Interview: Ingo Aicher, Sigma-Jones

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India has set itself a tough task to deliver Universal Health Coverage to a country of 1.3 billion citizens by 2030. It’s an enormous challenge but the country has made significant gains and come a long way, with the Ayushman Bharat Yojana health assurance scheme a central part of the drive.

This initiative was launched by Prime Minister Narendra Modi as part of the National Health Policy 2017 and includes the provision for poor and vulnerable families to access healthcare at private hospitals with treatment paid for by the government.

The policy has transformed healthcare access for millions but a strict reimbursement catalogue for procedures often leaves private healthcare providers out of pocket for treatments delivered. While you might expect shrinking margins to leave less room for Indian healthcare providers to invest in technology, there’s one healthcare technology provider who disagrees.

Ingo Aicher, a director at medical system integrator Sigma-Jones, points out that around 70% of the cost for any operation is staff. “These are highly skilled professionals with relatively high wages so you can achieve significant cost savings by working smarter,” he says.

Sigma-Jones offers a range of AV technology products and services to the healthcare sector from its head office in Bangalore including smart operating theatre integration. Aicher sees updating operating theatres as a clear way to gain efficiencies while improving patient outcomes. “If, in a standard operating theatre you carry out five or six operations in a day, [switching to a smart operating theatre and] saving ten minutes on each procedure would deliver an extra hour in which another operation can be done,” he says.

India, like many other countries, needs more skilled healthcare professionals and the expansion of healthcare access has only increased demand for surgeons, doctors and nurses. Training is essential and education is another area where AV is perfectly positioned to help with distance learning allowing many more students to access instruction and demonstrations.

Aicher says lockdowns through the Covid-19 pandemic helped to demonstrate how effective remote learning can be: “Previously you would get 10 students into a room to watch an operation, but you can get better insight into a procedure from implementing an AV system [for remote learning].

“But, as with anything, you need to have the right system to get good results. If you have a poor video connection from the operating theatre to a meeting room, you can’t see the details required to understand procedures and accurately view vital details.” In addition to demands on low latency and uncompressed images, medical tuition has some nuances that set it aside from other distance learning projects. There are specific requirements on the interface between meeting or teaching rooms and operating theatres with rigid rules and regulations that must be followed. Data protection is also a key area for hospitals, which of course extends out into aspects of medical tuition. “Patient data privacy is a huge and sensitive area. You shouldn’t use Teams or Zoom for example as the data goes through servers and some content is saved for analysis which can be in breach of regulations,” says Aicher. So the opportunity for advanced AV technology in healthcare is obvious, but so too is the need to understand highly specialised requirements. Sigma-Jones, a partnership between Indian AV integrator Sigma AVIT and medical specialist Jones AV, is perfectly positioned to provide the specific expertise needed to deliver these vitally needed technology, systems and approaches. Aicher is a seasoned professional in AV healthcare, founding UK-headquartered Jones AV in 2008. The advanced integrated theatre and medical training facility provider has notched up some significant achievements through its work across Europe over the years, delivering the world’s first integrated operating theatre at Oslo University hospital. Jones AV also topped the Inavation Awards Healthcare project category a staggering five times, the most wins within a single category for any integrator in the history of the Awards. It was at the 2018 Inavation Awards ceremony in Amsterdam that Aicher met Sigma AVIT who, by chance, was looking for a route into healthcare in India. As a large AV integrator with some of India’s largest corporate projects under its belt, Sigma AVIT was familiar with many aspects of work within hospitals that have lots of demand for videowalls, digital signage and meeting room technologies. But it wanted a specialist partner to start delivering high-end operating theatre integration. Shortly after the meeting in Amsterdam, Aicher headed out to India visiting multiple cities, different hospitals and talking to doctors and healthcare professionals. “There was at the time quite some interest in operating theatre integration,” he says. “There were the usual players, the big medical corporations were operating in India, but there wasn’t anything in the way of really high-end operating theatre integration. Of course, much like everywhere else in the world, everyone wanted these facilities and technologies, but the budgets often weren’t there, so we still faced many challenges.” Aicher notes the huge gap between the cost of technologies for medical purposes and standard products. For example, a 32-in 4K medical-grade display can cost anywhere from 6,000 USD to more than 12,000 USD. Overcoming the expectation that these specialist products require that level of investment, as well as why they are worth it, is difficult and Sigma-Jones is often hampered by decisions to cut costs and implement systems that aren’t fully suitable for a healthcare setting. He adds: “Due to high shipping costs, import taxation and higher VAT rates in India, medical technology products are also often more expensive than in Europe. There’s a big drive toward locally produced technology through the government’s Make In India programme. Wherever possible we are trying to develop solutions, source and also manufacture products locally in India.” Despite the challenges Aicher is hopeful for the future and the Sigma-Jones project pipeline is testament to the fact that the arguments the team is making for the benefits and efficiencies that these technologies can bring to healthcare settings are being heard. “There’s a lot of money going into hospitals both from the government and private sector in India,” he says. “From our point of view a lot of it gets invested in the wrong place. So you have a marble entrance hall and a great LCD screen, but the operating theatre is not up to scratch. But we’re also seeing a lot of movement in the right direction. When hospitals are being planned, we’re seeing the technologies we provide being specified as a requirement from the start.”