Connecting general practice to broadband

Many readers will be aware that the Broadband For Health (BFH) incentives for using “qualified” broadband Internet services in GP clinics ceased in December 2007.

As a result, the majority of practices in Australia that accessed the program will need to review their contracts with Internet Service Providers (ISPs) when existing contracts expire. Therefore, the inclusion of the “Connecting general practice to broadband” guide with this edition of Pulse+IT, is a timely initiative.

The broadband guide, which is also available online at http://www.agpn.com.au/broadbandguide, was developed by the Australian General Practice Network (AGPN) and a network of eHealth officers who supported access to the BFH program, within the Divisions Network, in each state and territory. AGPN acknowledges the financial support of the Australian Government Department of Health and Ageing for enabling this work.

During the course of the BFH program, it was clear that accessing accurate information about the details of a broadband service could be difficult for practices. At the same time, the number of affordable options for high-speed broadband services available to practices has increased, primarily because of the introduction of ADSL2+ and the increasing availability of SHDSL.

Nevertheless, purchasing a plan advertised as “business grade broadband” — the term used to define services available under the program, but also in common use in the industry — will not guarantee that the ISP will offer a reliable and consistent service.

What does general practice use broadband services for? Many applications are not affected by short delays or variations in the amount of available bandwidth, such as web browsing, reviewing evidence-based medicine resources on the Internet, downloading software updates, or using secure clinical or billing communication services. However, there are an increasing range of applications where such delays are not tolerable, such as Voice over Internet Protocol (VoIP) or remote access, which suffer from small delays.

The BFH program also provided incentives for ISPs to adapt to the needs of general practice through “value added services”. Over the last two years, many ISPs have begun including similar services to those that were offered under the BFH program, such as online data backup, VoIP services, SPAM filtering and antivirus options as part of many business and domestic grade broadband plans.

A review of websites from 12 ISPs previously regarded as “qualified” shows that several continue to offer ADSL2+ business plans that are targeted at clinics. AGPN offers this information as a starting point for research only, does not endorse any particular ISP, and encourages practices to investigate their options fully as suggested in the broadband guide.

Options include:

Telstra’s “business broadband” advertises 99.85% reliability and 24x7 support, online backup services, options for MIMS on PDA, SMS messages (integrated with Outlook), hosted email bundled with security features to avoid the risks and overheads associated with running an email server, and options for the management of networking equipment.

Optus also terms its offering as “business broadband”, though directs customers to services such as SHDSL (which advertise 99.9% reliability) for mission-critical or delay-intolerant applications. Pacific Internet’s health offering advertises a range of business benefits, including 99.9% network availability and 24x7 support, a redundant communications link, 5 static IP addresses, and options for managed networking equipment.

The Divisions Network has been active in facilitating the adoption of appropriate connectivity in general practice. For example, as previously reported in Pulse+IT, Hunter Urban Division of GP partnered with Pacific Internet to provide integrated support to clinics. This has enabled free data traffic across the network to leverage services including remote desktop support, secure electronic messaging, and online backup services, and secure access to clinic systems from GP homes. The HUDGP service won the Australian Telecommunications User Group “Best Broadband Solution for Small to Medium Business” in March 2007.

Broadband access in rural and remote areas faces particular challenges, and for many communities, satellite is the only available solution. The Commonwealth Government’s Australian Broadband Guarantee (ABG), ensures the availability of “metropolitan equivalent” pricing for broadband for eligible customers, which includes small businesses with less than 20 employees.

Satellite services have been successfully used by practices for broadband Internet access, and the ABG now includes options for services with speeds in excess of those available under BFH. It is likely that higher levels of service should be considered to enable mission-critical or real-time applications, which are increasingly available in the market, and for some applications, non-satellite or terrestrial broadband has significant advantages. Increasing access to mobile wireless services is creating new opportunities in these areas.

Posted in Australian eHealth

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