Videoconferencing – strategy for larger hospital trusts

Many UK hospitals are developing network visual communications for within the hospital, between hospitals and externally.

HD lecture theatre Southampton

St Marys Live Demonstration

Videoconferencing Maternity Telemedicine

HD lecture theatre Southampton

Not only do these save time, particularly in travel, but they also help improve the productivity of experts, which makes the health service more efficient in delivering the best care to patients. One by-product is that almost every such project is environmentally friendly and fits with demands to lower carbon footprints. The saving in travel alone can show very good returns.

But if there is a growing concern among all this good news, it is how more and more video traffic can be accommodated by networks. Most current users of good quality videoconferencing will have had periods of frustration when problems of connection and quality have been frustrating to the point of cancelling important sessions. If the equipment is good quality and the configuration suitable for the envisaged communication, then it is usually network users that cause problems. This is not a matter of good or bad networks or unreliable room equipment – it is much more complicated than that.

We have all suffered when web access on a usually good pc is disrupted or when our mobile telephone cannot achieve service, even in a city. These problems are almost always due to unexpected high levels of traffic flow or the lack of tools to manage such a problem quickly.

As videoconferencing grows on a ‘need’ basis, project by project or by hospital department, there will be more and more traffic without network management or the means to control or even monitor the traffic. The IT department and network manager may not even know how much network resource a system purchased by a department uses and when it is often in service. The network bandwidth required by videoconferencing is quite great, compared with other functions on the network.

For instance, a modern IP telephone call would be less than 50kb/s, and you could use Skype with video or watch YouTube at less than 1Mb/s. A videoconference for teaching with slides is good at 2Mb/s but HD quality with full motion (surgical demonstration) would be better at 10Mb/s.

When you consider that links between hospitals of the same trust may have been upgraded to 100Mb/s, it does not take too much videoconferencing to use half of this.

Furthermore, videoconferencing uses unlabelled packets on the network. This means that security systems and firewalls find it especially difficult to be set up to allow these streams top priority and free movement, as they must do for a real time medium. This is why some site-to-site concepts have had very difficult issues. Any Trust system and firewall must be state of the art for security.

 

Who uses network visual communications?

Business:

  •  Management strategy meetings
  •  Department management meetings
  •  Address (broadcast) to staff
  •  Recruitment/discipline interviews other HR users
  •  Estates/planning/project/design

Medical:

  •  MDT meetings for cancer management
  •  Other MDT (cardiology/paediatric)
  •  Education – lectures and demonstrations
  •  Multi-centre expert meetings/research
  •  Participation in live intervention
  •  Training for surgery/cardiology/gastro etc
  •  Acute telemedicine – A&E, Stroke
  •  Child/neonatal assessments
  •  Chronic telemedicine support (in the home)

 

In any hospital, patient confidentiality is paramount and so multiple streams of sensitive unlabelled packets within or across a firewall present an issue of identification.

But there are systems developed to deal with all of these issues. Video South would say that all central network design that is to accommodate growing video traffic should be equipped for:

Hard encryption so that no video/audio can be witnessed or captured.

Sophisticated firewall traversal which allows traffic in and out but which supports encryption and is achieved without opening any incoming ports on a Trust firewall.

Obeying rules set up in a network traffic monitoring tool which allows certain users certain bandwidth, allows internal/external calls and can limit which locations are available for connection from other places.

Remote immediate management and support. This allows a network expert to see and monitor each room in use from a pc terminal. From that terminal they can see local room set up, make alterations, make that system dial or receive calls and reboot or change protected settings.

Monitoring the video activity of each room/system/network device and creating a log. This shows what resources and bandwidth each user is requiring by time of day, which otherwise that user is probably unaware of.

Remote management, to allow such as broadcasts to be set up so that every recipient gets an auto dial/answer at any time simultaneously. No user has to boot up or dial in on time for the address.

Sending all dialling directories and updates via the network to all rooms regularly. On a well managed system, any user in any location can select a room name or person (even when recently installed) and dial to them. At present each room or system needs updating in the directory for each new location and to do this needs knowledge of the new user IP address and what to call the location. This can all be harmonised from one distributed directory.

In short, there are now suites of interoperating tools that can be installed to any large IP network that manage the traffic to ensure good quality connections and also make the growing number of locations easy to operate for users, as well as providing quality remote support for problems. These systems enhance security while providing answers to firewall issues and ideas for global connection.

Contact Video South and ask for Andy Mattingley or Alistair Holdoway. We will be happy to explain these network systems and how we have applied them in major UK hospitals. Our experience in multi-site trust, cancer MDT networks, operating over N3 and network-to-network integration, has all been developed in the NHS. Join the growing number of successful users of visual communications on NHS networks.