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September 2017

Evolving Education: What to Consider When Implementing Streaming Video
By Alan D. Greenberg
For The Record
Vol. 29 No. 9 P. 6

Streaming video is one of many video technologies gaining currency in health care. Why? Think about the many changes technology has brought to the workplace in recent years, including mobile technologies, consumerization (bring your own device/app), improved bandwidth availability for both fixed and wireless networks, and high-definition video.

However, technology is but one of several ingredients necessary to successfully introduce streaming video into a health care setting. Leadership must also consider use cases, strategy, usability, deployment models, policy and compliance issues, and metrics.

As health care organizations work to maximize streaming video's impact on operations, the following are 10 considerations that must be factored into the implementation.

What's Possible?
First, consider streaming video to be one component of a larger technology strategy. Select video technologies based on how they can help meet organizational goals. In all likelihood, the choices will come down to streaming video (one-to-many, either live or on-demand), streaming video platforms such as video content management (curation and handling of video, whether produced by professional content creators or in-house staff), and video conferencing (two-way/multiway interactivity).

Communication Needs and Objectives
While video conferencing traditionally has been the choice for real-time meetings and telemedicine, streaming video is a Swiss Army knife able to serve a wide variety of both real-time and on-demand use cases, including clinical care (live streaming and recording/distribution of grand rounds, specialization board meetings, sharing of advanced techniques), training (who wants to sit through an eight-hour class when continuing education credits can be obtained in smaller increments?), community building following a merger, and patient education (whether related to clinical health care options or insurance).

An emerging use case is the creation of microlearning content such as short recordings describing how to use a technology or a device. Often, practitioners receive one-time training on equipment they use only on occasion. Microlearning is an answer to that challenge.

Obtain Buy-In
Identify thought leaders who can help drive viral adoption of streaming solutions. The selection of use cases must include a discussion of who will be the project's role models—power users who will promote the use of the technology and make it viral.

However, this role should not be viewed in the traditional sense of someone who is most vocal in evangelizing a technology during the acquisition process. Instead, it should be the person most likely to use the technology—for example, a tech-savvy nurse who might want to create ad hoc recordings or trainers using an adjacent technology (such as web conferencing) who are hitting roadblocks in terms of what they can accomplish and are searching for more robust capabilities.

The mission: When well used, the technology becomes viral.

Be Receptive to Subsequent Changes
Video can be used for new use cases but also can change how an organization works. For example, many organizations use a learning management system for compliance tracking but require manual entries by administrators. A video-based course can be integrated with a learning management system or be a part of a video content management system such that tracking and notifications are automated, helping to reduce workload.

Usability Matters
Look for both a positive user experience and the technical underpinnings that will make a platform meet both user and organizational needs. Elements that make a streaming video platform more usable include scalability (the ability to handle large events, lengthy recorded video sessions, and additional users over time) and how the platform performs either behind the firewall or, in cases where communication occurs outside of the organization, across a firewall.

How users interact with the front end of the technology can make or break a deployment.

Venues Affect Technology Choices
The types of use cases strongly influence how a streaming video platform should be deployed. For organization meetings that take place in auditoria, equipment such as streaming appliances or PCs, cameras, audio systems, and network availability are necessary.

Some organizations stream or record from multiple rooms, often using switches so centralized servers can record and live stream based on need. Are physicians mobile, making grand rounds, and in need of a cart with recording capabilities? Some organizations, especially those focused on patient education or creating training content, often have fixed recording studios. Don't forget to take into account how users will access the content. From PCs and Macs? Tablets and smartphones? Even with video standards such as MPEG-4 and MP4 recordings, capabilities vary by vendors.

HIPAA Matters
Organizations that deliver clinical content that may identify patients must pay attention to policy and approaches to user authentication and access. Is encryption necessary? Is content accessible via a learning management system or a video content management system that requires both single sign-on and role-based access? Take the necessary steps to avoid situations such as the one that occurred at a teaching hospital where nursing school students were piling patient-related data such as videos and clinical notes into the learning management system without paying attention to HIPAA requirements.

Bandwidth, Network Management Are Important
Not all corporate networks are created equal. Users at a health care facility may not enjoy the same experience at work as that at home with Netflix or Hulu unless organizations work with network administrators and vendor partners to understand the current network architecture. Use cases will affect network performance, making it necessary to evaluate whether the network needs to be modified to support streaming. Also consider whether it's necessary to add support for the enterprise content delivery network.

Pay Attention to Analytics
Here's the unique thing about the use of video in health care: It can be mission critical and an essential element of an organization's mission, making its return on investment less of a concern. Nevertheless, don't ignore any metrics that can be gathered. This can range from travel savings (no longer are business trips necessary for education and training) to the number of programs and stakeholders served (training courses delivered, hours of content recorded).

These metrics matter when it comes time to expand or upgrade.

Fasten Your Seatbelt
Get creative when deploying streaming video. For example, there have been instances where nurses record how to operate equipment using their iPhones to create microlearning videos for their peers. Organizations create rapid-fire responses to health care policies or insurance issues. The military has deployed streaming video to provide remote specialist care and help address specific soldier needs.

Bottom line: Be as strategic as possible, then embrace stakeholder needs.

— Alan D. Greenberg is senior analyst and partner with Wainhouse Research based in Austin, Texas. He can be reached at agreenberg@wainhouse.com or www.wainhouse.com. Learn more at www.sonicfoundry.com/healthcare.