Healthcare professionals are increasingly turning to audiovisual equipment as procedures become more sophisticated and medical staff recognise the benefits new technologies can provide. However, Anna Mitchell finds out the market isn’t as immune to economic pressures as some might think.
As medical procedures and environments rapidly progress, hospitals and associated medical sites increasingly demand sophisticated and cutting-edge equipment. Amongst the new technologies, audiovisual equipment is featuring more and more as it becomes an integral, if not essential, part of many modern operating theatres, consultancy rooms, lecture halls and training centres.
EU regulations mean that in Europe these projects usually go through a fairly open tender process. However, Alistair Holdoway, managing director of Video South Medical Television, a UK based company that has more than 20 years’ experience in the medical arena, says it takes a particular company to understand how the huge machine that is the NHS works.
"It’s a very complex arena that’s often why it suits the medium sized company that’s been there for a long time," he explains adding that this can be seen in companies that supply other types of equipment to the NHS. "It takes a company that can get very close to the way the whole machine operates not just what we sell in terms of technology but actually understanding what it takes to close a deal and get a project underway – it’s quite complicated."
In the Netherlands, the way the contract process works depends on how the project is financed. "If the hospital has funding from the government they have to write out a tender and if not they can ask some preferred suppliers directly," says Jeroen Ruikes, project consultant for Netherlands based integrator, Inter Visual Systems. He offers some examples: "When we have an academic hospital it has funding from the government for education – any installation related to that kind of project goes through a tender process. When we have a local hospital, with no connection to the department of education, they can do what they want and do not have to commit to European regulation."
Ronen Brookstein, managing director of Barkai Benny Brookstein – an audiovisual systems integrator based in Israel, says it’s harder to get contracts in the public sphere in Israel. "You have to meet competitive prices or will be rejected and disqualified," he elaborated. "In the private sector they are occasionally willing to say ‘okay we value your better solutions and we agree to pay a higher premium’." However, right now there’s a slight difference in the situation. "On the one hand the economy has affected the medical market. Even an organisation which can afford it and has the money is being affected by the mood. But on the other hand the public medical market, just like public infrastructure business, is more open to investment or spending because the money has come from the Government. This Government has already announced one of the best ways for them to get business and the economy growing again is investing in infrastructure." But, explains Brookstein, there are further factors at play." Public hospitals are heavily funded by donations. "Donations have disappeared as the organisations that usually offer them have cut them. We know some tycoons who used to donate a lot of money to hospitals and they just say ‘sorry we don’t have that kind of money this year’."
Funding for medical installations in other regions is undergoing major threats and changes as the economy wavers. In the Netherlands Ruikes claims the government has had to intervene in areas where private money would usually support installations, saying the hospitals would otherwise be bankrupt. And in the UK, Holdoway has some concern for the future. "Our business with the NHS has been slowly rising over the last ten years," he starts. "But the recessional thing will probably kick in a bit later." In fact the very morning I spoke to Holdoway news reports in the UK claimed the NHS was facing a £15 billion funding shortfall.
But for now Holdoway says videoconferencing has been successful in healthcare. "Perhaps, in terms of percentage, more successful in its penetration than in business," he adds. "I think because expertise are clustered into health centres and hospitals videoconferencing makes a lot of sense." He continues: "Good quality large screen technology has always been very useful in medicine. We started putting projectors into rooms in the medical environment when a lot of people were still using overhead projectors and slides. Now, HD and HD projection as well as the falling cost of large LCD panels is proving very important." Holdoway dismissed 3D projection in the medical environment as a myth. "We don’t see any uptake on that. People often think that medicine is an obvious place for 3D, I just don’t agree at all."
Ruikes says a legal requirement to have every surgical operation recorded in the Netherlands has led to a greater uptake of audiovisual equipment throughout the whole medical arena and explains a typical installation Inter Visual Systems implements. "Cameras on endoscopes and laparoscopes are linked up to a recording system which is outside of the surgery room. The advantage of that is we can use high-performance equipment that does not need to meet medical requirements because it is outside the operating room. The link is also completely safe because there is no electrical connection between the surgical room and the technical room.
"There is also a feedback to displays on the walls of the surgical room," Ruikes continues. "We do that with a fibre optic connection. What is also important is the co-ordination between the hand and the eye because when the doctor is doing the operation, if the picture he sees from the endoscope of laparoscope is delayed by a second – he has a problem and cannot work accurately. The monitors must also meet medical standards and there should be no ventilators that can cause hygienic problems."
Training also drives a lot of audiovisual installations in healthcare. Brookstein highlights an interesting installation in a simulation centre. "It’s used for doctors to improve their skills by looking at what they’ve done. An actor will pose as a patient and will talk to the doctor about their symptoms in a session that is recorded." The doctors can then look back on how they responded to the patient’s concerns and how they handled situations. "A controller will sit in a control room and watch the video as it is recording. They can flag certain points and add remarks so when the video is reviewed with the doctor they can make suggestions for how they should have handled a situation." Physical exams, with actors also take place at the simulation centre and are recorded and reviewed in the same way. The actor can also hear instructions from the control room using an in-ear system.
Medical institutions seem, on the whole, eager and accepting of new technologies, making it a potentially profitable market for audiovisual integrators. However, most installations have specialist requirements and companies working in the field must know how the organisations they are targeting work and what they require. Furthermore, both private and public funding have been, and will continue to be, under pressure. Whilst there’s plenty of opportunity out there, the market doesn’t represent the gold mine some might think.