One of my responsibilities as CIO at BIDMC and HMS includes oversight of Media Services. Historically Media Services produced slides/posters and provided slide projectors, TVs and VCRs. In this digital world, it is now the focal point for streaming, telemedicine, and all digital presentation services including LCD projectors/plasma screens/digital whiteboards. My media services organizations at BIDMC and HMS have been evolving to provide services required by today's digital savvy customer. Strategic questions include:
1. What is our video teleconferencing strategy?
Several years ago, Caregroup acquired bulky Picture-Tel teleconferencing units to link together our hospital executive teams. They were challenging to use, and required engineers to establish and maintain connections. They were not mobile and provided few features other than basic voice and picture connectivity. They were used less than 5% of the time. Today, with H320 (ISDN) and H323 (IP) mobile units, are we seeing more video teleconferencing? For group meetings, telemedicine consultation, and interpreter's Carelink (video delivery of interpreter services to the bedside), we're seeing more interest. To support these initiatives, BIDMC installed a teleconferencing bridge so we can link internal IP teleconferencing to external ISDN teleconferencing units, host video conference calls and provide security for internal to external IP calls. A year ago 90% of our video calls were ISDN, currently 90-95% of our calls are IP, All internal video calls are IP and about 60% of our external calls are IP over the public internet, with very reliable results.
Video teleconferencing is still not a seamless technology, as easy and reliable to use as a telephone. Cisco Teleprescence has amazing clarity and ease of use, but it requires specialized equipment in a dedicated space. BIDMC will embrace video teleconferencing more when desktop to desktop communication becomes easy and reliable.
At HMS, we're running several tele-learning pilots, making lectures at the medical school available in real time to students at Harvard University and linking together outside institutions for collaborative coursework over Internet 2. As with BIDMC, doing each of these requires significant media services resources, so they are not broadly deployed. HMS, along with the other Harvard schools are jointly investigating enterprise licenses for Webex and Elluminate as real time collaboration tools, realizing that the value of a real time video feed is limited.
2. Should we offer full service presentation support or self service classrooms?
I've lectured in numerous auditoriums around the world which are outfitted with sophisticated Crestron equipment. Each one I use has a custom user interface which hides the details of room lighting, screens, curtains, video projectors, and video sources from the user. This may sound like an advantage, but I've had many presentations delayed because the Crestron unit itself becomes unresponsive and no one knows how to reset it. If I had a simple AV switch box, light dimmer, and screen switch, I could operate the room myself with ease. Reseting a projector is just an off/on switch. Cabling is a VGA or DVI connector. However, not all users are completely comfortable with AV equipment, so some prefer Crestron user interfaces.
Do we provide staff at every event to set up and assist all presenters? Do we use complex Crestron programming to make room control easy for the average user? Do we provide a basic set of off/on switches and assume most users can figure it out?
My personal favorite is Extron HideAway desktop PC Interface, which is a basic AV switchbox and VGA cable. It works every time. I think its likely that we'll try to standardize most conference rooms using Extron equipment, ensure most users are familiar with it and staff just large public events or those events with visiting faculty to ensure their success. This means we'll need to invest in our conference rooms to bring them all up to a consistent level. The capital to do that has been challenging to obtain, but I believe striking a better balance between consistent self service infrastructure and staffed presentation support will increase customer satisfaction and better utilize the time of skilled AV staff.
3. What is our video streaming strategy?
We're increasingly asked to host video streaming for grand rounds, resident report, simulations, operating room procedures and continuing medical education. BIDMC does not have internal video streaming hosting. Harvard Medical School hosts video streaming for 1600 courses and has made this infrastructure available to BIDMC on a case by case basis.
Our challenge is what to do with streaming video available to the public. Providing streaming servers and networks with appropriate bandwidth is no problem for a few hundred students, but what about public video streams that could be watched by thousands. We'd used Akamai for public streaming and self hosted infrastructure at HMS for private streaming. HMS uses several tools to automate the video streaming process including AnyStream and Apreso. We currently host Real formats, but in the future we'll likely host additional Flash formats.
4. What is our podcasting strategy?
HMS currently has an audio podcasting infrastructure to support 1600 courses. We're investigating video podcasting but at present, there is limited demand. The value of watching a talking head while listening to a lecture on an iPod is limited. We've recently developed public podcasts too.
5. What is our new media strategy?
Historically, media services at BIDMC provided graphic design for public web pages. This resulted in graphically interesting pages, but designs were so sophisticated that real time revisions were not possible. We're moving our external website to a content management system so that complex HTML coding and graphic design are no longer required. This may result in less graphically interesting pages, but makes real time changes easy. Currently, we do not offer Flash programming services, but we do offer photography, video encoding, and basic graphic design. In the future, it probably makes sense that Media Services will offer services to produce still images, flash animations, and streamline video to support websites using our new content management system.
6. What's the right mix of services to provide?
Creating the right mix of poster services, graphics services, photography, video, and presentation services is challenging. At both HMS and CareGroup, we've thinking about this, realizing that presentation services (both self service and full service) are important, and that various digital graphics services will be increasingly important.
7. What media services do patients expect?
Media services at BIDMC include providing Television services to the hospital. Patients now expect additional services such as movies on demand, video game services, and web access via in room televisions. At present, we offer wireless to all patients at no charge, but do not provide rentable laptops. We're investigating partnerships to provide additional media services to patients.
8. What should we insource and what should we outsource?
Clearly, presentation services are something that we must insource because demand is unpredictable and services are often needed at the last minute. Flash and high end collaboration services might best be outsourced. We're thinking about the best balance of internal and external staff to support basic verses advanced digital media services.
9. How should we divide the role of web content management?
At BIDMC, Corporate Communications has taken the lead in our web content management project. They will lead the governance effort which oversees departmental production of content. Media services has taken a lesser role in web design and daily web content production. In the future, it's likely that content production will be divided between departments, corporate communication, media services, and outsourced high end content providers.
10. How do we optimize management of team?
Given the evolving roles of media services, the need for presentation support, and the increasing customer demand for advanced digital services, how do we manage a forward thinking and agile media services team? At HMS, we're considering adding additional operational team leadership such as an "air traffic controller" to schedule each day's events and ensure all presentation services are well orchestrated. At BIDMC, we're considering the addition of a "new media" specialist.
Working together, the management and staff of Media Services will refine their skill sets, optimize their alignment with customer needs, and evolve to meet the demands of a web 2.0 world.
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