As the healthcare industry continues to seek ways of cutting costs and boosting efficiencies, a growing number of procedures are taking place outside of the hospital's operating room. This has driven an increase in the number of surgical centers across the country-specialized facilities where operations are performed on an outpatient basis.
"Fifteen years ago, there was no such thing as a day surgery unit, and today that is a very typical procedure room," observed Mark Dundas, president and CEO of communications systems manufacturer Tech Works. "People are in and out in a day, and this is done in small medical office suites as opposed to conventional hospitals. It's basically put the smaller hospitals out of business."
The primary force behind this is, predictably, economics. "The process of booking a person into an acute care facility, including the staff it takes to book and route people through a hospital, is expensive," Dundas said. "Not everyone needs all of the things in that hospital. It's much more efficient to have specialties in a small, specifically tailored facility where everything is right there." These clinics also solve the problem of geography: no longer must patients from suburban and rural areas travel to a major city to undergo these procedures.
This shift toward smaller facilities is changing the way AV technology is used in the healthcare market. Much like regular doctors' offices, these surgical centers are more casual than hospitals are, and elements such as music and video playback are not only present in the waiting room, but in the sterile procedure room as well, with an intercom system linking the two areas. "Now there are full-blown music systems with iPod inputs and all sorts of things to accommodate different sources of music, and wireless headsets are integrated with the intercom system so that when you touch the headset, the music automatically mutes," Dundas explained.
Healthcare professionals are placing more emphasis on pre- and post-op care, most notably through educating both the patient and the patient's family and friends about the procedure that is slated to take place, as well as what to expect afterward. "Education has become a fundamental part of a lot of healthcare facilities because it shortens the recovery period," Dundas said. AV playback systems-similar to the media retrieval systems used in schools-contribute to this process. In pre-op, the patient watches a video detailing the operation. While they are on the operating table, their family watches a similar video featuring instructions on patient care during recovery. "One of the things that they have found is that the recovery period is much more effective if they can teach both the patient and the family what to expect after the procedure. Everyone is much more informed and aware."
In large hospitals, the push for fully integrated operating rooms remains strong. "I have seen a large influx of Crestron products being implemented in the O.R. to control surgical devices such as bone shavers, pumps, lights in the O.R. and tables," Rich Sasson, director of technical services at Crestron Electronics. Surgeons manipulate these devices via touchscreen, and transmit information gathered by an endoscopic camera to and from the pathology lab. Most medical devices are controlled via RS-232, however medical instrument manufacturers have started to incorporate IP functionality.
To optimize workflow, hospitals require that these technologies not only communicate with each other in a given room, but throughout the entire building. "Hospitals are very much focused on having all of the various systems communicate with each other within the facility," said Maureen Pajerski, vice president of sales and marketing at Rauland-Borg.
Some of this is quite simple: the refrigerator in the blood bank is equipped with an alarm that pages the right people should temperatures fall below the acceptable level. More complex applications involve the integration of operating rooms with nurses' stations. "There is a workflow area that provides all of the information on the operating rooms," explained Scott Birdsall, president and CEO of CompView, a systems integrator and AMX dealer in Beaverton, OR. This enables the concerned parties to remain updated on the status of the O.R.: clean-up crews are alerted when a procedure is in its finishing stages, and nurses know when they should move patients from pre-op into the actual operating theater. With the assistance of plasma screens positioned throughout the building, patients' families have less trouble locating their loved ones as they are moved throughout hospital.
Communication And Training
Videoconferencing between hospitals, in the form of telemedicine, remains a popular way for surgeons to share information and new techniques throughout the country and around the world. Predictably, these systems are starting to incorporate HD.
Birdsall notes that teaching hospitals are taking advantage of AV integration technology, such as telemedicine and simulation systems. "Because they are moving toward minimally invasive surgery, they can train people in a simulation environment," he said. "It's a lower cost way to train people. With robotic surgery, it's a quick way to get people up and running on new technology."
As America's population grows older, one area that promises significant growth is assisted living. In order to address a demographic that has become increasing accustomed to the comforts and convenience offered by various forms of technology, these facilities-many of which include their own health clubs, wellness centers, and medical centers on site-boast integrated audio and video systems above and beyond the traditional nurse call systems that are present in every healthcare facility.
Smaller assisted living residences-large houses containing 12 or 15 beds-are also an untapped market, Dundas believes, and could present significant opportunities to those contractors who also work in the residential sector. "It's something that, right now, is not being fully addressed and hasn't really evolved completely," he said. "That is probably an area for huge growth over the next 30 years."