ADSL broadband slows remote medical education

Faster upload and download speeds critical for telehealth, says GP Synergy CEO John Oldfield

Australia should invest in faster broadband for regional areas to promote telehealth and clinical education, according to the head of a non-governmental organisation (NGO) that trains general practice doctors.

“One of the biggest challenges for Australia is the fact that we don’t have the sort of reliable and robust broadband connectivity that fully meets the needs of videoconferencing,” GP Synergy CEO John Oldfield told Computerworld Australia.

Broadband limitations have held back telehealth and remote clinical education, he said.

“We just seem to be so far behind the rest of the world in this respect,” Oldfield said. “I can have a broadband connection or meeting over with someone in the [United] States, and it’s far better than someone just around the corner.”

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GP Synergy is an NGO that provides general practice vocational training to Australian doctors with funding from the Commonwealth. Doctors with an undergraduate degree receive about three-years training to become general practice specialists.

GP Synergy’s doctors work in community-based private clinics scattered around New South Wales, and many are in rural areas with poor broadband availability, said Oldfield. Those areas include the south and southwest corridor and the New England northwest region, an area that is larger than Tasmania.

GP Synergy connects the clinics using videoconferencing for interactive meetings among doctors and supervisors in the program. However, the success of the meetings relies on the quality of the Internet connection.

At its own office, GP Synergy has invested in a synchronous broadband connection with 5Mbps upload and download speeds, and uses software to prioritise VoIP and videoconferencing traffic. However, “no matter what we do on our end, we’re always at the mercy of the broadband connection at the other end.”

Remote training posts use ADSL “and so they’re dealing with all the usual issues such as contention [and] dropout,” he said.

“You’re pretty lucky if you’re getting 1Mbps upload, and the key issue for videoconferencing is you need just as much for upload as you do download.”

Ideally, GP Synergy would like to have 10Mbps up and down at all of the end points, Oldfield said. “If we had that, then we would have high-definition, point-of-presence videoconferencing without dropout and without contention on the line.”

The NBN is likely to provide better quality videoconferencing when it reaches all training posts within the region, Oldfield said. However, the CEO makes no predictions on when that will happen.

“I really don’t know whether the NBN will reach our sites any time soon,” he said. “We’re talking about a very expansive area, and they’ve barely even touched us.”

The NBN has gone through the University of New England, but is not available to some business areas of Armidale, he said.

Making it work

While there was little GP Synergy could do about the slow connection speeds in regional areas, the NGO was able to achieve acceptable videoconferencing service levels using a customised platform from Radvision.

Other vendors had insisted on point-of-presence high definition, which is “wonderful if you’ve got the pipes to accommodate it,” but such advanced capability was not viable for GP Synergy’s training posts, Oldfield said.

“What I was very impressed with was that [Radvision] went to the extent of redeveloping the product to accommodate what we needed to do.”

Now the NGO can scale down the videoconferencing quality to ensure a smooth connection for all, he said. “We’ve got it to a point where by and large the feedback we get is quite positive.”

GP Synergy installed 87 Radvision Scopia VC240 units to provide a more consistent videoconferencing experience for GP Synergy’s in-training doctors.

“What we found was that people would come in on desktops and laptops and too often the audio was not working properly or the video was not working properly or both.”

With the VC240 units, “we’ve taken care of all the hardware side of things,” Oldfield said. “We’ve taken care of the high-definition video, we’ve given them a good screen and a good monitor to work with, and we’ve taken care of the audio which tended to be the most problematic aspect,” he said.

Oldfield added that Radvision and supplier VMtech has provided highly responsive support to GP Synergy. “I couldn’t get any adequate service and support from our [previous] vendors here in Australia,” he said.

Follow Adam Bender on Twitter: @WatchAdam

Follow Computerworld Australia on Twitter: @ComputerworldAU, or take part in the Computerworld conversation on LinkedIn: Computerworld Australia

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Tags broadbandNBNADSLvideoconferencingRadvisiondownloadtelehealthRemotesynchronousuploadGP SynergydoctorsVMtech

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