for Alexa for Hospitality. Part of the business case is reducing the amount of staff required to field calls and then forward those requests. For example, guests could simply say, “I need more towels,” and the smart speaker’s AI would automatically route that to housekeeping.

In the hospital, patients could use speech control to turn lights on and off, adjust the room temperature or close the motorized window shades instead of summoning a nurse. Besides freeing harried nurses to focus on care, speech control also would eliminate injuries when patients try to get out of bed to do those things themselves. Those use cases fit what Siemens’ Kamphuis says are the goal of government initiatives such as the UK’s health infrastructure plan: making healthcare facilities more efficient, more comfortable and safer.

Time — a lot of it — will tell how many of these use cases become reality simply because of the nature of healthcare.

“The medical technology world is a slow-paced area for technology implementation,” says Jones AV’s Aicher. “Devices have to be approved and certified before used in, near and on patients. This certification can take a long time, and these processes costs a lot of money. So a lot of tech never makes it quite all the way to be cleared for use in hospitals.”

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