Author Archives: Adam Kaiser

Learning the Cloud Way – Part I

March 4th, 2013 | Posted by Adam Kaiser in Cloud Services | Education - (0 Comments)

As cloud services pick up speed in the private sector, questions about security, cost savings, implementation and best-practice models have emerged in concert with its rapid growth and adoption. But are institutions of higher learning following suit? Cambridge, MA-based Forrester Consulting turned their focus on 12 universities in the U.S., the U.K., Australia, India, and New Zealand, surveying CIOs and IT directors for their July 2012 report “Cloud Bursts Into Higher Education.”

They found out how and why these schools are employing the cloud; plus they give some suggestions as to where the partnership between higher education and the cloud is headed.

So, how is Higher Ed approaching cloud services?

The Forrester study found that universities are adopting cloud services to boost productivity, and speed, budget, and scalability were the top three features university interviewees valued most about cloud services. But the study uncovered an interesting dynamic: professors and department staff are leading the way with cloud services at their universities, implementing cloud applications as needed, and circumventing the IT department. One side benefit of this autonomy is that IT departments can then focus their resources on other, critical IT tasks.

Echoing concerns coming from the private sector, universities are concerned about security. In fact, the report states “security is the No. 1 roadblock to cloud service adoption.” For schools, the two primary concerns are keeping research (intellectual property) and private student information confidential and secure.

The most common cloud adoption right now is the private cloud, with many of these schools keeping private information, like emails and research, on their private cloud, and “student-related information” on the schools’ servers. The report does note, however, that hybrid clouds are in use, and expected to increase. Additionally, as academic institutions partner up to offer expanded learning experiences, often online, expect to see a growth in the use of community clouds for sharing research and course materials.

Lastly, schools are looking to the cloud for cost savings; however, as cloud usage goes up so do costs. While several interviewees claimed significant cost savings with adoption of various cloud models, in one example the “expanded use of the services over three to seven years raised the cost of SaaS to nearly even with the cost of a perpetual license and on-premises deployment.” In other words, as academic staff and students become more familiar and comfortable with using cloud services, related costs increase, thereby erasing some of the gains.

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Learning the Cloud Way – Part II

Overcoming Obstacles to Telepsychiatry

February 28th, 2013 | Posted by Adam Kaiser in Healthcare | Video Conferencing - (0 Comments)

With the technology used in telepsychiatry becoming more reliable, inexpensive, and ubiquitous, there has been a corresponding increase in mental health professionals who are turning to remote treatments. In fact, psychiatry has been at the forefront of telemedicine use.

The general consensus thus far is that telepsychiatry is particularly useful for rural populations, children, the military, and those in institutions like prisons. In other words, telepsychiatry reaches people who otherwise wouldn’t have access to mental health services. (There is a severe shortage of child and adolescent psychiatrists). Telepsychiatry can also lessen some of the barriers often cited to obtaining mental health treatment, including cultural, shame, cost, and distance.

Many states, often in conjunction with state university medical and public health departments, have recently initiated telepsychiatry programs. The South Carolina Department of Mental Health established a program in 2007 to provide telepsychiatry in state hospital emergency departments. Also in 2007, University of Alabama’s College of Community of Health Sciences joined the Alabama Department of Mental Health (and others) to launch a telepsychiatry program, focusing on rural populations. New York State’s Office of Mental Health runs the New York Consultation and Telepsychiatry Program (NYCaT) aimed at children, and last fall West Virginia University’s WVU Healthcare received a government grant that will cover four years of telepsychiatry programs for an addiction treatment clinic. The Centers for American Indian and Alaska Native Health at the Colorado School of Public Health also run a telehealth program that includes mental health services.

That’s just a handful of examples, but they demonstrate the range of applications and growth of telepsychiatry. While the interest and investment is there, acceptance is by no means guaranteed. Here are five potential obstacles to telepsychiatry adoption.

Cost: States vary greatly in their definitions, approach, and regulation to telehealth (or telemedicine) according to a recent report from the Center for Connected Health Policy, State Telehealth Laws and Reimbursement Policies. While the majority of states reimburse telehealth through Medicaid; some do not, including Connecticut, Iowa, Massachusetts, New Hampshire, New Jersey, and Rhode Island, plus the District of Columbia. Amongst those that do reimburse, there is a wide range of what and who is reimbursed, and when.

Privacy: “Increased video-conferencing over public networks also creates the potential for unauthorized access to protected health information.” This is from a recent article in Current Psychiatry. The authors’ recommendations: use VPNs and encryption; train health professions in data storage and telemedicine ethics.

Legal: A provider must be licensed in every state they provide care. So a health care provider in one state that is conducting a telepsychiatry session with a client in another means they must be licensed in both states. There are 9 states, however, where the medical boards have instituted special telehealth certifications. As telemedicine becomes more common, look for this issue to become a hot topic.

Habits: Old habits die hard, and not every mental health care provider sees the value of telepsychiatry, or wants to invest the resources in training and adopting new modes of treatment. A study by the California HealthCare Foundation, which focused on telepsychiatry adoption in 7 emergency departments, found that in every case, there were initial problems getting support from involved parties, including doctors, nurses, and psychiatrists. From the study: “Some of the spoke sites felt that they had neither the time nor the energy to devote to telemedicine efforts.”

Lack of training or incorrect training: “Training is critical,” writes Mark Vanderwerf in his chapter Ten Critical Steps for a Successful Telemedicine Program. He recommends “layered” training, that is, training presented in progressive stages, and it should be formal to increase its perceived value. For the first level, he suggests course materials, a syllabus, registration, and testing, and even a certificate awarded to those who pass the course. The second layer includes on-site evaluations, and the third includes support and “refresher sessions.”

Video Conferencing Gets Elastic

January 8th, 2013 | Posted by Adam Kaiser in Industry News | Video Conferencing - (0 Comments)

As cloud computing and cloud based services continue their meteoric rise to the top of IT strategies everywhere, an interesting convergence of these new technologies with video conferencing is occurring. Over the last few years countless services and organizations have focused on providing computing power in the cloud. Several of these services have achieved notoriety including Amazon’s Web Services and Microsoft’s Azure.

The previous model for hosting computing power was to enable users to “rent” a server in a provider’s data center or to buy shared space on an existing machine. Web hosting and other hosting services used this model for several years. However, with the advent of virtualization (the ability to simulate multiple servers on one server with software) the model is rapidly changing. Hosting providers are now offering users the ability to launch server instances at will and pay only for the time in which that instance is used.

This new model is significant for several reasons. First, it essentially allows an organization to only pay for what they use; as opposed to absorbing the full expense of servers that might not be fully utilized. Second, the ability to quickly scale and add on additional server resources has gone from a multiple day or week process to a simple software setup that can happen in minutes.

This “elastic” server model allows for infinite scalability at a fraction of the cost and resources required. Additionally, many of these cloud computing providers offer a simple web-based interface to easily monitor and manage all of a customer’s server instances.

So what does all of this mean for video conferencing? With the continued shift of video conferencing infrastructure and services from hardware based appliances to software applications that run on standard servers, a whole new world is opening to video.

Previously, when an organization required additional “ports” to bridge large groups of callers, a significant hardware purchase would be required and the device installed into current infrastructure. Now, as more and more software based products become available, it will be as simple as purchasing a software license and simply adding additional cloud computing power. Even better, when these additional licenses are not in use, there will be no need to pay for the additional server power.

In the last few months several products have been announced that will be able to take advantage of this new model of deployment. Polycom announced its RealPresence ® Collaboration Server 800s, Virtual Edition. This software based bridge (or MCU) will be compatible with virtualized platforms and allow organizations to quickly and easily deploy and scale implementations.

Another notable product launch from last year was Vidyo’s VidyoRouter Virtual Edition. Vidyo is an entirely software based video conferencing platform that runs on standard servers. This new virtualized edition allows for deployment on elastic cloud services like those mentioned above.

As the power of the cloud continues to grow and be leveraged in new and exciting ways, video conferencing will benefit and become more agile for both deployment and management. The growth of elastic cloud services and the move to video conferencing to software based platforms is perfectly aligned to create new and exciting offerings for organizations of any size.

Video Conferencing Year In Review

December 20th, 2012 | Posted by Adam Kaiser in Cloud Services | Industry News | Video Conferencing - (0 Comments)

The past year has been full of exciting announcements in the video conferencing and visual collaboration industry. The industry is rapidly changing and 2012 was a particularly noteworthy year for video conferencing. The term ubiquity was thrown around more than ever before due to increased access to video solutions . Here are some particularly noteworthy announcements and trends from 2012.

Greater Interoperability
Always a hot topic, interoperability continued to be a major trend in 2012. The Open Visual Communications Consortium (OVCC), of which Polycom was a founding member, continued to expand its membership; and in late 2012, the first services that connect its members’ clouds became available. This was a major step to breaking down barriers between video conferencing and telecom providers.

Video Conferencing in Your Browser
The introduction of HTML5 and WebRTC have made video conferencing widely available by allowing participants to video conference directly from their browser. Participants no longer have to download software and set up different accounts for different platforms. This provides numerous opportunities for business-to-consumer video conferencing. Blue Jeans greatly enhanced its service this year with a browser connection option.

Higher Quality Mobile Video
Mobile devices, like smartphones and tablets, are being equipped with better cameras on the front of the device making high quality video more readily accessible. Users no longer have to sacrifice quality for mobility; as long as they have a solid internet connection, users can have the best of both worlds. Both the iPhone and iPad were updated to include 720p resolution on their front cameras.

Pervasiveness of Cloud Services
Cloud services have become one of the biggest trends in 2012. Cloud services play a major role in business continuity by providing an extra layer of redundancy. Additionally, these services help expand an organization’s network by easily connecting remote employees. The cloud has also been incredibly powerful in expanding interoperability.

Nintendo and Vidyo Partnership
In a revolutionary announcement, Nintendo announced that the Wii U will support point-to-point video conferencing capabilities powered by Vidyo technology. This has the possibility to represent the largest deployment of living room video conferencing systems in history and truly makes video available to the masses.

Polycom
Polycom continued to shift its focus to software and cloud based services. In October, Polycom made a slew of announcements that included new room endpoints, mobile applications, software based infrastructure, and most notability, its CloudAXIS suite. This solution (another browser based option) enables users to video conference with anyone on their social contact list including Facebook, Google Chat, Skype, and more. The user simply drags their contacts into a window, clicks connect and each participant receives a link on whatever service they are logged into.

Cisco
In 2012, Cisco continued to expand its collaboration footprint beyond video conferencing. Key announcements included the expansion of their WebEx offering, as well as, moving its Quad offering (a social collaboration tool) to the WebEx brand. Expect Cisco to unveil a slew of new video offerings in 2013.

This past year has been significant for the world of visual collaboration. As we move to 2013 (provided the world doesn’t end tomorrow), the industry will continue to grow and evolve. Each announcement and service has the potential to bring the true video ubiquity that many have envisioned.

 

 

Telestroke: Minutes That Can Change Your Life

December 5th, 2012 | Posted by Adam Kaiser in Healthcare | Video Conferencing - (0 Comments)

Telemedicine continues to be one of the most exciting advancements in the delivery of healthcare today. The benefits are significant and legislation throughout the United States is being passed to provide parity between a telemedicine visit and a live, in-person doctor visit. At a high level, telemedicine is about extending the reach of healthcare and providing care to those who may not have access to specialists and other needed experts.

Within telemedicine there are a number of very specific applications that are finding their place in hospitals throughout the country and the world. Telestroke is the application of telemedicine technology for the diagnosis and treatment of stroke victims.

According to the Centers for Disease Control and Prevention more than 795,000 people in the United States have strokes and 130,000 of those stroke victims lose their lives. One of the greatest allies to a stroke victim is time. The sooner a patient is able to be seen and diagnosed by a doctor, the higher likelihood of a positive outcome. Many of the treatment options available today are highly effective but require a rapid diagnosis.

Of the many treatments out there, two are particularly time sensitive. Thrombolytic drugs dissolve the clots that block the flow of blood to the brain. These drugs need to be given as quickly as possible. Another option is tPA which is an enzyme that can help dissolve blot clots as well. It is found naturally in the body and if given within three hours of stroke symptom onset, it has a high success rate ofpreventing the stroke from occurring. This, however, is highly dependent upon the recognition of early stroke signs and symptoms.

The application of telemedicine to stroke, or telestroke, is usually deployed in a hub and spoke model. Hospitals with stroke/neurology services serve as the hub and allow connections from outlying or rural hospitals, known as spokes. Many of these rural hospitals simply do not have access to neurology and stroke specialists so these hubs can assist with timely diagnosis and treatment.

The technology of telemedicine allows neurologists to remotely examine patients when they are admitted to an emergency room or the hospitals. These doctors can review CT scans and other diagnostic tests quickly and make real-time decisions on initial treatment.

Beyond the obvious benefits to the patient, there are several other key advantages to telestroke including:

  • Reduced Costs: For hospitals who have established a comprehensive stroke care center, the investment is significant. This prevents smaller hospitals from implementing these critical programs. With a telestroke program in place, patient care is not sacrificed when budgets are not available.
  • Fewer Transfers: When facilities are lacking the specialists needed to care for strokes, it can become necessary to transfer those patients to larger, more distant facilities who offer a stroke center. The cost of these transfers is incredibly high, both for the patient and the medical facility. With remote specialists on hand, patients can stay in one facility, get the care they need, reduce the risk of their condition worsening, and ultimately save the system money.
  • Training: When local doctors get exposed to stroke specialists they are able to get real-world training on key stroke indicators and how to rapidly respond to them. This type of training can make the difference between a full recovery and a life of stroke complications.

The application of video conferencing and telemedicine technology to healthcare is truly exciting. As facilities continue to bring this technology on board, patients will be the ultimate beneficiaries. The highest level of healthcare diagnosis and treatment should not be reserved for those who live in proximity to major medical centers. Telemedicine technology has the potential to reduce or eliminate both geographic and financial barriers that can prevent access to high quality healthcare for everyone.