Expanding the Reach of TELESYNERGY®: Using a live video stream to extend the base of TELESYNERGY® Communications to those Without Videoconferencing Facilities
The UPMC McKeesport Hospital’s CDRP grant (the Radiation Oncology Community Outreach or ROCOG program) was designed and funded as a multi-site program with five participating institutions, each with a diverse service area and differing minority populations. Assuring optimal use of the TELESYNERGY® at each of our partner locations not only implied the ability to periodically relocate the system, but also required developing a method to extend assess to TELESYNERGY® system (TS) programs and educational events outward to all facilities, staff, and community areas of interest. These potential program viewers included physicians, who were unable because of distance or time, to personally attend TELESYNERGY® sessions. These potential viewers also included community groups, churches, health advocates, patient’s families and friends and others as targets for distance learning opportunities. The difficulty, however, was that few of these facilities or individuals had available videoconferencing equipment, yet all physicians and many individuals or groups in minority communities had access to the web via their computers. We therefore evaluated options to extend the capabilities of a TS to a much larger group of interested parties without significant costs, provided they had basic computers with web access.
Methods and Materials
An example of using additional audio/video signal routing from a TELESYNERGY® System (or other videoconferencing devise) is dependent upon extracting appropriate audio and video signals from the videoconferencing device. For the TELESYNERGY® system (TS) we used signals routed from the TS to a secondary desktop computer with a video card ($115 to $250) and installed Windows Media Encoder (a no cost Microsoft corporation software). This allows encoding of a video and audio signal and transmitting (pushing) pushing live streaming AV signals to a dedicated server for open distribution to physicians, community groups, and others with web-linked PCs over a large geographic area.
A. Signal routing
With the TS, access to audio or video signals is available at several system locations. The easiest signal access, however, is provided by extra ports at the rear of the Tandberg unit. If your installation does not have free ports, (a different TS version or another videoconferencing system) one can extract signals using quality splitter cable such as the Velocity splitter cable for S-video signals described at the following link: http://www.cablestogo.com/product.asp?cat%5Fid=2009&sku=29164 Alternatively, one can use a audio visual amplifier/distribution box to extract and send signals to your encoding computer.
For encoding most any available Windows desktop PC may be used provided there is an open slot for an AV card. We recommend purchase and installation of an Osprey 210 card as is described at http://www.viewcast.com/products/osprey/osprey210.html . This card comes complete with a versatile breakout cable capable of a variety of audio and video inputs. Once the card is installed, download Windows Media Encoder 9 from: http://www.microsoft.com/windows/windowsmedia/forpros/encoder/default.mspx . This encoding software will convert your AV signals to an encoded version and allow you to “Push” the stream to Windows Media server for web distribution. The word “Push” must be selected to assure your IT people that there will be no firewall issues with an outgoing video stream.
Streaming is easy using the encoder software. The user will need to specify the input type for the video and audio signals in the software, select the streaming modes (“live stream”, “push” etc.) and define the destination of the server. Once the server acknowledges log on the stream can be switched on. Hint: be sure that your TS microphone is turned on. Whatever is seen on the large plasma screen and heard from all TELESYNERGY® conference participants will be pushed to the server and available to anyone who uses internet access to connect to the stream’s web address. Thus outward communication from videoconferencing sources may be expedited by live streaming video
To date, we have generated more than 20 hours of video streams using this methodology to link TS based communications and conferences in a faultless manner. Both video clarity and resolution and audio clarity are very good. Most all intended recipients have as part of their computer software a version of Windows Media Player that enables the end user to appropriately view and listen to content as it is streamed. Although this system is obviously a “one way out” type of approach to provide large audiences with information access, two-way communication may be established using a concurrent phone conference call. (see note that follows) It is imperative that all users of live video streaming recognize that proprietary information, issues of a private nature, and HIPAA non-compliant information be judiciously avoided in streams because of the fully open and public nature of the web access. To minimize this risk, prerecording, post hoc editing and then a selective delayed distribution of the recorded media may be accommodated by the software, and by the TS system directly.
The issue of streaming delay, sometimes referred to as network latency, may become problematic for viewer interaction if the viewer does not remember to only listen to the audio/video stream at their locations when calling in a comment or question. This is much like calling a talk show on a radio program. Strategies to minimize this issue are addressed in the FAQ section of the Microsoft page referenced above. When we first set up streams the latency in the origin, server, and recipient computers was as high a 30 seconds. A bit of tweaking as explained in the Microsoft web site has reduced this latency to about 10 seconds. Some delay is always expected because of the buffering systems used at each interface. Selection of lower image resolution and slower video frame rates per second, will keep this latency to a minimum.
Larry L. Schenken, PhD
Program Director for Professional Development & Education, TELESYNERGY® and Web-based Communication/Education
ROCOG Grant Offices
Third Floor Shaw Building
UPMC McKeesport Hospital
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McKeesport PA 15132
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