Poor network capability threatens telehealth plans

Health trusts urged to improve networks to cope with assistive technology boom

Health trusts are being warned to plan ahead as the rapid adoption of assistive technologies threatens to put pressure on network capability.

Industry experts are concerned that the recent push by the Government to roll out telecare, telehealth and telemedicine systems has left providers unplanned and unready for the huge amount of data they contain.

The fears come just a matter of weeks after the Department of Health launched its 3millionlives campaign, which will see increased efforts by local authorities and health trusts to deploy innovative technologies into the homes of people with long-term conditions. The aim is to give patients more independence so they can stay in their homes for longer. In turn, this will ease the pressure on social care and healthcare services.

The way it seems to have worked in the past is that trusts procure more bandwidth when they need to, but almost straightaway they need even more. If trusts want to employ all these new technologies, they have got to have a better infrastructure in place

But, speaking to BBH this week, Jim Gerrity, director of global industry marketing at network specialist, Ciena, said these technologies rely on a robust IT infrastructure, without which the Government’s plans will be flawed.

He added: “All assistive technologies are enabled by networks. It is all about getting the relevant data to the relevant people, wherever they happen to be. From our work with trusts, we are finding there are issues with bandwidth that urgently need to be addressed. The way it seems to have worked in the past is that trusts procure more bandwidth when they need to, but almost straightaway they need even more.

“If trusts want to employ all these new technologies, they have got to have a better infrastructure in place.”

This is such a pressing matter because delivering care and support services in communities and patients’ homes relies on the retrieval of data, such as electronic patient records and prescribing support. In terms of storage, these are large files, with an average computer tomography (CT) study in excess of 50Megabytes (MB) and radiography files in excess of 40MB. Timely image archiving and transfer requires high capacity and low latency network connectivity.

But possibly the biggest potential threat that could bring networks to a standstill will be the emergence of telemedicine. While this is only currently in its infancy in the UK, pressures on public spending and a switch from providing re-active healthcare to improving the health and wellbeing of communities mean it is expected to become much more widespread over the coming years.

From MRI images to high-definition video consultations, healthcare networks must perform at high speeds to deliver critical services

While telecare provides support to help people maintain their independence; and telehealth helps to monitor and record symptoms, telemedicine deals with the actual delivery of healthcare. It covers remote consultations, when a medic can speak to, and even examine, a patient from another location. Linked by IT systems, clinicians can also speak to each other and even surgery can be undertaken while the doctor is outside of the facility.

The adoption of this in the UK will have a huge impact on networks and Gerrity is warning that unless trusts consider this in the early stages, the drive to adopt technology that has the potential to transform healthcare and bring costs down considerably will fall at the first hurdle.

“Ultimately, the advancement of assistive technologies is driven by a need and a desire to improve patient outcomes and the patient experience,” Gerrity said.

“But, when you consider the potential of telemedicine, you can see the need to build robust systems and ensure network capability. Trusts will need systems with adequate bandwidth and storage and the ability to grow this as more and more data is loaded into them. From MRI images to high-definition video consultations, healthcare networks must perform at high speeds to deliver critical services.

“To ensure critical data availability, best practice recommends that healthcare networks support a minimum of 10Gigabits per second (10G) access speeds in most areas, and 40G/100G in data centre core networks. Latency is also a critical requirement, in particular for telesurgery. The round-trip latency from the issuing of a robotic control signal to the resulting video displayed at the surgeon’s site is of great importance, as it essentially determines the safety of these critical procedures. A delay in the robotic control signal causes delayed action of the surgical robot, which can potentially have catastrophic results. Video transmission from the patient site to the surgeon site is also crucial as being able to see the result of a robotic control command on a patient determines the surgeon’s ability to make a decision on the next movement.

Trusts will need systems with adequate bandwidth and storage and the ability to grow this as more and more data is loaded into them

“To overcome these challenges and put all the pieces together in a safe and cost-effective manner, healthcare providers are increasingly adopting optical networking and Ethernet infrastructure to reduce latency and jitter to ensure patient data is delivered quickly and reliably.”

Looking ahead, he predicts the marketplace will advance swiftly over the coming years, with an expansion of PACS technology and further exploration into the potential of telemedicine in the UK.

“In order to do all these things, and ensure data is available and secure, now is the time for trusts to look much more closely at their systems and to futureproof their networks,” he said. “The market is a lot more competitive and trusts need to make sure they do not get left behind.”

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