Ohio VA centers call on videoconferencing system

Veterans Affairs Department medical centers in Ohio expect immediate
returns when their new asynchronous transfer mode WAN begins to carry voice, video and

“We estimate we could save $600,000 to $700,000 a year in staff travel time by
having a videoconferencing system,” said Hank Rappaport, chief information officer
for Ohio’s Veterans Information Systems Network.

The savings would increase if VISN telephone traffic moved onto the WAN. Adding
telemedicine applications would make the statewide hospital system more efficient and
increase savings, he said.

The Ohio VA’s video-optimized WAN, designed by Global Telemedix Inc. of Westford,
Mass., was set to link five VA hospitals, three outpatient clinics, a nursing home and
administrative offices by the end of last year, Rappaport said. A second phase could put a
dozen satellite clinics on the network.

“We are running it all over ATM, including ATM up to the site” for design
simplicity, he said. “We have five major facilities in Ohio, and we try to act as a
single entity in many ways. We typically meet in Columbus,” which means all the
doctors and administrators spend a lot of time on the road.

Although telemedicine is the hot hospital application for network video, administrative
conferencing was the driving need behind the $1.3 million Ohio project. Telemedicine is
useful, Rappaport said, but “I just don’t view it as a big deal.”

The network will cost about $100,000 a year to operate, Rappaport said. Initial video
endpoints are located in administrative conference rooms, and he hopes to add telemedicine
workstations soon.

VISN runs over T1 lines leased from Ameritech Corp. of Chicago. Telemedix will manage
the network from an Ameritech network operations center, probably in Cleveland with a
backup in Chicago, said Telemedix president William Kazman.

The network will have Access NGI switches from Fvc.Com of Santa Clara, Calif., for
standards-based H.320 and H.321 videoconferencing. Alan J. McMillan, sales vice president
for Fvc.com, said switched virtual circuits will maximize available bandwidth, and voice,
video and data can be assigned priorities for guaranteed quality of service.

The Fvc.com equipment works with all standards-compliant end devices, he said. The Ohio
VA facilities use coder-decoder equipment from PictureTel Corp. of Andover, Mass., and
Zydacron Inc. of Manchester, N.H.

The Access NGI switches also can accept private branch exchange modules to move
telephone traffic onto the ATM network. “We haven’t done that yet, but we
are told it is easy to do,” Rappaport said.

A TeleMedix server for telemedicine applications will operate in Columbus, running
TeleConsult software. Client software will run on TeleMedix dual-monitor PCs with 400-MHz
Pentium II processors. Some existing VA PCs will also be adequate for telemedicine, Kazman

Potential telemedicine uses range from basic face-to-face consultation to more complex
high-definition digital imaging and remote manipulation.

“Telemedicine does not have to be more complicated than an administrative
videoconferencing system,” Rappaport said.

About the Author

William Jackson is a Maryland-based freelance writer.


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