Hospital still uses ISDN for Trinidad link, rolls out mobile video conferencing unit

Hospital for Sick Children has an international reputation, and many children travel from outside Canada for care at Sick Kids. But thanks to video conferencing, physicians at Canada’s largest pediatric hospital are now helping patients in Trinidad and Tobago without their having to travel here.
A year ago, Sick Kids and the University of the West Indies established a video conference link so doctors in Toronto can assist colleagues in Trinidad and Tobago with cardiac and general-surgery patients. This project extends the hospital’s nine-year use of videoconferencing for telehealth consultations and education within Canada, says Karen Fontana-Chow, clinical leader for telehealth.
When telehealth at Sick Kids started in 1996, it used ISDN lines between video conference rooms. Now, domestic video conferencing uses IP, although the link to Trinidad and Tobago still relies on ISDN because of the difficulty of arranging secure IP connections internationally — the hospitals would have to work with multiple network providers, Fontana-Chow says, so ISDN is easier.
Fontana-Chow says IP video conferencing isn’t significantly easier than ISDN, but the fact that the cost is fixed no matter how much the facilities are used encourages more videoconferencing. Physicians at Sick Kids carried out about 700 clinical consultations with remote Canadian locations last year, she says. Sick Kids’ first mobile video conference unit was a large TV monitor and other equipment mounted on a trolley. “It wasn’t built to be mobile,” she recalls, “but we put it on a trolley and we mobilized it.” This year, the hospital acquired a truly mobile videoconferencing setup — a PC with specialized video conferencing hardware and a flat liquid crystal display, mounted on a compact rolling stand.
By taking this to physicians’ offices rather than requiring them to go to a dedicated conference room, Fontana-Chow says, Sick Kids can integrate long-distance consultations into physicians’ schedules, allowing more consultations.
The partnership with University of the West Indies is only a year old, and Sick Kids doctors have seen only a handful of children there so far. But Fontana-Chow expects the hospital’s use of telehealth will continue growing, thanks partly to improved technology.