Telemedicine – Videocalls and Videoconferencing Project Questionnaire

Please submit detailed information about your telemedicine video link project so that we may respond in the quickest and most effective manner possible. Submitted information will be treated as confidential. This form is to be used only for Telemedicine video link [videocalls(point-to-point) and videoconferencing(multi-party videocalls)] projects. Since it costs us to carefully select among the wide variety of choices and the varying quality that is available on the market, please provide as much detailed information as possible. Ultimately that will help us select a solution that will best meet your immediate and future needs. Thank you

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Name:*

E-Mail Address:*

Organization*

I understand that I represent the organization mentioned in the application form for the purpose of the application and may be contacted by InterNetworking Link for further processing of the application.*

Implementation Timeline*

Clinical Expectations*

Provider expectations for both provider and user experience. Please provide general info about Expectations, Priorities, portability, maneuverability. .

Administrative Expectations*

Expectations for provider's performance and user experience. Please provide details about Scope, requirements, expectations, priorities, scalability. Please clarify whether video conferencing(multiple video calls at the same time) is required.

Solution Preferences*

Please indicate if you have a preference for a software solution only or a hardware and software mix. Please indicate if you have a vendor in mind. Any existing H.323 system? Is a Software as a Service model acceptable?

Current Networking System*

Please provide details about your broadband connection and network traffic. Please indicate whether wireless or cellular technologies are available and if they will be used. Do you have HD screens and cameras? Type of firewall in place? Client computer systems must meet the following minimum requirement: CPU(Pentium IV 1.8 GHz Duo Core or 3.0 Gz single core)/ Graphics(128 RAM)/ RAM(2GB)/ Server(Windows 2003)/ OS(XP Pro or Media center, MAC with Parallels or Bootcamp)/Sound(sound card, echo canceling mic, speakers)

Funding Options*

Please indicate if funding is available or if you are seeking funding sources. Do you have and internal or an external grant writer specializing in healthcare and technology able to identify corporate, foundation and private funding sources?

IT Staff*

Will you need IT personnel with the skills to set up, test and maintain the equipment and its availability? Do you have a staff familiar with telecommunications services and networks? Do they have experience with video and audio equipment? Are they good on keeping emphasis on ease of use and patient care? Please provide details

User Community*

Please state what level of technology your user community is generally comfortable with. Are they enthusiastic about the use of video calls. Will they participate in the testing process? Is it a remote, underserved community? Will the project cover prisons, disaster areas?

Existing Telemedicine implementations*

In your region, are they existing telemedicine implementations? Are they operating successfully?

Supported Specialties and Applications*

What medical specialties and applications will the telemedicine project support? Provide expectations and priorities for each application or specialty. Will it provide opportunities for continuing education for healthcare professionals?

Other uses*

Will the project provide only live interactions or will it also require store and forward technology? Are the needed servers(including NAS/SAN) in place?

Interoperability Capabilities*

What are the characteristics of the peripheral medical devices. Will they connect to telemedicine video and audio equipments?

Security and Confidentiality Compliance*

Compliance with HIPAA specifically with the Privacy Rule and the Security Rule is a must. Is your organization in compliance with the 'meaningful use' regulation? We also offer solutions for encrypted communications. Please state if your organization has protection mechanisms already in place against unauthorized access, use, and modification; unintentional loss, theft, etc. What does your project require for video, voice messaging and file exchange protection: AES 128 or 256 bit encryption? Will your project require sessions to be recorded and archived for compliance review or future playback?

Complete address*

Please provide location of the project and all your contact information(phone, fax, etc))

Mobility Requirements*

Is the project requiring fixed video rooms solution or a distributed solution for mobile workers? Only software solutions provide greater flexibility

Collaboration and Synchronization Requirements*

If a multi-party solution is required, up to how many parties at a time? Does the project require a presence list? What are the collaboration tools needed? Which are most useful to your organization(Application sharing, Flip-chart, whiteboard, Public or Private IM, Secure File Transfer, testing, polling, voting, content creation, etc)?

Video Interpreting Requirements*

Please state if video interpreting is required and for what language(s). Do you have your team of interpreters or do you require an on-demand sessions provided by a third party? What type of coverage(24, 12 or 9 hours a day)? Do you currently have telephone interpreting in place? Please understand that we do not provide Video Relay Service. We only provide Video Remote Interpreting service.

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