Tom Mottlau, LG Healthcare

The 16:9 PODCAST IS SPONSORED BY SCREENFEED – DIGITAL SIGNAGE CONTENT

The health care sector has long struck me as having environments and dynamics that would benefit a lot from using digital signage technology. Accurate information is critically important, and things change quickly and often - in ways that make paper and dry erase marker board solutions seem antiquated and silly.

But it is a tough sector to work in and crack - because of the layers of bureaucracy, tight regulations and the simple reality that medical facilities go up over several years, not months. People often talk about the digital signage solution sales cycle being something like 18 months on average. With healthcare, it can be double or triple that.

The other challenge is that it is highly specialized and there are well-established companies referred to as patient engagement providers. So any digital signage software or solutions company thinking about going after health care business will be competing with companies that already know the industry and its technologies, like medical records, and have very established ties.

LG has been active in the healthcare sector for decades, and sells specific displays and a platform used by patient engagement providers that the electronics giant has as business partners. I had a really insightful chat with Tom Mottlau, LG's director of healthcare sales.

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TRANSCRIPT

David: Tom, thank you for joining me. Can you give me a rundown of what your role is at LG? 

Tom Mottlau: I am the Director of Healthcare Sales for LG. I've been in this role for some time now; I joined the company in 1999 and have been selling quite a bit into the patient room for some time. 

David: Has most of your focus through those years all been on healthcare?

Tom Mottlau: Well, actually, when I started, I was a trainer when we were going through the digital rollout when we were bringing high-definition television into living rooms. My house was actually the beta site for WXIA for a time there until we got our language codes right. But soon after, I moved over to the commercial side and healthcare, around 2001-2002. 

David: Oh, wow. So yeah, you've been at it a long time then. Much has changed! 

Tom Mottlau: Yes, sir. 

David: And I guess in some cases, nothing has changed. 

Tom Mottlau: Yep.

David: Healthcare is an interesting vertical market for me because it seems so opportune, but I tend to think it's both terrifying and very grinding in that they're quite often very large institutions, sometimes government-associated or university-associated, and very few things happen quickly. Is that a fair assessment? 

Tom Mottlau: Absolutely. There's a lot of oversight in the patient room. It's a very litigation-rich environment, and so there's a bit of bureaucracy to cut through to make sure that you're bringing in something that's both safe for patients and protects their privacy but also performs a useful function. 

David: I guess the other big challenge is the build-time. You can get word of an opportunity for a medical center that's going up in a particular city, and realistically, it's probably 5-7 years out before it actually opens its doors, right?

Tom Mottlau: That’s true. Not only that but very often, capital projects go through a gestation period that can be a year or two from the time you actually start talking about the opportunity. 

David: And when it comes to patient engagement displays and related displays around the patient care areas, is that something that engineers and architects scheme in early on, or is it something that we start talking about 3-4 years into the design and build process? 

Tom Mottlau: Well, the part that's schemed in is often what size displays we're going to need. So, for example, if somebody is looking to deploy maybe a two-screen approach or a large-format approach, that's the type of thing that is discussed early on, but then when they come up on trying to decide between the patient engagement providers in the market, they do their full assessment at that time because things evolve and also needs change in that whole period that may take a couple of years you may go as we did from an environment that absolutely wanted no cameras to an environment that kind of wanted cameras after COVID.

You know, so things change. So they're constantly having those discussions. 

David: Why switch to wanting cameras because of COVID? 

Tom Mottlau: Really, because the hospitals were locked down. You couldn't go in and see your loved one. There was a thought that if we could limit the in-person contact, maybe we could save lives, and so there was a lot of thought around using technology to overcome the challenges of contagion, and so there was even funding dedicated towards it and a number of companies focused on it 

David: That's interesting because I wondered whether, in the healthcare sector, business opportunities just flat dried up because the organizations were so focused on dealing with COVID or whether it actually opened up new opportunities or diverted budgets to things that maybe weren't thought about before, like video?

Tom Mottlau: True, I mean, the video focus was definitely because of COVID, but then again, you had facilities where all of their outpatient procedures had dried up. So they were strained from a budget standpoint, and so they had to be very picky about where they spent their dollars. 

Now the equipment is in the patient room, but at the end of the day, we're still going to get the same flow of patients. People don't choose when to be sick. If it's gonna be either the same or higher because of those with COVID, so they still need to supply those rooms with displays, even though they were going through a crisis, they still had to budget and still had to go through their day-to-day buying of that product. 

David: Is this a specialty application and solution as opposed to something that a more generic digital signage, proAV company could offer? My gut tells me that in order to be successful, you really need to know the healthcare environment.

You can't just say, we've got these screens, we've got the software, what do you need? 

Tom Mottlau: Yeah, that's a very good question. Everything we do on our end is driven by VOC (voice of customer). We partner with the top patient engagement providers in the country. There are a handful that are what we call tier one. We actually provide them with products that they vet out before we go into production. 

We go to them to ask them, what do you need? What products do you need for that patient? I mean, and that's where the patient engagement boards, the idea of patient engagement boards came from was we had to provide them a display that met, at the time, 60065 UL, which is now 62368-1, so that they can meet NFPA 99 fire code. 

David: I love it when you talk dirty.

Tom Mottlau: Yeah, there's a lot of stuff out there that. 

David: What the hell is he talking about? 

Tom Mottlau: Yeah, I know enough to be dangerous. Basically, what it boils down to is we want to make sure that our products are vetted by a third party. UL is considered a respectable testing agency, and that's why you find most electronics are vetted by them and so they test them in the patient room. It's a high-oxygen environment with folks who are debilitated and life-sustaining equipment so the product has to be tested. 

We knew that we had to provide a product for our SIs that would meet those specs as well as other specs that they had like they wanted something that could be POE-powered because it takes an act of Congress to add a 110-amp outlet to a patient room. It's just a lot of bureaucracy for that. So we decided to roll out two units: one of 32, which is POE, and one that's 43. Taking all those things I just mentioned into consideration, as well as things like lighting. 

Folks didn't want a big night light so we had to spend a little extra attention on the ambient light sensor and that type of thing. This is our first offering.

David: So for doofuses like me who don't spend a lot of time thinking about underwriter lab, certifications, and so on, just about any monitor, well, I assume any monitor that is marketed by credible companies in North America is UL-certified, but these are different grades of UL, I'm guessing? 

Tom Mottlau: They are. Going back in the day of CRTs, if you take it all the way back then when you put a product into a room that has a high-powered cathode ray tube and there's oxygen floating around, safety is always of concern. So, going way back, probably driven by product liability and that type of thing. We all wanted to produce a safe product, and that's why we turned to those companies. The way that works is we design a product, we throw it over to them, and they come back and say, okay, this is great, but you got to change this, and this could be anything.

And then we go back and forth until we arrive at a product that's safe for that environment, with that low level of oxygen, with everything else into consideration in that room. 

David: Is it different when you get out into the hallways and the nursing stations and so on? Do you still need that level, like within a certain proximity of oxygen or other gases, do you need to have that? 

Tom Mottlau: It depends on the facility's tolerance because there is no federal law per se, and it could vary based on how they feel about it. I know that Florida tends to be very strict, but as a company, we had to find a place to draw that line, like where can we be safe and provide general products and where can we provide something that specialized? 

And that's usually oxygenated patient room is usually the guideline. If there's oxygen in the walls and that type of thing, that's usually the guideline and the use of a pillow speaker. Outside into the hallways, not so much, but it depends on the facility. We just lay out the facts and let them decide. We sell both. 

David: Is it a big additional cost to have that additional protection or whatever you want to call it, the engineering aspects? 

Tom Mottlau: Yes. 

David: So it's not like 10 percent more; it can be quite a bit more?

Tom Mottlau: I'm not sure of the percentage, but there's a noticeable amount. Keep in mind it's typically not just achieving those ratings; it's some of the other design aspects that go into it. I mean, the fact that you have pillow speaker circuitry to begin with, there's a cost basis for that.

There's a cost basis for maintaining an installer menu of 117+ items. There's a cost basis for maintaining a Pro:Centric webOS platform. You do tend to find it because of those things, not just any one of them, but because of all of them collectively, yeah, the cost is higher. I would also say that the warranties tend to be more encompassing. It's not like you have to drive it down to Ted's TV. Somebody comes and actually remedies on-site. So yeah, all of that carries a cost basis. That's why you're paying for that value. 

David: You mentioned that you sell or partner with patient engagement providers. Could you describe what those companies do and offer?

Tom Mottlau: Yeah, and there's a number of them. Really, just to be objective, I'll give you some of the tier ones, the ones that have taken our product over the years and tested and provided back, and the ones that have participated in our development summit. I'll touch on that in a moment after this.

So companies like Aceso, you have Uniguest who were part of TVR who offers the pCare solutions. You have Get Well, Sonify, those types of companies; they've been at this for years, and as I mentioned, we have a development summit where we, for years, have piled these guys on a plane. The CTOs went off to Korea and the way I describe it is we all come into a room, and I say, we're about to enter Festivus. We want you to tell us all the ways we've disappointed you with our platform, and we sit in that room, we get tomatoes thrown at us, and then we make changes to the platform to accommodate what they need.

And then that way, they're confident that they're deploying a product that we've done all we can to improve the functionality of their patient engagement systems. After all, we're a platform provider, which is what we are. 

David: When you define patient engagement, what would be the technology mix that you would typically find in a modernized or newly opened patient care area?

Tom Mottlau: So that would be going back years ago. I guess it started more with patient education. If Mrs. Jones is having a procedure on her kidney, they want her to be educated on what she can eat or not eat, so they found a way to bring that patient education to the patient room over the TVs. But then they also wanted to confirm she watched it, and then it went on from there. 

It's not only the entertainment, but it's also things that help improve workflows, maybe even the filling out of surveys and whatnot on the platform, Being able to order your culinary, just knowing who your doctor is, questions, educational videos, all of those things and then link up with EMR.

David: What's that? 

Tom Mottlau: Electronic medical records. Over the years, healthcare has wanted to move away from paper, to put it very simply. They didn't want somebody's vitals in different aspects of their health stored on a hand-scribbled note in several different doctor's offices. So there's been an effort to create electronic medical records, and now that has kind of been something that our patient engagement providers have tied into those solutions into the group. 

David: So, is the hub, so to speak, the visual hub in a patient care room just a TV, or is there other display technology in there, almost like a status board that tells them who their primary provider is and all the other stuff? 

Tom Mottlau: So it started as the smart TV, the Pro:Centric webOS smart TV. But then, as time went on, we kept getting those requests for, say, a vertically mounted solution, where somebody can actually walk in the room, see who their doctor is, see who their nurse is, maybe the physician can come in and understand certain vitals of the patient, and so that's why we developed those patient engagement boards that separately. They started out as non-touch upon request, we went with the consensus, and the consensus was we really need controlled information. We don't want to; we've had enough issues with dry-erase boards.

We want something where there's more control in entering that information, and interesting enough, we're now getting the opposite demand. We're getting demand now to incorporate touch on the future models, and that's how things start. As you know, to your point earlier, folks are initially hesitant to breach any type of rules with all the bureaucracy.

Now, once they cut through all that and feel comfortable with a start, they're willing to explore more technologies within those rooms. That's why we always start out with one, and then over the years, it evolves. 

David: I assume that there's a bit of a battle, but it takes some work to get at least some of the medical care facilities to budget and approve these patient engagement displays or status displays just because there's an additional cost. It's different from the way they've always done things, and it involves integration with, as you said, the EMR records and all that stuff.

So, is there a lot of work to talk them into it? 

Tom Mottlau: Well, you have to look at us like consultants, where we avoid just talking folks into things. Really, what it has to do with is going back to VOC, voice of the customer, the way we were doing this years ago or just re-upping until these boards were launched was to provide a larger format, and ESIs were dividing up the screen.

That was the way we always recommended. But then, once we started getting that VOC, they were coming to us saying, well, we need to get these other displays in the room. You know, certain facilities were saying, Hey, we absolutely need this, and we were saying, well, we don't want to put something that's not rated for that room. Then we realized we had to really start developing a product that suits that app, that environment, and so our job is to make folks aware of what we have and let them decide which path they're going to take because, to be honest, there are two different ways of approaching it.

You can use one screen of 75”, divide it, or have two screens like Moffitt did. Moffitt added the patient engagement boards, which is what they wanted. 

David: I have the benefit, at least so far, of being kind of at retirement age and spending very little time, thank God, in any kind of patient care facility. Maybe that'll change. Hopefully not. 

But when I have, I've still seen dry-erase marker boards at the nursing stations, in rooms, in hallways, and everywhere else. Why is it still like that? Why haven't they cut over? Is it still the prevalent way of doing things, or are you seeing quite a bit of adoption of these technologies?

Tom Mottlau: Well, it is, I would say, just because we're very early in all this. That is the prevalent way, no doubt. 

It's really those tech-forward, future-forward facilities that are wanting to kind of go beyond that and not only that, there's a lot of facilities that want to bring all that in and, maybe just the nature of that facility is a lot more conservative, and we have to respect that.

Because ultimately they're having to maintain it. We wouldn't want to give somebody something that they can't maintain or not have the budget for. I mean, at the end of the day, they're going to come back to us, and whether or not they trust us is going to be based upon whether we advise them correctly or incorrectly. If we advise them incorrectly, they're not going to trust us. They're not going to buy from us ten years from now. 

David: For your business partners, the companies that are developing patient engagement solutions, how difficult is it to work with their patient record systems, building ops systems, and so on to make these dynamic displays truly dynamic? Is it a big chore, or is there enough commonality that they can make that happen relatively quickly?

Tom Mottlau: That's a very good question, and that's exactly why we're very careful about who's tier one and who we may advise folks to approach. Those companies I mentioned earlier are very skilled at what they do, and so they're taking our product as one piece of an entire system that involves many other components, and I have full faith in their ability to do that because we sit in on those meetings. 

Once a year, we hear feedback, we hear positive feedback from facilities. We see it but it really couldn't happen without those partners, I would say. We made that choice years ago to be that platform provider that supports those partners and doesn't compete with them. In hindsight, I think that was a great choice because it provides more options to the market utilizing our platform. 

David: Well, and being sector experts in everything that LG tries to touch would be nightmarish. If you're far better off, I suspect I will be with partners who wake up in the morning thinking about that stuff.

Tom Mottlau: Yeah. I mean, we know our core competencies. We're never going to bite off more than we can chew. Now granted, we understand more and more these days, there's a lot of development supporting things like telehealth, patient engagement, EMR and whatnot. But we're also going to make sure that at the end of the day, we're tying in the right folks to provide the best solution we can to patients.

David: How much discussion has to happen around network security and operating system security? 

I mean, if you're running these on smart TVs, they're then running web OS, which is probably to the medical facility’s I.T. team or not terribly familiar to them. 

Tom Mottlau: Yeah, that's a very good question. Facilities, hospitals, and anything that involves network security bring them an acute case of indigestion, more so than other areas in the business world. So these folks, a lot of times, there's exhaustive paperwork whenever you have something that links up to the internet or something that's going to open up those vulnerabilities.

So, Pro:Centric webOS is actually a walled garden. It is not something that is easily hacked when you have a walled garden approach and something that's controlled with a local server. That's why we took that approach. Now, we can offer them a VPN if there is something that they want to do externally, but these systems were decided upon years ago and built with security in mind because we knew we were going to deploy in very sensitive commercial environments. And so not so much a concern. You don't need to pull our TV out and link up with some foreign server as you might with a laptop that you buy that demands updates. It's not anything like that because, of course, that would open us up to vulnerability. So we don't take that approach.

It's typically a local server and there is the ability to do some control of the server if you want a VPN, but other than that, there is no access. 

David: Do you touch on other areas of what we would know as digital signage within a medical facility? 

Like I'm thinking of wayfinding, directories, donor recognition, video walls, and those sorts of things.

Tom Mottlau: Absolutely. I mean, we see everything. Wayfinding needs have been for years and years now, and those are only expanding. and we start to see some that require outdoor displays for wave finding. So we do have solutions for that. 

Beyond displays, we actually have robots now that we're testing in medical facilities and have had a couple of certifications on some of those.

David: What would they do? 

Tom Mottlau: Well, the robots would be used primarily to deliver some type of nonsensitive product. I know there's some work down the road, or let's just say there's some demand for medication delivery. 

But obviously, LG's approach to any demand like that is to vet it out and make sure we're designing it properly. Then, we can make announcements later on about that type of stuff. For now, we're taking those same robots that we're currently using, say, in the hotel industry, and we're getting demand for that type of technology to be used in a medical facility. 

David: So surgical masks or some sort of cleaning solutions or whatever that need to be brought up to a certain area, you could send in orderly, but staffing may be tight and so you get a robot to do it.

Tom Mottlau: Absolutely. And that is a very liquid situation. There's a lot of focus and a lot of development. I'm sure there'll be a lot to announce on that front, but it's all very fluid, and it's all finding its way into that environment with our company. 

All these future-forward needs, not only with the robots but EV chargers for the vast amount of electric vehicles, we find ourselves involved in discussions on all these fronts with our medical facilities these days. 

David: It's interesting. Obviously, AI is going to have a role in all kinds of aspects of medical research and diagnosis and all those super important things. 

But I suspect there's probably a role as well, right down at the lobby level of a hospital, where somebody comes in where English isn't their first language, and they need to find the oncology clinic or whatever, and there's no translator available. If you can use AI to guide them, that would be very helpful and powerful. 

Tom Mottlau: Let me write that down as a product idea. Actually, AI is something that is discussed in the company, I would say, on a weekly basis, and again, I'm sure there'll be plenty to showcase in the future. But yes, I'd say we have a good head start in that area that we're exploring different use cases in the medical environment. 

David: It's interesting. I write about digital signage every day and look at emerging markets, and I've been saying that healthcare seems like a greenfield opportunity for a lot of companies, but based on this conversation, I would say it is, and it isn't because if you are a more generalized digital signage software platform, yes, you could theoretically do a lot of what's required, but there's so much insight and experience and business ties that you really need to compete with these patient engagement providers, and I think it would be awfully tough for just a more generalized company to crack, wouldn't it? 

Tom Mottlau: I believe so. I mean, we've seen many come and go. You know, we have certain terms internally, like the medicine show, Wizard of Oz. there's a lot out there; you really just have to vet them out to see who's legit and who isn't, and I'm sure there are some perfectly legitimate companies that we haven't worked with yet, probably in areas outside of patient education we, we have these discussions every week, and it's, it can be difficult because there are companies that you might not have heard of and you're always trying to assess, how valid is this?

And, yeah, that's a tough one. 

David: Last question. Is there a next big thing that you expect to emerge with patient engagement over the next couple of years, two-three years that you can talk about? 

Tom Mottlau: You hit the nail on the head, AI. But you know, keep in mind that's something in relative terms. It has been relatively just the last few years, and it has been something that's come up a lot. It seems there's a five-year span where something is a focus going way back, it was going from analog to digital. 

When I first came here, it was going from wood-clad CRT televisions to flat panels, and now we have OLED right in front of us. So yeah, there's, there's a lot of progression in this market. And I would say AI is one of them, and Telehealth is another; I guess we'll find out for sure which one sticks that always happens that way, but we don't ignore them. 

David: Yeah, certainly, I think AI is one of those foundational things. It's kind of like networking. It's going to be fundamental. It's not a passing fancy or something that'll be used for five years and then move on to something else.

Tom Mottlau: Yeah, true. But then again, also, it's kind of like when everybody was talking about, okay, we're not going to pull RF cable that went on for years and years because they were all going to pull CAT5, and then next thing, you know, they're saying, well, we have to go back and add CAT5 because they got ahead of themselves, right?

So I think the challenge for any company is nobody wants to develop the next Betamax. Everybody wants to develop something that's going to be longstanding and useful, and so it's incumbent upon us to vet out those different solutions and actually see real practical ways of using it in the patient room and trusting our partners and watching them grow. A lot of times, they're the test beds, and so that's the benefit of our approach. 

By providing that platform and supporting those partners, we get to see which tree is really going to take off. 

David: Betamax, you just showed your age. 

Tom Mottlau: Yes, sir. That made eight tracks, right? 

David: For the kiddies listening, that's VCRs. All right. Thanks, Tom. That was terrific. 

Tom Mottlau: Thank you very much, sir. 

David: Nice to speak with you.