RESOURCES Telehealth Provincial Health Services Authority Telehealth Room Preparation Generic Guidelines Document adapted with permission from the Vancouver Island Health Authority Telehealth Office.
Contents 1. Network Drop with Quality of Service... 3 2. Location... 3 3. Room Size... 3 4. Room Paint... 4 5. Illumination... 4 6. Acoustics and Noise Levels... 5 7. Signage... 5 8. Telephone and Fax... 5 9. Clocks... 5 10. Furniture... 6 11. Camera and Monitor Placement... 6 12. Security and Protection of Privacy... 6
1. Network Drop with Quality of Service Three network drops are typically required: one for the videoconference system, one for a computer, and one for a networked printer/fax. Rooms should also be equipped with a regular telephone line (landline). 2. Location 2a. Provider Room Choosing a location that is convenient for healthcare providers will help gain their participation and support for the Telehealth program. At the same time, the room should be in a quiet location, away from noisy areas with high traffic volumes. 2b. Patient/Client Room Ideally, the room should be located near an ambulatory care area, such as the emergency or outpatient department. This will make it accessible to patients and likely provide access to washrooms, change facilities, patient reception areas, etc. *Note: At some locations, a Telehealth room will need to be available for both provider and patient/client use. 3. Room Size The size of the room must be large enough to comfortably accommodate users, your Telehealth workstation, and peripheral devices. The room will likely be multi-purpose and used for patient consultations, team conferences, and larger groups attending educational sessions or administrative meetings. Telehealth rooms should have a ceiling no higher than 10 feet (9 feet is recommended). Participants need to be sitting at least 5-6 feet from the main camera and monitor, so the remote viewers can see more than a close-up of their noses! In addition, some patient consultations require the patient to lie on a stretcher or walk a short distance. This means the door to the room should be wide enough to admit a stretcher or wheelchair and the furniture should be arranged in a way that allows patients to walk a distance. Doors to the room should be out of view of the main camera. Seeing people come and go during a videoconference can be distracting, as well as may have implications for privacy protection.
4. Room Paint Walls should be painted a medium shade of blue. This colour provides the same depth of colour as skin, hair, and traditional clothing, allowing the camera lens to let in just the right amount of light. All four walls should be the same colour. Flat or matte finish is recommended (i.e. not semi-gloss). White walls and dark furniture should be avoided as they fool the camera lens, resulting in images that are either overexposed or shadowed. Offwhite, suspended acoustical ceiling tile is recommended. The following are examples of paint colours that have been used in videoconference rooms: Benjamin Moore #HC-152 Whipple Blue (grey blue) Benjamin Moore #2065-40 Utah Sky (bright blue) Para Paints P1622-1 Sweet Dreams (bright blue) Canadian Tire D29-5 Winter Fog (grey blue) 5. Illumination Proper illumination levels must be attained to ensure proper skin colour. Regular fluorescent lights can cause a glare or produce a greenish hue, which is misleading during patient examinations. Glare from lights can make an image look blurry on the videoconference monitor. Avoid a room that has windows. Windows let in light from the outside, which may interfere with your videoconference. If you do not have a choice, then heavy window coverings to block out light are recommended. Do not have the workstation directly facing the window. This will cause people sitting in front of the camera to appear dark to your audience. Standard fluorescent fixtures (usually 2 x 4 feet) with colour corrected fluorescent tubes (Kelvin 4100 recommended) and clear acrylic prismatic diffusers are recommended. Do not use egg-crate diffusers as these concentrate the light, creating spots of light called hot spots. Poor lighting can also accentuate light colours or create dark shadows under participants eyes. To avoid racoon eyes a light source may be required to provide direct frontal lighting. A light suspended from the ceiling angled at 45 degrees is a frequently used solution to eliminate shadows. Product codes for electronic ballasts and colour corrected florescent tubes from Westburne Electrical Supply are provided for reference: Ballasts: #GT232A12347GEBSSR (1 x 4 Electronic Ballast Fixtures) Fluorescent tubes: #F32T8SPX41 T8 fluorescent bulb (4100 Kelvin colour temperature) Special fluorescent parabolics are available for videoconference lighting from Columbia Lighting, if budgets allow. Please visit www.columbialighting.com.
6. Acoustics & Noise Levels Too much background noise will interfere with and result in poor quality sound during your videoconference. The microphones on some videoconference systems are ultra-sensitive to noise and can pass this on to remote sites. Microphones should be placed in front of and close to the individuals speaking in the videoconference, ideally at least four feet from the Telehealth workstation to prevent audio feedback. The room should be located away from internal and external noise and vibration sources, such as fans, air conditioners, or plumbing. Ensure that the ventilation system is quiet. Public address systems should not be included within the room. Carpet on the floor helps control noise as do chairs that are mounted on wheels. One inexpensive and effective solution for reducing noise is to install regular wall insulation above the ceiling tiles. 7. Signage The room name should be identified for participants, either electronically or by signs posted in the room. They should be positioned in the room, so the remote audiences can easily see them during each Telehealth session. Tabletop signs are best viewed when placed on the table in front of the participants. Wall signs are best seen when they are on the wall behind the participants. Additional suggestions for signage include a nameplate on the outside of the door, to identify your videoconference room, and a Session is in Progress sign, to hang on your door during a Telehealth session to avoid interruptions. 8. Telephone & Fax All Telehealth rooms should be equipped with a regular telephone (landline). This allows users to communicate, should technical problems arise during a Telehealth session. It is much easier to troubleshoot a technical problem when you are sitting in front of your system, instead of running back and forth to another room to use a phone. A fax machine may also be required to assist with transmission of additional written patient information required during a tele-consultation, for example laboratory results or diagnostic image reports. 9. Clocks To avoid scheduling conflicts, sessions should begin and end on time. A clock mounted on the wall near the Telehealth workstation allows users to keep track of the time.
10. Furniture In a patient/client Telehealth room, a desk or table and three comfortable arm chairs, a floor lamp, decorative plants, etc. An exam table should be part of the furnishings, when possible. 11. Camera & Monitor Placement To ensure as natural as possible exchanges between Telehealth participants, close attention needs to be paid to camera and monitor placement. Since participants speak to the image they see of the far end participants, camera placement needs to be set so as to ensure that the recipients perceive the exchange as happening eye-to-eye. 12. Security & Protection of Privacy To ensure protection of privacy for both patient and provider, please consider the following: The videoconference room is secure with a lockable, soundproof door. Equipment is accessible by authorized personnel only. Carpets, acoustic ceiling tiles, and sound absorbing wall coverings are used where necessary to contain the transmission of sound. The videoconferencing waiting area is organized and managed in a manner to ensure that participants are treated respectfully and with discretion, and allows for as much privacy as is possible in any given facility. A sign is placed outside the door during a Telehealth session. We re here to help! On-demand technical support is just a phone call away. If you have any questions or require assistance, please contact Telehealth Support at 604.297.8777 or 1.866.966.4347. Telehealth is open Monday to Friday, from 7:30 am to 5:00 pm (PST).