Broader Broadband

Based on the number of practices that have taken advantage of the Broadband for Health incentives, many medical practices have only recently upgraded from dial up modems or no Internet access at all. For these people, their new ADSL or cable connection may be welcome; however, there have been a few notable advances over the past year that offer some Australians better, equally affordable options.

There is little doubt that the Internet will play an ever increasing role in the delivery of services and information to medical practices. Some of these services won’t be bandwidth intensive, however others will only become feasible when coupled with faster network capacity.


While Telstra has recently upgraded the speed of its cable Internet offering, ADSL2+ is a technology with greater relevance for most readers particularly those outside of the capital cities.

Download Speed

The most obvious benefit of ADSL2+ is the dramatic download speed increase. Compared to the 1.5Mb/s limit of the initial ADSL offering, the 24Mb/s speeds quoted for ADSL2+ appears revolutionary. Be mindful however, that the providers of ADSL2+ are quite open about the fact that this is a theoretical maximum and the reality is less impressive. The variation in speed is directly related to two factors, both of which will be out of the Internet Service Provider’s (ISP) and your hands:

  1. The distance the practice is located from the exchange.
  2. The quality of the phone line.

Based on vendor provided figures, the realistic speeds of ADSL2+ range from 6Mb/s to 20MB/s which is still impressive even at the bottom end of the scale.

Upload Speed

While the download speed is the figure most people are interested in when choosing an Internet plan, it is actually the upload speed that will be increasingly important for many future Internet services.

As discussed later, maturing technologies including Internet telephony, remote access, and Internet based backup solutions all require fast speeds in both directions.


Like its slower sibling, ADSL2+ makes use of standard copper phone lines. The increased speed is facilitated by a hardware upgrade at the telephone exchange, so no line work should need to be performed at your practice.

Despite currently having an ADSL modem, you may need to purchase a new ADSL2+ model to take full advantage of the speed. Fortunately these are very affordable and easy to configure.


Faster Internet access provides many benefits:

Web Browsing and Email

Perhaps this goes without saying, but having a faster Internet connection will make routine tasks like web browsing and email a smoother, more efficient process. In larger practices with multiple users accessing the Internet simultaneously, this improvement will be more pronounced.


Podcasting has been rapidly embraced by even non technical users, and is an ideal media format for time poor doctors. An avid podcast listener may download tens or hundreds of megabytes per day, so maximising the Internet capacity is important.

Remote Access

While the popular remote access software does perform well over slow connections, faster access allows for more fluid control and transfer of data. This will be appreciated by both your software vendor and IT support person, and will allow both of these parties to provide practice staff with more effective support when required.


While it isn’t a stretch to suggest that most copyrighted video downloaded from the Internet is done so illegally (ask any teenager), there are an increasing number of organisations delivering or seeking to deliver video content legitimately via the Internet.
Advances in compression techniques have helped make online video feasible,  however real time, high quality video is only viable with a fast Internet connection. Companies looking to deploy IPTV (Internet Protocol Television) are claiming that a network capable of at least 2.5Mb/s will be required for the service to work reliably.


Only a limited number of ISPs have the capability to offer ADSL2+. This is primarily due to the fact that Telstra, who provide their infrastructure to the bulk of Australia’s ISPs, are backing a competing technology that isn’t currently available.

The largest problem with ADSL2+ stems from a reliance on new hardware being installed at telephone exchanges. As this work is being performed by companies with no government ownership (i.e. not Telstra), their roll-out is targeted based purely on commercial considerations.For practices in rural areas who may have only recently had ADSL enabled at their exchange, getting excited about any improved technology is not advised. The most established provider is iiNet,  who claim to have surpassed 100,000 ADSL2+ connections with current capacity for another 55,000. They have a large lead, however other popular ISPs including Optus and TPG are also competing for a piece of the action.


ADSL2+ plans suitable for most medical centres weigh in at around $50 per month, with setup costs ranging from nil to a few hundred dollars depending on the length of the contract and whether a new modem is purchased.

As with traditional ADSL, an active phone line will be required, however this can be shared with an existing phone or fax. Many ISPs bundle VOIP services with their plans, allowing a standard phone to be plugged into the modem. As alluded to earlier, the quality varies greatly, but using this feature selectively (e.g. for appointment or payment reminders) may reduce your total communication costs.


Like many IT professionals who have seen the greener Internet pastures overseas, I’m frustrated by the broadband apathy displayed by providers, customers and Government. While ADSL2+ doesn’t compare to many of the cable options available in other countries, it is currently the best solution if your practice is in range of a compatible exchange.

If you are a current ADSL user, there is little downside to upgrading. The price isn’t inflated and the benefits will be realised both immediately and into the future.

Posted in Australian eHealth

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