Microwave broadband: an alternative to fibre for telehealth

This article first appeared in the August 2013 edition of Pulse+IT Magazine.

One of the big selling points for the former government’s National Broadband Network (NBN) was its potential to open up new modes of healthcare delivery, including telehealth and telemedicine, to areas of Australia that experience barriers to access. However, the fibre, fixed wireless and satellite services envisaged by the NBN are not the only technologies available.

In November last year, a fire at Telstra’s exchange in Warrnambool in south-west Victoria brought home to many just how much we rely on telecommunications infrastructure in our daily lives. Not only were phones and internet cut off to the public, affecting tens of thousands of people, but things we take for granted like ATMs and EFTPOS were disabled for days, if not weeks. According to some reports, many businesses in the area were accepting paper IOUs as customers did not have access to their money.

For Warrnambool Base Hospital, on the other hand, it was business as usual. It was able to keep functioning and even offer assistance to Deakin University and Ambulance Victoria because it was not connected to the virtually monopoly Telstra service.

The hospital is part of the South West Alliance of Rural Health (SWARH), which for many years has been using a microwave broadband service to provide unified communications across a range of regional hospitals and clinics.

Microwave broadband is, as Andrew Findlay, managing director of microwave telecoms provider Vertel, puts it, certainly not new technology, as it is used to provide the backhaul for the majority of mobile phone services, and nor is it suitable for every application. Microwave is a point-to-point technology that can provide extremely reliable, high-capacity wireless communications, with the limitation that it needs clear line of site (LOS).

“We have a transmitter and a receiver at both ends, for instance at a hospital and at a high site,” Mr Findlay says. “It might be on top of a mountain or a tall tower, and between those two points we get the right from the government to operate at a radio frequency and a path between those two points exclusively.”

As it is an exclusive, licensed frequency rather than an open frequency such as that used by mobile carriers, Mr Findlay says microwave is able to use a much higher frequency band to deliver high-speed data services. “It is a very mature and reliable technology and if you engineer and design it well, it will give the same performance criteria as you get from fibre. The availability and the performance of our service matches and in some cases exceeds that of fibre optics.”

SWARH has been using microwave broadband for many years in one form or another. The technology has changed over time – Mr Findlay says the standard upon which it is built has moved away from a circuit base, which was quite hard to manage and share, to an Ethernet base that can be shared with anyone.

SWARH's CIO, Garry Druitt, says the organisation decided on microwave for very practical reasons. The alliance was first established in 1997 as a result of a government initiative to facilitate the aggregation of hospital services and their ICT spend. The south-west region devised a strategy for what it required, at the heart of which was the development of a wide area network (WAN) that could be used by all participants so they could standardise and centralise the distribution of services, thereby lowering the unit cost.

In addition to determining what patient management applications and finance systems the alliance would agree to use, Mr Druitt says they also wanted to achieve some quick wins, including a restructure of telephony services by replacing all PABXs with an Internet Protocol (IP) based system.

“We established in about 1999 or 2000 the first IP-based telephone system in health in the world,” he says. “We partnered with Cisco and what was known at that time as Com Tech and has now morphed into Dimension Data. From 2000 to 2004, we replaced all of the PABXs, and there were 16 of them, with a single call manager, or UC as they call it these days.

“That delivered telephony to everybody via a server and IP, and so we had low-cost calls and calls that were routed to each hospital were free. We had a 30 or 40 per cent reduction in call costs, and that created a confidence level to continue our investments so we could then invest in other things and invest in more. That has really been the SWARH story.”

To read the full story, click here for the August 2013 issue of Pulse+IT Magazine.

Posted in Australian eHealth

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