AV’s part in saving lives

Remote meetings and consultations save time and money for the NHS, long journeys for patients, and sometimes even lives through faster diagnosis and treatment. Training sessions can be seen in better detail, relayed live to students in remote locations, and accessed on-demand via e-learning.

Solutions vary to fit almost any budget and bandwidth, from immersive telepresence for lecturers to tablet PCs for district nurses. AV networks are becoming technology-agnostic, enabling thousands of healthcare workers to connect from any available device.

High status, busy schedules and big egos mean that clinicians can be demanding clients. But if suppliers treat them professionally – and, crucially, deliver the goods – the relationship need not be stressful.

“Clinicians don’t want to encroach on your expertise, and they can show an incredible degree of patience and attention,” says John Sykes, principal consultant at the consulting engineering firm Arup which has worked on many medical projects.

An iPad being used in hospital, with Polycom VC software

“They’re very clear about their requirements, which makes the designer and specifier’s job much easier. Medical institutions also tend to have good technical knowledge in-house.”

Top of a doctor’s AV wish list is quality, says Ben Pain, technical and AV manager at the Royal College of Physicians: “They’re looking for detailed, high-definition imaging, and colour reproduction that’s as close to perfect as possible. If, for example, you’re showing an inflamed heart valve, the exact colour can be critical.”

Ease of use and smooth operation are essential, especially if clinicians are presenting to their peers. “It’s like having a room full of senior executives. The technology has to work first time, every time,” says Julian Rutland, director of the visual communications group at Canon.

More critically, as Andrew Graley, EMEA director of healthcare at video conferencing vendor Polycom, points out: “These can be life or death situations and the technology must be reliable. There must be no downtime, so that patient care isn’t negatively impacted.”

Sustainability is a growing issue within the healthcare sector, says Sykes, adding to the attractiveness of lower-energy technology such as cloud-based systems. Cloud is also attractive as a way of reducing costs in a sector that has become even shorter of cash since the squeeze on public spending.

“They’re keen to explore cloud, unified communications, and convergent technologies because these free up money to spend on high-quality products where they’re really needed,” says Sykes. “They want the best quality their budget can buy, and they’ll simplify the specification rather than over-complicate and compromise on quality. The greatest challenge to wider adoption of cloud technology is the need for absolute confidentiality, which the cloud has yet to deliver.”

Polycom Practitioner Cart Patient Room

In many cases, however, cost and quality are on something of a collision course. “More and more we’re asked to provide high-quality collaborative products that don’t cost very much, and it’s hard to achieve both,” says the Royal College of Physicians’ Pain. “Some hospitals are plodding on with five- or 10-year-old AV kit because they lack the funds to replace it,” he adds.

Lack of central control and lack of funding can cause problems, warns Freddie Elliott, UK sales manager at NEC Healthcare: “Typically, each NHS department will manage its own budget, and in departments other than radiology (which is relied upon to make the diagnosis) there’s a temptation to find quick-fix solutions that are detrimental to achieving long-term efficiencies.

“Vendors will find this a challenge and should stress the importance of making a long-term investment in a product that’s fit for purpose rather than a cheap, non-commercial product that’s likely to fail,” he says.

There is a strict dividing line between medical imaging, such as using X-rays for diagnosis, and more general AV applications.
Monitors and projectors used for diagnosis and clinical review should conform to the strict DICOM (Digital Imaging and Communications in Medicine) standards, whereas for more general communications and teaching, high-quality commercial products are considered perfectly adequate.

“An X-ray has to look like an X-ray and if, for example, your gamma table is wrong, it won’t,” says Rutland. “Colour matching and how colours and grey scales are displayed is a fine art that people don’t always appreciate.”

Canon produces special medical versions of its high-end LCoS projectors. There is also a potential market for calibration products that use a sensor to adjust the projector to the ambient lighting conditions, adds Rutland.

Tailored healthcare systems are now appearing. Polycom has developed a Practitioner Cart for use in hospitals or other locations such as patients’ homes. The doctor uses an HDX room video conferencing system while the Practitioner Cart is at the patient’s end, containing a pan-and-zoom camera, monitor and moveable workspace, enabling doctors to examine patients remotely.

Cyberfish, a network of Swiss AV experts, has created an interdisciplinary, international Cybermedical Community using technology from video conferencing and telepresence vendor Vidyo

The Healthcare Alliance Group (HAG) – led by Reflex AV and including NEC, Polycom, Crestron, Smart, Teammate and others – offers tailored healthcare systems by drawing together a number of relevant vendors. It is successfully selling operating room systems combining video conferencing, desking, bed management and digital signage, says Elliott.

Three-dimensional imaging is still a little way off thanks to the inconveniences of wearing 3D specs and the cost of creating 3D content, say the experts. But venues are already installing the necessary infrastructure in anticipation.

The Royal Society of Medicine’s new lecture theatre at its One Wimpole Street headquarters has a Christie 10k M series projector and other system elements that are 3D compatible or upgradeable should demand increase, says the society’s AV manager, Kevin McLoughlin.

“We’re certain to see 3D impacting video conferencing in the future,” says Polycom’s Graley. “The next evolution is probably a holographic projection, with life-size images of people standing in the 3D physical space. This could be of particular relevance to doctors performing patient examinations via video.”

But despite the highly demanding nature of medical AV systems and their users, there is still a place for more basic AV.

“It doesn’t always have to be about HD, 3D or other advanced technologies,” says McLoughlin. “The often-forgotten visualiser/document camera can have an entire audience glued to the screen when a human heart is placed on it for live dissection.”