Telehealth dawns on Saskatchewan’s Sunrise Health Region

Like most publicly funded healthcare organizations, Sunrise Health Region in Saskatchewan is on a perpetually tight budget. For the umbrella outfit, made up of six hospitals, 14 long-term care facilities, and a smattering of clinics and community health centres in the southeast region of the province, wanton upgrades to technology infrastructures simply aren’t permissible.

That forced frugality, however, hasn’t stopped Sunrise from deploying a new Telehealth system that will help physicians and other health care professionals deliver diagnoses and treatments to patients in locations that aren’t exactly around the corner from the brick-and-mortar facilities.

The system is a two-way, telephone-based videoconferencing system that allows doctors and other medical professionals use tele-diagnostic instruments, such as digital stethoscopes, patient examination cameras and digital imaging.

The deployment was made possible by Sunrise’s rollout of voice over IP gear from Hewlett-Packard (HP), a process that began in 2005. According to Sheryanga Jayasinghe, director of IT for Sunrise, the entire VoIP rollout is about 50 per cent complete, with the target completion date set for 2009 or 2010.

“Part of the problem is (our) budgets, so we have a full VoIP system in place in certain facilities and we have partials, where the backbone of the PBX is VoIP-enabled but the front end is still analogue or digital, and other areas where there is a mix of VoIP and older systems,” Jayasinghe said.

Prior to undertaking the HP-only setup, Sunrise had a mish-mash of equipment from various vendors, which Jayasinghe said was a constant source of managerial headaches.

“Because [the products] were from so many different vendors, they might talk to each other or they might not. We were going back and forth from one vendor to another, trying to figure out what was wrong. There was a lot of finger-pointing going on, with each saying it was the others vendor’s product (causing the problems).”

A considerable amount of time, Jayasinghe added, was spent merely trying to determine where the problem was instead of just trying to provide a solution. Some of the most common problems afflicting the network at that time, he said, were network outages or an inability for a user to log on.

“Also, a user might try to access a Web site and that would download some software and would create an IP problem. There was no way for us to figure out where the problem was initiating from and how to solve it.”

A decision was made to standardize on a single vendor. For Sunrise, the choice came down to HP and Cisco Systems. The former won out for a number of reasons, one of which was that the organization already had a significant number of HP desktops in place, making it easier for the network equipment to fit in with the machines on the floor.

The bottom line was also a determining factor for Sunrise. “The cost was so much less than Cisco,” Jayasinghe said. Finally, HP was the preferred option due to what Sunrise officials perceived to be a less complex environment with which to work.

“(With Cisco), we had to take a certain level of certification to actually get the knowledge to understand how the equipment was working,” Jayasinghe said. “The learning curve was less steep (with HP).”

Darren Hamilton, business manager, ProCurve Networking by HP, said that for outfits like Sunrise Health, which is primarily using well-established technologies such as Ethernet and IP, the back end needn’t get too complicated.

“If you take a company like Sunrise, they shouldn’t have to send a couple of their folks to a southern state for a course in network management when they’re dealing with relatively mature technologies.”

Although not overly complex, the switches in the Sunrise VoIP system, Hamilton said, had to be engineered to handle a variety of different media, such as streaming video and large image files.

“The data can be bursty at times, so the network needs to be capable of supporting the various types of media that you put on that wire,” he said. The key (was ensuring) the bandwidth…was capable of supporting the bursty traffic and was able to prioritize voice.”

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