A New Model of Care
Telehealth broadly refers to the remote provision of clinical services via technology, and has been possible for decades. In Australia specifically, due to our metropolitan concentration of healthcare professionals, telehealth can be a powerful means to increase service levels and access to healthcare for regional and remote areas. Historically, the adoption of telehealth has been slow due to technical and financial barriers. With the introduction of a Federal Medicare rebate scheme for telehealth consultations in 2011, increasing availability of high speed broadband, and video calling software and hardware becoming more intuitive, telehealth is now a mainstream clinical model of care.
One Size Does Not Fit All
There is no single technology that suits the range of clinical use cases for telehealth. Factors influencing the choice of telehealth solutions include the clinical context, volume of usage, picture quality requirements, available bandwidth, and fault tolerance. Microsoft telehealth solutions cover the spectrum of these requirements, and include:
- Consumer level public cloud: Skype and Windows Live Messenger are free to download and use, and often are the first experience healthcare providers have with a modern video-calling experience. Although these services have limitations, which include picture quality and support, as an entry level service these products can add an extra dimension to a traditional voice call.
- Business grade public cloud: Lync Online and Office 365 are low cost, quick to establish video calling software solutions that offer the simplicity of consumer software with the quality and supportability advantages of a business solution. These telehealth solutions can be federated with other healthcare organisations running Microsoft Lync or Lync Online to tap into the advantages of a larger pool of healthcare providers and patients. This service is best suited to small to large scale community based practices and small to medium sized organisations like aged care providers.
- Business grade private cloud: Microsoft partner-hosted Lync telehealth solutions deliver a more tailored experience from a local, in-country datacentre. This higher grade service with greater levels of support is best suited to medium to large sized organisations making frequent telehealth consultations, who are looking for a service rather than managing their own systems.
- On premises locally hosted: Microsoft Lync Server provide an on-premise solution that offers the greatest levels of flexibility and autonomy. Install and deploy the solution in your own datacentre, and integrate Lync into other line of business applications. This solution is best for large sized organisations with a dedicated IT team looking to provision and support their own service.
The simple ability to make a video call does not itself support a sustainable telehealth practice. A range of other technologies are appropriate for the budding telehealth practice. They include:
- Scheduling, Calendaring, Appointments and Email: Microsoft Exchange Server and Microsoft Outlook provide the capability to manage appointments and correspond via email. These are available as a managed service via Office 365 or as on-premise software to install and manage locally.
- Collaboration: Microsoft SharePoint provides the website presence and document management solution that makes your service visible and accessible to the outside world, and organised manage internal documentation.
- Hardware: To run a video consultation, the right hardware needs to complement the software. This may be as simple as using a laptop with built in webcam, speakers and microphone, or scale up to a dedicated telehealth room with wide angle, high definition, voice activated cameras, noise cancelling built in microphone and speakers, and high performance computers.