From hospitals to dental practices, healthcare remains a growth market. Tim Kridel explores where AV pros are finding the biggest opportunities – and challenges.
Healthcare arguably is the world’s biggest vertical: $7.2 trillion worldwide in 2013 (approximately €6.4 trillion), which is 10.6% of the global gross domestic product, according to Deloitte. By 2018, it will top $9.3 trillion, driven by trends such as aging populations and greater access to care in emerging markets.
Those numbers should add up to plenty of opportunities for pro AV, and they do – just not equally everywhere. For example, countries hit hardest by the eurozone crisis – such as Greece and Spain – have tight budgets, potentially meaning less money available for AV-heavy systems such as telemedicine. Some countries are also in the midst of reforms of their insurance systems that will mean years of uncertainty in terms of both budgets and how care is delivered.
The Middle East is among the growth markets.
“They’re putting up new hospitals all over the place,” says Bill Nattress, who was a principal at Shen Milsom & Wilke before joining Biamp Systems as director of channel strategy for paging last year.. “If the price of oil were stronger, I’m sure there would be three times as many going up.
“The problem with 4K is that there’s not enough dental software that supports it.”
“Qatar has been in a major push to increase its healthcare facilities. Oman, Jordan, they’re looking to play catch up because they see what’s going on in the countries around them.”
But it’s one thing to build clinics and hospitals, and quite another to staff them. In the UK, for example, it can take up to two weeks to get an appointment with a general practitioner. So two years ago, the UK government began encouraging doctors to use Skype to better accommodate patients. The result: Nearly a fifth of patients now have used video to avoid a trek to the doctor. In a survey, another 25% said they would consider video if it meant they could have the appointment that day.
Driven by distraction
Waiting rooms are where old magazines go to die. That’s slowly changing, as clinics and hospitals add digital signage, whose content helps reduce perceived waiting times.
“You’re reading a Time Out magazine from 2012,” says James Keen, Tripleplay marketing manager. “It often makes what may only be 20 minutes feel like an hour. So they’re trying to counteract patient distress, which makes their satisfaction a lot lower.
“We’ve seen an increase in wanting to put in IPTV with digital signage. It’s quite a nice opportunity for integrators. Hospitals in the UK must have 20, 30, 40 waiting rooms.”
The signage can also be integrated with other systems so, for example, it can alert patients that their doctor is now available and in which exam room. That approach means a lower noise floor in a waiting area because there isn’t a PA or nurse constantly barking names.
Increasingly, the signage network extends outside the hospital walls to what’s broadly known as care hotels. Sometimes these are owned by the hospital and sit on its campus. Other times, they’re nearby and run by a third party, such as Ronald McDonald House. Either way, they exist as a convenient place for patients and their families to convalesce.
“If it’s a 200-room hotel, they need 200 TVs. They need Wi-Fi. They need IPTV,” says Keen, whose firm has worked on care hotels such as the one at Antwerp University Hospital in Belgium.
Care hotels sometimes need video not just for entertainment, but also for on-demand instruction.
“They’re using it to give them care information afterwards,” Keen says. “For example, if you’ve been in a car crash and broken a leg, they’ll provide you video content that shows how you should be rehabilitating. We’re seeing that coming up a little more.”
If the hospital owns the care hotel, the signage network can span both facilities, which means a bigger, more lucrative project for the integrator.
“With the right setup, you can service both from a single system,” Keen says.
Regardless of the signage network’s scope, it needs content. So as with signage in other verticals, there’s also often an opportunity for the integrator to provide content-creation and -management services.
“We have some clients that are brilliant at producing their own content,” Keen says. “For every client that’s self-sufficient, there are going to be two or three that require help. There’s a large opportunity for a professional service to be offered.”
That content could include advertising, such as from pharmaceutical companies or for the hospital’s restaurants. Third-party advertising used to be considered taboo, but some healthcare providers are warming to it. The promise of that revenue could mean a bigger budget for signage and related services.
“They’re a little more open to the idea now because budgets are being stretched quite badly,” Keen says. “So if there’s any way of monetising and getting a return on the investment, they’re sort of being forced into considering it now. But a lot of the drivers in NHS facilities are reducing costs rather than making money. Around Europe, you see it a little more.”
Containing costs
AV technology is another tool for hospitals to reduce readmissions, which insurance providers often balk at reimbursing if they believe they were avoidable. For example, displays in hospital rooms are a way to deliver information about caring for wounds, hopefully to the point that patients don’t let them worsen when they return home.
The business case for that AV gear is based partly on its ability to contain costs. Indeed, Barco’s marketing collateral for its PXP bedside platform cites a study showing that uninformed patients cost hospitals 8% to 21% more than informed patients.
“A big opportunity for interactive patient care systems has been created by the regulatory requirements of the US government around meaningful use, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and the electronic health records incentive programme,” says Ulrich Brüll, Barco market director interactive patient care. “These set the requirements for using patient engagement and education during the hospital stay to reduce preventable readmissions by patient education and to improve HCAHPS scorings by improving the patient experience.
“We see similar trends in Europe and the Middle East where patient experience moves more and more in the focus of healthcare organisations. [This] is a great business opportunity for the deployment of interactive patient care systems.”
Education opportunities can be found in other healthcare sectors, too. For example, some dentists equip their exam rooms with displays so they can show patients what a particular tooth looks like using intraoral cameras. This first-hand look helps patients understand why a particular procedure is necessary, helping maximise satisfaction because they’re not forced simply to take the dentist’s word for it.
Those displays can also show pre-packaged videos that educate patients about what a procedure entails and what to expect afterward. This information helps patients make informed decisions about whether to have the procedure and understand what to expect afterward.
“You can show a video of it being corrected and the person able to function,” says Dr. Craig Kohler, who’s been using video cameras and educational videos in his US practice for decades. “It’s a real positive for the patient as opposed to saying, ‘Let’s just pull it.’”
Kohler also uses video to educate patients about how to better care for their teeth and gums, such as by not flossing too aggressively.
“You can show someone a video and say: ‘Here’s a real, live person who got carried away because they were so interested in doing the right thing. So we want to make sure that when you floss, you don’t cut your gums because this is what it will look like,’” Kohler says. “That has value. It’s like, ‘That makes sense.’”
Attention to detail
For AV pros, success in healthcare hinges on understanding the vertical’s nuances. For example, 4K might sound like a natural choice for a dental practice because of the detail it enables, but that’s not necessarily the case.
“The problem with 4K is that there’s not enough dental software that supports it,” Kohler says. “In most offices, 1080p would be more than sufficient, [but] 4K would be nice in the waiting rooms.”
In other applications, colour purity is a key consideration when recommending technologies.
“I’m often humoured when I walk into a college of pharmacology auditorium and see a 1080p DLP projector because DLP doesn’t have the true yellow and cyan saturations necessary to get quality colour recognition out of them,” says Biamp’s Nattress. “Most people think, ‘It’s pharmacology, so it’s drugs.’ No, it’s cellular level, where colour is very important.”
Privacy is another major consideration, thanks partly to an increase in laws that levy six-figure fines for breaches. For instance, in the US, the Health Insurance Portability and Accountability Act (HIPAA) extends to speech privacy, which is driving the market for sound isolation. Those challenges and solutions are applicable in other countries where laws or health-care provider best practices demand privacy.
But medical facilities often have attributes that make it challenging to, for example, eliminate patient-doctor conversations from leaking into adjacent spaces. For instance, hard surfaces are the norm because they’re easier to disinfect. But hard surfaces also do a great job of reflecting sound, and solutions that work great in other verticals might not be viable if they’re likely to harbour dust, mould and germs.
Acoustical consultants often recommend building walls that go all the way up to the floor above rather than stopping at a drop ceiling, which creates an area that can transmit conversations from one room to another. This situation is also yet another example of why they should be involved with architects and general contractors early on in a project, when it’s easier and cheaper to address privacy-related design features.
The ability to identify such risks and offer solutions can be a competitive differentiator for AV pros, whether it’s against other AV firms or IT providers that are angling for a piece of the burgeoning healthcare market. At the very least, AV integrators and consultants need to be prepared to meet requirements that exceed those of many other verticals.
“They should be ready to offer a professional first-level support,” Brüll says. “Healthcare customers are very demanding when it comes to SLAs.”
Project timelines also can be long, and the need for integration with telephony and other systems is common.
“Interactive patient care projects can have very long project lead times: from six up to 24 months in some cases,” Brüll says. “Other challenges are the integration of IPC systems into hospital sub-systems like nurse call, VoIP or EMR systems via HL7, which can add some significant complexity.”
In the case of public facilities, yet another challenge is the tender process, where governments have to make sure each bid is competitive.
“If the value of your project is too high, then they have to go to public tender, and all the hard work you do selling the idea might go to waste because you charge €10 more for your digital signage player than the next one,” Keen says. “That’s a bit of a challenge. It’s price driven. It creates a bit of risk in the sales cycle.”