By Joe Diorio, Manager Telehealth, TANDBERG NA  The healthcare industry is confronting a growing number of challenges in today’s world. From the shortage of healthcare professionals and medical specialists to the mandated delivery of services in a growing number of cities and states, it has become increasingly difficult for providers to adequately meet the healthcare needs of an ever-growing population. A variety of societal issues are further compounding the shortage of qualified medical professionals, including this statement is repetitive—already referred to shortage above:
- The rise in the number of non-English speaking patients in communities nationwide, creating a high-demand for increased bi-lingual medical professionals and translators, also in short supply.
- The increased demand for healthcare services in large urban areas, further limiting the availability of medical professionals in remote or rural areas and further straining available medical resources forced to travel long-distances to service these non-urban areas.
- Increased certification and licensing requirements for healthcare professionals requiring more time away from patient care.
All of these factors have further complicated an industry already dealing with escalating healthcare costs. Providers are under constant pressure to control costs while increasing the quality of patient care, providing new services and reaching new markets. Identifying the Solution
For healthcare providers, visual communications can provide the solution for effectively addressing many of these challenges. Video communication technology can serve as an invaluable solution for linking patients with physicians and medical specialists anywhere, anytime—not to mention facilitate more efficient procedures within other healthcare practices. For a growing number of healthcare personnel, visual communication is used to: - Link physician and patient for traditional clinic visits, even though they may be many miles away from each other.
- Connect medical professionals together for interactive instruction during an actual patient procedure or for face-to-face mentoring without direct patient interaction.
- Hold administrative meetings even when staff members are located in various business locations.
- Offer continuing medical education to healthcare personnel located remotely from headquarters, linking them to specialized medical knowledge, resource sharing and knowledge transfer.
Gone are the days of primitive video communication technologies featuring low-resolution images and unstable connections. Today's technology combines high-quality, high-resolution imaging and CD quality audio with reliable and a secure connection; a significant and valuable tool for medical professionals. Picture This
 Imagine, for instance, a patient dealing with a high-risk pregnancy, living on an island hundreds of miles away from the nearest available specialist. For many Hawaiian women, that’s been a common situation for a number of years. However, thanks to videoconferencing, Hawaii Pacific Health (HPH), the only tertiary-level hospital for women and children in the Pacific Basin, now uses specially retrofitted ultrasound machines in 10 medical sites on four islands. Obstetricians who specialize in high-risk pregnancies now can “see” a fetus remotely using video monitors located within HPH Fetal Diagnostic Center. Perinatologists then can provide around-the-clock advice and care to patients, and consult with the local obstetrician, radiologists and sonographer. "It’s like being able to extend our hands, eyes and ears across the ocean to neighboring islands to care for a pregnant patient, just as though she were right here in our office," explained Dr. Greigh Hirata, of the Fetal Diagnostic Center. In a similar use of the video technology, the Wessex Cardiac Unit of Southampton General Hospital in the United Kingdom uses an advanced videoconferencing unit to let heart surgeons conduct clinical work in remote regions like the Channel Islands. The system helps provide highly accurate remote diagnosis by transmitting smooth motion pictures with high-resolution images for superior quality. The distinctive and increasingly innovative ways that telemedicine is being used around the world, such as helping pregnant women in remote areas of Hawaii and heart patients in the United Kingdom, underscores the importance and the need for videoconferencing in the healthcare industry. What follows are three case studies of how other healthcare providers are using visual communications technology.  Alameda County Medical Center in Oakland, Calif.
Alameda County in Northern California ranks among the nation’s top five most culturally and socio-economically diverse — and within the county’s boundaries, many residents have limited proficiency in English. To meet the language-interpretation needs of this growing and diverse population in a clinical setting, the Alameda County Medical Center (ACMC), consisting of two hospital facilities, a psychiatric facility and three community-based clinics, leads the nation with an innovative video-based solution for interpretive services.
With increasing numbers of limited English-proficiency populations, rapid changes in population densities and the continuing national and the state budgetary crises, ACMC had to find a cost-effective method to address the growing medical-interpretation requirements of the people it serves. Since 2002, ACMC has employed video-based interpretive services as a complement to in-person or audio-only language interpretation services. Providers and patients alike have responded well to the visual-communication system. Interpreters can see the facial gestures and body movements of patients and integrate these important visual cues into their interpretation. In addition, the videoconferencing system makes ACMC interpreters available to assist many more providers and patients by eliminating both wait and travel times. Interpreters are now able to serve other patients in this teaching hospital facility during the residents’ presentation time with their attending physicians — which can be as long as 40 minutes — with relative ease, and still return to finish the visits when the residents are again available. Interpreters also save up to 90 minutes per trip to remote facilities. "What’s more, our preliminary data has shown that the actual time spent during each interpretive event has shortened to an average of just 15 minutes from an average of 30 minutes," noted Janice Chin, program administrator for the medical center’s Videoconferencing Medical Interpretation program. "That’s an efficiency improvement of 50 percent." The present telemedicine routes call for interpretive services from participating clinics to a dispatch center. The dispatch desk logs the request and connects the interpreter to the facility over video. Total preparation and setup time is about 5 to 10 minutes. The medical center is employing a new telephony system that streamlines the process, with no more back-and-forth setup process. The calling process is easier, and its features even include directory search, hold, transfer and conference. In addition, ACMC is embarking on an exciting program with San Francisco General Hospital to share interpreter resources across counties. The potential also exists to offer combined interpreter services to hospital systems that haven’t any interpreter resources. This will enable these hospital systems to put their investment into the technology, instead of additional personnel costs or having to depend upon contracted phone interpretation services, which can be prohibitively expensive, especially for public hospital systems. South Carolina’s Research Universities
Universities, medical schools, hospitals and other centers of knowledge often rely upon grant and foundation monies to advance their efforts. In the current competitive funding environment, organizations need to stand out. Knowing that grantors reward institutions that foster collaboration among multiple stakeholders, the University of South Carolina School of Medicine spearheaded a cutting-edge video network to create a compelling case for essential grant funding. To meet and exceed the requirement of enhanced collaboration, the program took advantage of the latest technology for traversing computer-network firewalls. Dr. Stanley Fowler, associate dean for clinical research and special projects, University of South Carolina School of Medicine, describes the situation: "Separately, we looked relatively small without all the resources and expertise required to gain the funding we were seeking. However, taken together, we have truly exceptional resources and talent. We realized we needed to work together to be competitive, and that meant convincing the ‘powers that be’ we had an infrastructure that could foster very close communication and coordinate research services to produce the synergies of expertise and resources these grant and funding programs were expecting." Building on his experiences introducing telehealth to South Carolina, Dr. Fowler persuaded the state’s two medical schools and affiliated hospitals to share resources to initiate what he called the Interstate 26 or “I-26” virtual-communication corridor, which visually links academic medical centers and affiliated teaching hospitals from Greenville in the north through Columbia in the center of the state, down to Charleston on the coast with video. In-state foundations provided $1.5 million to create this virtual network. This amount was matched dollar-for-dollar with university and hospital funds. Yet, Dr. Fowler worried that connecting these dispersed colleagues would mean “poking hundreds of holes” in their respective institutions’ firewalls — not a popular proposition for either the universities or hospitals, all of which were on their own IP networks and very concerned with protecting their institutional assets. “We needed to get through the firewalls in order to get our people — physicians, medical researchers, graduate students, medical students — talking to one another, not only across the state, but across the country. And at each institution, there were IT people that were very protective of their firewalls,” explained Fowler. “With good reason, too, secure firewalls are necessary for HIPAA compliance, to protect research data and more.” Dr. Fowler successfully gained buy-in from each of the participating institutions and mapped out the planned infrastructure enhancements. The visual-communication network was designed to tie together major institutions as well as smaller hospitals and clinics, including those using private IP networks, as well as older ISDN technology. In early 2005, South Carolina learned of technology that allowed its institutional team to connect over video securely as often as members wished. The technology, provided by TANDBERG and its Expressway firewall-traversal product “provides easy, ad-hoc visual communications, an easy dial plan, and great security,” explained Dr. Fowler. While the technology initially was chosen to tie the three research universities and the three major hospital systems together, the system now shares the resources of these top institutions with nine four-year colleges throughout the state, serving them through project mentoring and distance-learning efforts. “The whole idea is to send a message — collaborate, collaborate, collaborate,” said Dr. Fowler. United Kingdom’s National Health Service
Spread across a network of eight regional hospitals and 32 remote sites, healthcare providers with the United Kingdom's National Health Service (NHS) faced the challenge of effectively diagnosing and treating cancer patients with a limited number of radiologists, pathologists and oncologists. The NHS deployed a videoconferencing system over a Cisco Systems network so that cancer specialists throughout the system can collaborate face-to-face on patient diagnosis and treatment plans. Collaborative care provides facilities, such as NHS, with an invaluable tool for meeting the diverse needs of the growing communities they serve. "Since deploying our video systems for multi-disciplinary teamwork within cancer networks, we have seen a reduction in patient waiting," said NHS Communications Specialist Gus Hartley. "Quite simply, we treat patients more effectively and clinicians make more effective use of their time." With the system, the medical-care network can collaborate over video for administration in real time, grand rounds, continuing medical education, translation services and even assisted surgery. The system’s highly secure visual-communication technology features the highest level of encryption and authentication to ensure patient confidentiality. | 
