It comforted me to spot the InfoComm booth at the HIMSS13 convention here in New Orleans. I'm a little out of my element. The vast majority of 1400 vendors are selling software solutions that capture, store, and parse medical information while wrestling with the federally mandated overhaul of the healthcare industry. I'm here looking for business opportunities for AV integrators (like me) in the world of healthcare-related hardware and solutions. If I can locate and vet some of the vendors providing equipment I can sell and install, my time here will be well spent. Healthcare integration is said to be the fastest growing AV vertical market segment; although it's apparent that the IT professionals and vendors here are more interested in big data than they are in big speakers.
The Ernest N. Morial Convention Center is just west of the Mississippi. In a way, I'm like a prospector in the New West. I know there is gold out there somewhere, but I'm not finding it laying around in the aisles and on the display tables like so much convention swag. It's hard to spot and harder still to bring it to the surface. There's a lot of free hand sanitizer, a mountain of monogramed pens - even free beer and popcorn - but no sparkling nuggets "as big as your fist."
I decide the best way to find opportunity is to find an empty chair, grab the floor guide, and start looking for familiar technology vendors in the index. Barco is here. That's a good start. I see Biamp, Canon, Elo, Epson, and scan all the way to Peerless without recognizing another vendor I know. Gold buried here is apparently in places I've not been, by vendors I don't recognize.
I've designed and installed traditional AV systems in hospitals using vendors and equipment I know. These paging systems, boardroom AV racks, training room projectors, and digital signs are all just like the ones in an office building or school. I've also provided routing and presentation systems in ORs, Cath labs, and EP theaters using some of this gear plus a few medical-grade items. There's opportunity to do this type of integration work in just about every hospital, but there's also a lot of other technologies around that traditional AV integrators don't recognize or might not know of. It's the gold dust, and that's what I'm looking for. I'm sure there are systems I've stepped over without seeing, but after walking the hall for two days, I found some that can be sold and installed by traditional AV integration firms willing to learn new products and skills.
We're all familiar with videoconferencing, but who's heard of a standalone medical evaluation kiosk linked to a full-time MD that can take your vital signs, diagnose your runny nose, scan your healthcare card, and write you an ePrescription on the spot. You can see the doctor and he can see you, but you can't see his pajama bottoms or the back door or his kitchen. He's working from home and you're in the BigMart pharmacy. This technology promises to save millions of unnecessary emergency room visits and is being considered by some of the largest retailers in the world as a viable and profitable service. AV integrators could sell, install, commission, and maintain these systems.
Another promising opportunity lies in the metamorphosis of the homely patient room TV into a beautiful point-of-service device capable of increasing patient satisfaction through the meaningful use of technology. These look like large touchscreens with GUI interfaces and video windows. They're mounted on boom arms that can be moved over the patient bed. They select TV channels, play instructional videos, and give you internet access. In addition, they replace the nurse call button, the pillow speaker, and the lunch menu. With a swipe of his or her ID card, your surgeon can retrieve the endoscope images from your angioplasty and review them bedside before your Propofol buzz wears off. Rapid physician consult and electronic entertainment increases patient satisfaction; one of the primary goals of reform and a top-level priority for providers. These point-of-service information displays help hospitals become more compliant with federal mandates and more likely to keep or capture their share of the evolving nationalized healthcare budget.
Another way of delivering better healthcare at lower cost is to closely track the flow of people and materials and to learn from their movements. Until recently, it was almost impossible to keep up with shared portable diagnostic equipment. It is rarely returned to storage immediately after use and tracking it down wastes hours of costly nurse time. Hospitals overstocked this leased or purchased equipment just to have spare units around when others could not be located. Enter RTLS, or real-time location systems. By tagging these items and tracking their locations in real time, hospitals can reduce the equipment they keep on hand, save hours of costly search time for it, and reduce or eliminate storage areas.
Using RF, Wi-Fi, and ultrasonic tracking, RTLS can triangulate the position of a particular unit within 10 feet anywhere in the hospital and let you find it using your smartphone. These are integrated systems that require facility heat mapping and engineering, installation of sensors and cable, and GUI software configuration. Sound familiar? The Department of Veterans Affairs just awarded HP a contract valued at upwards of $600 million to design and install these systems to track everything from ultrasound machines to hand soap. Some say it will top $1.6 billion before it's completed.
On a more personal level, RFID cards, bracelets, and dongles are used to locate patients and track their progress through their planned procedures. Mining the time and location data gathered reveals how long a patient stays in a waiting room, recovery room, or lobby. Using this data to identify and remove workflow roadblocks reduces inpatient length of stay. This is the essence of meaningful use of technology. There were at least 30 vendors at the show that provided software to analyze this data, but only a few manufacturers of the transmitters and receivers. Selling and installing these integrated systems represents another opportunity for systems integrators.
Linking location sensors to wayfinding monitors redefines the familiar "you are here" markers common to every location map. The signs show you where you are now by reading the location of your armband; it's like GPS for patients. Providing and installing these information displays is standard fare for AV integrators, but the many new sources for information and how it's formatted is driving demand for new and different displays, including large touchscreens, proximity sensing surfaces, and information walls. In turn, this information is integrated with electronic healthcare records (EHR) and workflow analysis software.
As a systems integrator, you have a choice of how much of this market you want to tackle. You can just install displays, or you can invest in training and knowledge necessary to configure the GUI and install servers and software. You can even sell the small-form-factor processors that mount to the displays if you know how to work with the hospital CIO and can speak his language.
Distributed antenna systems (DAS) are another low-voltage specialty market open to AV integrators. These are the systems that increase cellular coverage in the facility and allow emergency services radios to work inside hardened buildings. A little-known trend is the integration of wireless networking and DAS. Next-generation DAS will include full integration of wireless networking - replacing the familiar WAP with an antenna array and specialized RF repeaters and transceivers. This "whole house" integration initiative drives down costs and increases quality of service. Again, this is the essence of healthcare reform.
Nurse call systems are also becoming more integrated with RF and wireless networks. They are no longer just intercoms with pillow speakers, but now include wireless IP phone capability, remote equipment alarm transmission, and concierge services. Nurse call and overhead paging systems have long been a staple for low-voltage integrators, but with the addition of these complex software and hardware elements, savvy integrators should be able to expand their reach into telephony, diagnostic alarm integration, telemetry display, and DAS.
Human interface devices such as keyboards, touchscreens, computer monitors, and medical devices all need a place to live in the rooms where people wait, work, and collaborate. Mounting arms, kiosks, and attractive ergonomic cabinets represent a substantial integration opportunity, and there are plenty of manufacturers providing them. Some require special construction techniques and installation knowledge to meet infection control and ADA standards. Installing them requires coordination with other trades that provide power and data connections. That's integrator work, and AV integrators should be doing it.
Working and selling in the healthcare space will take some time to master, in addition to an investment in training and credentials. Most hospitals require infectious disease vaccinations and workplace training of vendors working in patient space. Opening ceilings, entering sterile spaces, or bringing non-sterile tools or equipment into operating rooms requires special training and permits. You also must understand the safety requirements of medical integration and how HIPAA plays into your designs. These requirements have kept most AV integrators out of this space - creating opportunity for those willing to overcome these roadblocks. It's easy to overstate the opportunity to find gold for AV integrators in this market, but it's there waiting for the patient, persistent, and determined.
