Videoconference Systems
Tips for Choosing a Video Conferencing (VC) system
Like any technology that integrates with your existing network, whatever you choose for video conferencing should be based on your current network capacity, your anticipated use for the technology and your budget.
Network capabilities
Can your current network support in-house VC; i.e. do you have adequate bandwidth for VC or do need to upgrade.
Consider the features you may need
If you expect to participate in only the occasional VC with only one or two other participants, you do not need capacity for up to 20 video attendees – nor do you need to pay for it! For an infrequent user, consider a subscription like Cirtix GotoMeeting or one of the other "small" solutions. Similarly, if you are unsure whether VC will be a consultation mode that will suit your type of practice, it would also be wise to consider a basic "entry level" VC set up until you determine the role of VC in the longer term.
However, if you know you want to hold regular videoconferences and/or have the ability to attach peripherals such as Otoscopes and ECGs, you need to consider a VC solution that accommodates these capabilities. Noting down all the likely uses and the additional capabilities you think you will need should help to determine the type of software and/or hardware you might need and this is also likely to be dependent on your sub-specialty.
Your budget and your VC requirements
Again, the cost of a VC set up will be driven by the range of functions you need; for many, entry level software-based (and usually free) solutions will suffice. However, if you
require additional on-screen capability, it is likely these basic solutions will not be adequate.
There is a wide range of VC systems – hardware and software based; there is software for tablets and smart phones. This range of options means you can have a high quality desk based system in your consulting room (e.g. with a large high definition monitor, stereo sound and voice locating camera), and also have a tablet or smart phone option for urgent calls, or as a back up if something goes wrong with your main system.
Security Issues
It is important to remember that there are security requirements associated with video conferencing: data sent needs to be encrypted in order to maintain appropriate patient confidentiality.
Please refer to our Technology Directory for guidance, as they all meet the required level of encryption you need when conducting a telehealth consultation. The encryption protocols you are most likely to find are 128-bit AES and 256 AES, with the 256-bit AES encryption being the most secure of all. For a more detailed explanation of telehealth security requirements please refer to the Telehealth standards document.
Will you always be able to connect with other VC participants?
While there is now a range of VC options, unfortunately they are not always interoperable – however, it is expected that interoperability will improve as more clinicians are involved in VC as vendors are, theoretically, developing their products on a common platform – that is, they should be able to "talk to each other". One approach is to encourage those clinicians with whom you will VC to have the same VC set up as yours, however this does limit your capacity to expand your VC reach if that is what you want to do.
Where possible find a solution that is compatible to your participants or choose multiple manufactures of VC equipment that will allow a more diverse audience, eg. Polycom Hardware CODEC's (more expensive) and several software solutions that your partners may use, eg. Cisco's Jabba (Free) and Citrix GoToMeeting (subscription).
Several vendors now offer gateway services or equipment that allows communication with competing products, but usually at an additional cost.
The other option is to join a regional VC service (e.g. some Medicare Locals are setting up regionally-based VC services which allow participants to purchase a "licence" (at a relatively low cost). This offers regionally-based CPPs a cost effective VC option.
However, metropolitan based CPPs could also consider participation in such arrangements since they will allow each of access to a VC network with their potential referring GPs and their patients and, while they will not guarantee such access in all cases, this would provide useful VC contacts for a significant number of patients who may be suitable for VC consultations. AACP is working with some Medicare Locals with a view to setting up such arrangements.
Firewalls
One of the most common problems with connecting a VC is reportedly the difficulty of traversing a public hospital firewall and for many CPPs, participating in a VC will involve one or other participant being in a public sector facility. Most software based VC systems allow firewall traversal, meaning that it will be much easier for participants behind firewalls to connect to your videoconference. However, connections are not assured where there is a significant firewall in place and if connections with a particular location are difficult it may be necessary to request the participant at that site to seek IT support.
Hardware, Software and Bandwidth
Hardware assisted VC solutions (that is, proprietary VC equipment with its own software – such as those offered by companies like Polycom, which is used in many public sector facilities) currently use considerably less bandwidth than software alone solutions. The hardware-assisted equipment (CODEC) has the ability to compress the data being sent and therefore this equipment uses less bandwidth (although it should be noted this is usually limited to communication with the same proprietary equipment).
IT support
Do you have IT expertise locally? Depending on your computer purchasing arrangements, there may be maintenance agreements available that will include technical support, warranty and software upgrades.