TTAC

Video Platforms: Site Preparation – Videoconferencing Endpoints

Room Setup

Much work and time is dedicated to the selection of videoconferencing endpoints, but one of the key issues to a successful videoconferencing experience is often ignored – room configurations for the equipment.  When a room is not properly set up for videoconferencing, even the nicest equipment can provide unsatisfactory results.  It is possible to improve audio and image quality as well as the patient and provider experience by doing a few things to set up the room.

Lighting

Appropriate placement of lights, as well as avoiding strong back lighting, can make for a clearer, more visible subject.  Lights that are closer to the plane of the subject’s face can reduce excessive shadows; harsh overhead lights can cause some details in the eyes and mouth to be lost depending on the subject’s positioning.

Back lighting, either from a window or other strong light in view of the camera and behind the subject, can cause a camera to automatically adjust the exposure levels to match the bright light.  This results in a very dark foreground and subject.  If it is impossible to orient the camera in such a way that the light is not behind the subject, consider using blinds to mitigate this problem and / or turn off the lights that are causing issues with the camera.

The color of the light, or color temperature, can also play an important role in affecting the overall appearance of a videoconferencing session.  The human eye is very good at adapting to different lighting environments, compensating for various hues of light to interpret surroundings as mostly-white light.  Imaging sensors are not as good at this, and light sources can cause color casting of the subject.  If possible, install neutral or white fluorescent bulbs in overhead fixtures.  Normal fluorescent bulbs tend to have a green or slightly “off” coloring, while incandescent lights tend to be “warmer” and slightly yellow or orange.

Microphone Placement

Depending on the unit being deployed, there may not be much that can be done to change the placement of the microphone.  If, however, there is an external or moveable microphone, consider where it will be placed in the room and whether or not the users of the system may move it.  Can the microphone be placed near the patient’s or provider’s position?  Will users be able to easily access the mute function of the microphone, or will they have to use a remote control?

Be aware of other environmental noise sources that may be especially distracting to the users of the videoconferencing system.  PC fans can sound incredibly loud if a microphone is placed near the vent on a computer, and typing can become rather distracting if the microphone is placed too near the keyboard.  Other issues are more an issue of user education on reducing noise – tapping on a table top with a pen or tapping a foot against a table leg can result in distracting noises on the receiving end of the call.

Appearance

Videoconferencing equipment can quickly become a mess of wires and cables if poorly managed, which can result in a both unprofessional-looking environments and potential support issues should a cable accidentally become unplugged.  Also, consider the view that the remote end will have of an endpoint’s surroundings.

There are many systems out there that provide an enclosure, mounting surface, or cable management solution.  Cables that should not be accessed by users need to be made inaccessible; simply expecting providers, administrators, and non-clinicians to not unplug a cable may result in unexpected support issues.  If there is support for sharing content from a computer, make the cable clearly identifiable and accessible.  If external video devices will be supported, make the necessary connections available.  You may also want to consider providing a breakout box with external switching between video sources if multiple devices are to be connected.

The appearance of the physical surroundings of a videoconferencing location also plays an important role in providing a positive videoconferencing experience.  Basic issues, such as clutter and haphazard placement of equipment, can result in a less than professional appearance.  Other issues also come up fairly regularly, and should be avoided and mitigated where possible.

  • Does the room provide privacy and is it free from ?
  • People walking in and out of the image in the background can be distracting, though may be necessary in some clinical environments
  • A patient should not have someone who is not supposed to be a part of the conference walk into either their room or into the consulting physician’s room
  • Consider having a sign available that can be used to indicate a conference is in session
  • Are there loud activities happening in the rooms and hallways surrounding the videoconferencing area?
  • Mechanical and vocal noises can be distracting in a videoconferencing session, and may result in a reduction of feelings of privacy and connectedness
  • Sound can carry very well in some settings – beware of sounds from private conversations making it into a video session or from the session being audible to surrounding areas
  • Typical clinical exam rooms are usually covered in hard surfaces that sound bounces off of quite well (sheetrock, cabinets, vinyl floor, etc.). If the user won’t be wearing a headset or a lapel microphone, then consider adding some sound absorbing materials to the room to help reduce echo and improve the sound.
  • Is the room kept clean and professional?
  • Make sure that people are aware of how to use the system, and how the room should be arranged when they are done with their videoconference
  • Consider having a person whose responsibility it is to keep the room tidy – a short pass through the room each day can make sure that it is up to organizational standards
  • Ensure that users of the systems have training on how to present themselves when in a videoconferencing session – users should give their full attention to the conference, without eating lunch, focusing on non-relevant computer systems, or having side conversations