In recent years, video communications (e.g. videoconferencing and telehealth) capabilities have gone from being expensive, hardware-based resources to inexpensive, cloud-based resources. Now, the driver for wide-scale adoption in healthcare is not what this technology costs, but rather how smoothly and seamlessly it can be integrated into existing clinical workflows, IT systems, and business environments.
So how does one get started? Well, the first inclination may be to reach out to your local telecommunications or media services company. However, high-quality video no longer requires special hardware or expertise. You can now get high-quality, high-definition video on devices that you, your organization, or your employees already own (newer smartphones and tablet computers) and which many would-be patients/consumers now have or could readily obtain. As a rule of thumb, any mid to high-level personal or laptop computer sold in the last ten years is probably “video-conference” ready.
Here are two approaches: a “minimal” list of requirements and a recommended “ideal” setup:
||Any video and audio-equipped computing device or smartphone
||Laptop or desktop computer (min. 1.8GHz Pentium i5/i7 processor and min. 4GB memory)
||Built- in camera
||External HD camera (e.g., Logitech HD Pro Webcam C920
||External speakerphone or headset such as Jabra Speak 410 or Plantronics Savi w740
||DSL or 4G connection (Minimum 500mb/sec. upload/download speed
||Home-type cable/broadband connection, with 1Gb/sec. upload/download speed and less than 50ms latency
Once you’ve got the requirements in place, the next step is to provision a video conferencing service. (Note: if you’re using a PC, think of the PC as a phone, and the video service provider as the phone company, or carrier.) Generally, you can purchase HD video conferencing from a service provider for less than $50/month. This would provide a fully encrypted, HIPAA-compliant solution. And, because many video service providers will sign business associate agreements, (check this out—hipaa or CFR?) eliminating privacy and security issues.
One such video-as-a-service (VaaS) provider is Connexus (www.connexusvideo.com), a solutions provider in both traditional as well as “new paradigm” video communications technologies. Connexus’ president, Jonathan Schlesinger, states that one of the most import issues to consider when utilizing video in telehealth is what happens if a call gets interrupted for technological reasons: What are the patient support and recovery procedures?
“You want to make sure you have good procedures in place in the event a call gets interrupted,” explains Schlesinger. “Therefore, while VaaS providers can get you provisioned with a service and started in virtual healthcare delivery in literally a few minutes, it is important to spend a good deal of time to put together a strategy for urgent psychiatry situations as well as routine therapy use.” Indeed, if a patient says they are suicidal and shuts off their connection, organizations will be liable and need protocols in place to handle situations such as these.
Resources to help
These service providers – and other organizations like them – provide high quality Video as a Service (VaaS), plus needed support.
||Extensive support options
||Full healthcare data services
From a technology readiness point of view, Amnon Gavish, the SVP Vertical Market Solutions at Vidyo (www.vidyo.com), talks about other important but less known technology related considerations. “One of the things we have seen is that the quality (defined as high definition and low latency) of video is much more important in mental health interactions than in other telemedicine scenarios, as mental healthcare encounters are typically much longer than a traditional 5-10 minute primary care or specialist interaction. These are longer consultations so key factors in the effectiveness of using video are supporting a smooth conversational flow and consistency of experience. If the experience becomes cumbersome and video issues affect the quality of a session, the effectiveness of the session can be compromised causing the physician and patient will lose interest in meeting in this manner.”
Gavish also cautions you need to ensure the patient on-boarding is quick and foolproof. One way to do this is to have the patient bring his or her home computer to an initial session, during which you can ensure it is properly set up to receive a telehealth visit. Another option is to ask your telehealth solution provider if their software can provide a single-click or web-based software installation and test process, so you won’t have to provide user support.
Whenever you’re going to work with a patient at home, Gavish advises that “you need to do an excellent job at teaching them how to select and set up their equipment and ensure they have adequate lighting and privacy to ensure a good-quality experience.” Because it is typical to begin a therapeutic relationship with a face-to-face encounter at the provider’s office, there’s almost always an opportunity to explain important requirements, provide educational materials, and help patients ensure that they’re ready to receive a telehealth appointment.
Utilizing cloud based video visit services minimizes your financial exposure. “There are enormous business advantages with VaaS as you are able to scale up with a very, very low cost,” states Schlesinger. “Putting together the brick and mortar infrastructure for that type of footprint would be cost prohibitive, but if an organization makes that investment later, the virtual practice will help them to determine where to locate based on the volume of calls they have made.”