To get a sense for what’s happening at HIMMS, we spoke to Terry Stroud, Carousel’s Director of Sales for South Central U.S., who is on hand at the event in New Orleans.

Healthcare IT mandates: Efficiency, Compliance, Urgency

Like a hospital emergency room, there’s a palpable sense of urgency among IT pros in healthcare these days, Stroud says. They’re seeking to make their organizations more efficient while also ensuring they stay in compliance with regulatory mandates including HIPAA along with various Joint Commission specifications.

Of course healthcare organizations are all about delivering services to patients in real time. To do that, IT must deliver appropriate data to caregivers where and when they need it – before, during and after a patient visit. Today, that means delivering data to smart phones and tablets as well as traditional workstations and laptops, whether they be in the hospital environment, a remote facility or maybe a doctor’s home.

When it comes to implementing IT projects to deliver on that mandate, “there’s no time to wait,” Stroud says. “They want projects implemented efficiently, so they need highly capable vendors and partners.”

Telemedicine Is Hot Topic at HIMMS

Among the projects healthcare providers are increasingly looking to implement is telemedicine. It makes sense, Stroud says, given the various benefits the technology provides. A single specialist is able to consult on far more cases if he doesn’t have to be physically in the room with a patient. Specialists such as radiologists can now be centrally located, reading x-rays coming in from virtually anywhere – saving lots of money in the process.

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And telemedicine is poised for a boost because of a forthcoming change in the way doctors get reimbursed under the Affordable Care Act. As we explained in a previous post, rather than getting reimbursed for every test or service they perform in the office, doctors will get reimbursed based on how well they improve patient outcomes. That change will bring with it new incentives for specialists to want to consult on all sorts of cases, whereas today that incentive may not exist.

Extending telemedicine to all these providers, however, requires a robust network infrastructure along with systems that are able to communicate with whatever end device a given doctor or even a patient may have. That’s where tools such as the Polycom RealPresence CloudAXIS Suite come in, which Carousel is demoing at the show. As Carousel’s partner Polycom explains:

[The] CloudAXIS Suite lets Polycom customers easily add anyone on Skype, Facebook, Google Talk and other business video apps to their video conferences from a browser. RealPresence CloudAXIS is a suite of software that runs on the Polycom RealPresence Platform and securely extends enterprise-grade video and content collaboration outside the firewall for B2B and B2C video communication that truly enables ubiquitous video collaboration.

Healthcare Providers Grapple With BYOD

While tools like CloudAXIS simplify making connections to various devices, healthcare providers are still sorting through how to deploy a comprehensive solution that enables doctors, nurses and others to use the device of their choosing.

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Among the issues they’re dealing with while coming up with a bring your own device solution are context aware wireless networking, Stroud says, to ensure high-priority communications get the bandwidth they need. Security is also a concern, since healthcare organizations are dealing with sensitive information and must comply with regulations like HIPAA. Technologies such as dual-factor authentication will likely play a big role.

BYOD also brings with it various management challenges, including how to handle the on-boarding of myriad devices while ensuring each has proper security tools and access to the applications and data each user needs – and nothing more.

“The multi-faceted aspects of these projects is leading to some rich conversations,” Stroud says.

The conversations will no doubt continue long after the HIMMS event is over, so feel free to contact Carousel whenever you’re ready to talk.

With that in mind, it’s worth taking a look at a webinar recorded by two Carousel Industries experts earlier this month. Titled “Mobility and Visual Communication – Outside The Conference Room,” the webinar is hosted by Dan Hofferty, National Sales Director for Visual Communications, and Mike Burgess, Director of Presales Engineering. Together, the pair walk through some of the value drivers and applications that are creating demand for mobile visual applications as well as the IT security challenges mobility brings.

Value Drivers of Mobile Communications

The first driver is the sheer number of mobile devices deployed. Users own some 64 million tablets today, a number expected to reach 320 million by 2015, Hofferty says. And in many cases, they’re being used for video.

Members of the so-called Gen Y don’t use email anymore, they text and use video, often from a tablet or smartphone, Burgess says. As a result, they expect to have the same capabilities on the job.

It’s not just video conferencing, either; some 3 billion videos are viewed daily on YouTube. Video is expected to account for two-thirds of all mobile traffic in 2015, Hofferty says.

Video, of course, takes significant bandwidth, but network capacity has largely kept pace with demand. Carriers are shifting from 3G to 4G cellular networks, and WiFi is becoming ever more ubiquitous.

Burgess calls wireless “the new access layer,” with LAN-based speed, reliability and performance. The current 802.11n wireless standard supports speeds of 300M bps, while the forthcoming 802.11ac spec will offer gigabit speeds amongst other benefits.

Bevy of Applications Driving Mobile Video

Applications are likewise cropping up to make use of all the mobile infrastructure. One is simply enabling road warriors to stay connected, Hofferty says. He tells the story of Carousel partner Polycom’s CEO, who likes to hold video meetings with customers, partners and colleagues around the globe. Maybe it’s a breakfast meeting with a client in AsiaPac, lunch with someone in a European country and late afternoon meeting with a partner in the U.S. – all in the same day.

“If he’s on the road, it doesn’t matter,” Hofferty says. Armed with his iPad, the meetings can go on.

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Service calls are another popular application for video. Technicians in the field can use a tablet to make a video call to a service center and show colleagues exactly the issue they’re dealing with. That saves time in terms of repairs, and often obviates the need for the technician to return two or three times.

Health care is another big user of video, for applications such as remote patient monitoring and home health care. It helps hospitals cut down on the number of patient return visits, for example.

Interpreters also find video to be valuable. Even if they’re not on site, an interpreter can see the person for whom they’re translating, which greatly helps them with accuracy.

Counting Up the Mobile Threats

As the number of mobile devices grows, however, so does the threat of security breaches. To date, most attacks have been targeted at Windows systems, especially XP, Burgess says – simply because it was the most popular platform.

“The challenge we’ll see this year is a shift, where attackers will start writing attacks for mobile devices,” he says. The end goal may be to steal data from the device itself, or perhaps use it as an entry point to the back end servers the devices connect to.

IT Security threats are part of the ripple effect of the mobility and BYOD movements. To fight back, customers need a whole host of security solutions. They range from penetration testing and next-generation firewalls to network access control, malware protection, intrusion prevention systems and security information and event management (SIEM) tools.

Carousel, with its partners such as Juniper, Fortinet, and Forescout , are in position to help. Users can choose from managed security services, security scanning services, outsourced IT and consulting or even secure private cloud solutions.

To learn more about the mobile video trends, check out the webinar. And to learn more about how to protect yourself, contact Carousel.

Now, a new report from the University of Texas at Austin has demonstrated that not only are workers still happy to be working from home in their pajamas, but they actually work as many, if not more hours than their office-based peers.  According to an article on the University’s website:

Thirty percent of the study’s respondents who work from home add five to seven hours to their workweek compared with those who work exclusively at the office. They are also significantly less likely to work a standard 40-hour schedule and more likely to work overtime.

One reason for this extended work week includes the elimination of the daily commute.  Workers can get to work earlier and continue to work later.  As a teleworker myself, a recurring (lame) joke in our house is me saying, “Alright honey, I’m headed to work. I hope the traffic isn’t bad”, as I slowly climb the stairs to my third-floor office.  Commute time = 20 seconds.

Line Blurs Between Work and Home Life for Teleworkers

The dramatic improvement in Unified Communications solutions and Mobility, while presenting tremendous efficiencies for workers and employers, also results in a blurring of the line between work and home life for teleworkers.  An example would be taking that video call from a customer on the West Coast at 8PM at night on a Tuesday.  According to the study’s authors:

“Careful monitoring of this blurred boundary between work and home time and the erosion of ‘normal working hours’ in many professions can help us understand the expansion of work hours overall among salaried workers,” says Jennifer Glass, professor in the Department of Sociology and the Population Research Center and lead author of the study.

Glass and her co-author Mary Noonan, associate professor of sociology at the University of Iowa, found that telecommuting causes work to seep into home life, a problem previously identified in the 2008 Pew Networked Workers survey. According to the survey, a majority of tech-savvy workers claim that telecommuting technology has increased their overall work hours and that employees use technology, especially email, to perform work tasks even when sick or on vacation.

One interesting finding was that it is not parents with dependent children looking to create an effective work / life balance that drives who telecommutes.

In fact, parents with dependent children are no more likely to work from home than the population as a whole. According to the findings, employees with authority and status are more likely than others to have the option to work remotely because they have more control of their work schedules.

With all of this said, the trend towards teleworking is not slowing down.  As businesses and managers get more comfortable with the concept and more employees request the option to telework at least part-time, companies need to be sure they are ready to deliver.  To find out more about ensuring you have the right unified communication solutions in place to empower your teleworkers, contact Carousel today.

Miscommunication Has Dire Results in Healthcare

Consider a 2006 study on “sentinel events,” by the Joint Commission on Accreditation of Healthcare Organizations, an independent, non-profit organize that accredits and certifies health care organizations and programs in the United States. Sentinel events are defined as circumstances arising in medical environments that result in death or serious injury, but are not directly related to the patient’s original illness. Rather, sentinel events are often the result of medical errors ranging from treatment delays to surgical errors – and are thus considered preventable.

The study found that more than 70% of the sentinel events researched were caused by miscommunication of some kind among medical staff, most commonly during handoffs between clinical care providers.

It’s not hard to envision such a scenario. Maybe a nurse can’t access crucial and timely patient data on an ICU ward, or one attending physician attempting to hand off records to another finds the records are unavailable or – perhaps worse – doesn’t realize the records are inaccurate.

Yesterday’s Infrastructure for Today’s Challenges

Part of the problem is that it’s difficult for a healthcare organization to upgrade IT infrastructure. The 24×7 nature of a hospital, for example, makes a wholesale technology rip and replace project infeasible.

As a result, many hospitals are using aging technology. Approximately 40% of hospitals surveyed by Aruba Networks were using cordless phones based on IP-DECT and CT2 protocols, which were designed to bridge the gap between wireless and analog but are now facing the threat of technology obsolescence.

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Similarly, the wireless infrastructure in many hospitals is aging, based on the 802.11 wireless networks of yesteryear that lack the robust security and reliability features of today’s mobility solutions. Increasingly, they are fit only for guest applications that don’t pose HIPAA-related security risks.

Meeting the Mobility and BYOD Challenge in Healthcare

That’s a significant issue in an environment where workers are most certainly on the move. A survey of nearly 800 nurses by Kaiser Permanente in 2008 found that most of their time – 54% – was spent on the move, such as walking from one patient room to another. In a typical 10-hour work shift the average nurse travels up to five miles on foot, the study found.

At the same time, hospitals are no different from other organizations in that they must deal with the bring your own device (BYOD) phenomenon. Doctors and nurses who use iPads at home naturally want to use them at work as well.

But it’s not that simple because medical applications require specialized communications solutions and, often, more ruggedized devices. An iPad or typical smartphone won’t last long once it’s dropped in water as a nurse bathes a patient, for example, or gets dropped in the midst of the organized chaos that often exists in an emergency room.

The good news is that Carousel Industries and its partners have solutions tailored specifically for the healthcare environment. To learn more, read the Carousel white paper, “Care in Motion: Overcoming Clinical Mobility Challenges In Today’s Healthcare Environment.”

Gartner calls it the era of the nexus and says it involves four forces:

• Cloud computing, which involves the delivery of services everywhere, and as users’ prefer to consume them
• Mobility, which means pervasive access to just about everything
• Big data, which refers to a flood of information of various kinds
• Social media, which allows new forms of collaboration and shifting behavioral patterns

These four themes cropped up throughout the conference, with the focus being on the various ways in which they will play out in the enterprise and what IT needs to do to either take advantage or protect the organization. Following are a few examples.

Social Computing Platforms Make It Easy to Leak Sensitive Corporate Info

Social computing brings with it potential dangers – and there’s no easy technical solution to combat them.

Consider one of VP and Gartner Fellow Daryl Plummer’s top predictions for 2013 and beyond:
By 2017, 40% of enterprise contact information will have leaked into Facebook via employees’ increased use of mobile device collaboration applications.

Extensive application integration between address books and applications like Facebook makes it relatively easy for users to pour lots of contact data into the social networking world. Once there, it’s far more likely that it will be used by those up to no good than when it’s safely stored in a corporate directory.

The answer? Hold users responsible, Plummer says. Revise your corporate code of conduct to hold users responsible for the loss of enterprise contact information, while educating them about how to protect it.

In short, it’s about reducing risk and Plummer contends we’re headed in the wrong direction in that regard. Gartner research suggests the amount of risk users are willing to take has gone up 15% to 20% in the last few years. Many people use services such as Dropbox, iCloud and various social networks for business purposes without considering the risks behind them, he warned.

Crowdsourcing: Get Others To Do Work For You

On the other hand, social networks and the cloud can also be used to help ease the burden on IT, Plummer said. One example is “crowdsourcing,” the idea of essentially outsourcing a task to – well, you don’t really know who. The idea, Plummer said, is to “get customers to do all the work.”

An example is application development. Think about iPad and Android devices and how many apps have been created by the vast community that uses them. While some are from corporate sources, many are from individuals who just had an idea and, in many instances, came up with something useful or fun. Chances are you have no idea who created most of the apps on your phone.

The same techniques may apply for others. Some universities, he noted, are considering the idea of encouraging students to write applications for mobile devices and share them with the school. “It’s an innovative use of cloud to get something done you couldn’t do before,” Plummer said.

Plan for Many Types of Mobile Devices

In terms of mobility, the first item on Gartner Fellow David Cearley’s list of top 10 strategic technology trends for 2013 was “mobile device battles.”

His main message: plan for and expect heterogeneity. No one form factor will dominate, as users will choose different devices and, given the bring your own device phenomenon, will want to use them at work.

Microsoft Windows 8, especially, may well change the picture over the next year or so, as Cearley expects Microsoft to gain about 20% market share – unless its Surface tablet turns out to not to provide a great consumer experience.

“Windows 8 puts Microsoft in the game in a big way,” Cearley says. Over the next 12 to 18 months we’ll see what the impact is on OEMs, competitors and customers as the battle shakes out. But the bottom line is customers will need to have a plan and model in place for dealing with multiple device types.

Oh, and one more cheery prediction from Plummer:
Through 2014 employee-owned devices will be compromised by malware at more than double the rate of corporate-owned devices.

His solution: invest at least one-third of any money you save from BYOD on security tools to detect malware and prevent it from spreading.

Windows 8 – On the Road to Unified Applications

Carousel has Windows 8 installed on a couple of machines and, more importantly to Zanni, has the new Visual Studio 2012 development tool – that’s what his team uses to develop applications for Windows 8.

“Microsoft has released guidelines for the user interface and the way they want it to be,” Zanni says. “From that angle, what I see in terms of what it offers to businesses is a unified style of application.” With Windows 8, Microsoft has streamlined its underlying API architecture, a move Zanni says was “overdue.” The Windows API has been split up over the last 10 years, with several different libraries emerging, such as Win32 and .NET. “Now, every language you use can access the same API in the same way,” he says.

A Common Look and Feel

Ultimately, the goal is to deliver applications that have the same look and feel across myriad devices, from Windows phones to tablets to laptops. “It’s definitely better in Windows 8,” Zanni says. “You can write an application now that will run on Windows 8 desktops, the phone and Xbox. So it’s cross-platform, which is nice.”

That cross-platform capability is a good thing for the bring your own device (BYOD) era because it will simplify the chore of writing applications that work on whatever device a user may want to employ. While we’re certainly not there yet, Windows 8 is another step in the right direction.

Windows 8 Support for HTML 5

With the BYOD trend taking hold, “the era of a target operating system is kind of dead,” Zanni says. When you don’t know what OS your users will be employing, you’ve essentially got two choices. One is to employ an army of developers to ensure you have experts in all the various OSs you need to support.

“Or you find a way to make your apps cross-platform compatible, which tends to be Web applications,” he says. “At Carousel we’re certainly making that move to everything being Web applications.”

Crucial to that effort is [wikipop]HTML 5[/wikipop], which is intended to enable a Web application to take advantage of the unique features of any given OS, but still work on other OSs that have different features. While the HTML 5 spec isn’t yet complete, the support for it in Windows 8, and in Visual Studio 2012, is the best to date.

“The introduction of this unified architecture and API, and exposing that to the HTML 5 layer, allows you to build this robust Web app that you know will be exceptionally functional on the Windows 8 desktop, even if it’s only partially functional on these other devices,” Zanni says.

Windows 8 Could Mean a Tablet Shakeout

While it’s still early, Windows 8 may also have a profound affect on the tablet space, Zanni says. He has played with Windows 8 on some tablets and found that, while it works like you’d expect a tablet would, it has a distinct advantage once you dock it.

“You can compile a program on it and execute it. It was like a fully functional laptop,” he says. “You’re going from an easy to manipulate tablet to a full-function computer and it’s all in this tiny kit.”

Asked whether that means employees will no longer have to carry laptops, Zanni says, “That’s the dream.” But the real proof will come once Microsoft’s own tablet, Surface, is released in October, he says. “I think two months after that you’ll know the fate of Windows 8.”

That kind of thinking should not keep companies from cashing in on the strong ROI that video can provide, says Patrick Britton, VP of Visual Communications for Carousel Industries. “Carousel’s perspective is we don’t sell hardware, we sell solutions,” he says. “Hardware is almost secondary. If you build a robust infrastructure that allows firewall traversal, video bridging capabilities and the like, you can extend end points as needed and as they become available.”

Video is a Must to Meet Expectations of Young Workers

The younger people who are now joining the workforce, and all those who will soon follow, have grown up using Facetime, Skype and the like. Video is an organic part of the full gamut of unified communications applications that also includes VoIP, instant messaging and interactive white boards.

From an ROI perspective, failure to give these younger workers the tools they expect means you’ll be losing productivity. “The younger workforce, as they continue to get embedded in the enterprise, will be more productive when they have this technology in their hands,” Britton says.

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Cut Travel Costs, Boost Productivity with Video

Probably the oldest ROI driver with respect to the business benefits of video is its ability to cut travel costs. But previously the travel argument was tied to expensive room-based systems used to host larger meetings. Not anymore.  New devices put video in the hands of virtually any employee.

“Say you’ve got a mobile sales force and you want them to connect for a monthly or quarterly sales meeting,” he says. “If they can do it from their iPad and not have to travel, they only lose 2 hours of time in front of clients. That’s a huge savings for a company.”

Better Team-building and Training Via Video

For all sorts of applications companies can also take advantage of the ability to record video sessions and play them back later, Britton says. Maybe the CEO records a quarterly address so employees in different time zones can play it back when it suits them. Carousel does that with some of its quarterly meetings. “We stream it live but also capture it and have it on the network for those who are unavailable,” he says. “It keeps everyone feeling like they’re part of the team.”

Likewise, companies can record training and reference sessions so that employees can view them when it’s convenient, from wherever they like. That can greatly help with training as well as processes such as employee onboarding, cutting down significantly on costs.

BYOD Trend Eases the Video ROI Equation

The fact that so many employees now want to use their own devices at work, the bring your own device trend, actually helps ease the burden on companies to provide video-capable end points. “BYOD does make the ROI equation easier,” Britton says. “You can have endpoint clients that are software-driven.”

Investing in a software client for an iPad costs far less than the previous generation of components for a telepresence or videoconferencing room. “And it gets that video out to more members of the team,” he notes. “You have more people using it and connecting with a lower barrier to entry.”

When push comes to shove, however, to take advantage of these trends and realize an ROI on your video investment, you have to plan properly, prepare your network and execute effectively.  If you want to learn more about how to video-enable your organization, and make the ROI case for it, contact Carousel.

In the hospital environment, another impetus is giving patients and visitors access to the Internet – because even sick people (maybe especially sick people) want to be connected. “So hospitals need to be compatible with BYOD scenarios and integrate self-provisioning guest portals,” he says.

Keeping up with the demand for mobility creates challenges in a number of areas, including planning, installation and security, Williams says.

Conducting a Site Survey for Wireless in Healthcare Settings

One of the first steps is to start planning where to place wireless access points (APs), a process that starts with a predictive survey. “We take a floor plan from the customer and they identify which areas are most important in terms of wireless coverage, what types of walls exist and the client density for each area,” he says.

It’s important to think ahead during this process, especially given the new wireless standards coming down the pike. The 802.11ac spec, which is due out as a draft around the end of this year, supports wireless speeds of up to 1G bps, but at shorter distances than previous standards. “You need to plan for that,” Williams says. “Build the system so it can scale, because the need for wireless is growing every day.”

Wireless Installation Can Be Tricky Business in a Hospital

Next you get into how to actually install the cable that the APs connect to. “Hospitals have strict rules on opening up ceiling tiles because it brings dust in,” he says. To deal with such rules, installation involves using a specialized enclosure with a vacuum that takes all the dust outside. The enclosure is only two or three ceiling tiles wide and the installers have to be inside it the whole time, making the installation somewhat painstaking.

In some areas, such as the lobby, the requirements may be more lax. But in general, the installation becomes a logistics discussion in an attempt to minimize disruption – while recognizing that the installation will take longer than in an office environment.

Given these constraints, Williams says it’s a good idea to use any existing cabling runs that you can, so long as they support your current and future requirements.

Security is Paramount for Wireless Healthcare Systems

All that medical data is of course sensitive as well, so the wireless system must be highly secure such that it meets regulations such as HIPAA. That means keeping the public portion of the network separate from the internal portion and ensuring proper authorization and authentication is in place.

But as health care firms move toward electronic medical records, now they have to keep those databases secure as well, Williams notes. “With HIPAA, you can’t take personal information and put it on a public server,” he says. Carousel partners such as Fiberlink with its MaaS360 offering have fully integrated mobile device management solutions that, among other features, enable companies to create secure virtual environments in which to save sensitive information – so nothing is saved on a doctor’s iPad, for example.

If you’re looking to beef up your mobility solutions, whether you’re in healthcare or not, let us know if we can lend a hand.

In this video version of our partner podcast series, I spoke with Simon Dudley, a “Video Evangelist” from a Carousel Partner LifeSize, to discuss the role that visual communications plays in the modern enterprise. We discussed trends, new opportunities and technology in our wide ranging conversation.  Here are some of the highlights:

What Matters in Teleconferencing?

Before LifeSize was the industry leader that they are today, Simon went around and spoke with several heads of corporations to discuss what they thought of video conferencing.  He spoke with one CEO of a big company that had over 500 video systems.  After a number of platitudes, he told Simon that they were all “rubbish” and that everyone hated using them because the experience was mediocre and the complicated technology made the overall process difficult and unenjoyable.  The CEO went on to say that “if the meeting matters, I will come see you, if the meeting doesn’t matter than I will get you on the phone or send you an email.”

Simon then asked the CEO what would make him want to use video conferencing and he replied: “Cut a hole in the wall of my office and give me a glass window to another place.  The quality and experience need to be as if the person is just looking through that window to another location. If you achieve that and make the technology go away for the users, then it will succeed.”

Great insight….sounds like a corporate mission to me.

Why HD Video Matters in the Enterprise

Before LifeSize pioneered High Definition technology in video conferencing in 2006, competitor’s products had resolutions and frame rates that were ten times lower than that of LifeSize.  Add to this the challenge that making the a video call was time consuming and complicated for most users.

Fast forward six years.  Now with seamless connections and crystal clear video, businesses have begun using LifeSize video for purposes other than just one-on-one conference calls. Companies have started utilizing video to train employees, collaborate on complex projects, bring internal experts in for consultation even if they are 3,000 mile away and myriad other applications.  “Making the calls easy for the end user and providing high-def resolution is making all the difference.  It’s like being in the room with someone and companies are really learning how to take advantage of that”

Bring Your Own Device (BYOD) and Mobility in the Workplace

The idea of an office is, in many ways, starting to go away.  Back in the day, we needed to be in the same room as our co-workers to communicate and exchange information between one another.  Now we have access to all of those things and more from wherever we are. The  BYOD trend has accelerated this transition and is a perfect solution for teleworkers.

As Simon explains, Apple really kicked off the BYOD trend by making their products the iPhone and iPad so compelling.  Devices such as these with a video app on them gives video the ability to become a mass deployed technology throughout every aspect of business.  Lately, there has been a lot of noise in the industry about BYOD killing the room based devices that exist today.  LifeSize doesn’t buy into this argument.  “Think about watching a movie.  You can watch it on your iPhone if you need to, but if you have the option and it is convenient, you will watch it on the 50 inch high definition TV in your living room,” Dudley explains.  In fact, LifeSize is optimistic that the BYOD network effect will be a huge benefit for their company, connecting millions of additional endpoints to seamless video collaboration solutions.

For more insights from this entertaining discussion, watch the whole video. To learn more about Lifesize and Carousel can help your business effectively implement an enterprise visual communications solution, contact Carousel today.