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Category: Tip Sheets

Virtual Care Network Checklist

Virtual Care Network Security Without Clinical Disruption

Tele-nursing, tele-sitting, and tele-consults represent just a few of the virtual care programs gaining prominence in hospitals. As hybrid care models that blend remote and in-person caregivers expand, enterprise telehealth is paving the way for virtual engagement at every patient’s bedside.

Under this new paradigm, healthcare IT teams are understandably looking to drive security standards across rapidly expanding virtual workflows. The challenge is that many corporate IT standards around network security and performance can disrupt patient care in always-on virtual environments where devices must be available 24/7.

Common Network Security Standards that Negatively Impact Virtual Care

Login expirations
It’s common for cybersecurity teams to force users to log out at certain intervals. That means tele-sitters may need to log back in multiple times during a shift, interrupting patient observation.

Device timeouts
To keep unused devices from overloading the network, sometimes idle systems that are on for a
certain number of hours are automatically disconnected. If you’re in the middle of monitoring a
patient and that connection drops, that creates a safety risk for that patient.

Firewall port restrictions
Firewall updates frequently disconnect virtual care applications. If you’re a virtual sitter watching a
patient, your system disconnects, and you can’t call back in, the time it takes to reestablish access to
a high-risk patient can feel like an eternity.

DHCP registration requirements
When managing IP addresses, enterprises often reset assigned addresses, sometimes as often as
every 30 minutes. This can cause disconnects. If multiple systems are trying to renew their IP lease at
once, it can cause congestion. If you’re a doctor trying to call into a patient room that’s still in queue
to get an IP address, that call will not connect.

Wi-Fi over-subscription
You can have excellent coverage when you evaluate your Wi-Fi heat map, but it’s really about network
congestion. How many devices are connected to your access points transmitting data? That can
impact connectivity and disrupt care during periods of high traffic.

Bandwidth restrictions
Most networks are designed for data applications, not two-way video. This leads to bandwidth strain
during peak usage times when concurrent session rates are high.

Virtual Care Network and Security Best Practices Checklist

It’s essential that your hospital clinical and IT teams connect early on, collaborate, and are willing to compromise to support network and security in a way that does not disrupt virtual patient care.

Follow these best practices to ensure your network is optimized for bidirectional virtual engagement:

… Compromise on staff login expirations by having automatic logouts coincide with shift changes.

… Avoid automatic disconnection of devices used in hybrid care models.

… Use static IP addresses for virtual care resources if you can. If not, at least have a reserve of IP addresses designated to virtual care support and set the IP lease to last a full shift.

… Measure the experience of your Wi-Fi-connected devices and calculate how many devices are within a
wireless access point. How much are they being used? Can they be hijacked?

… Calculate your peak bandwidth. Look at your fleet of devices, review your network capacity, and
estimate the number of concurrent connections you can comfortably do. Then design your network to
what that peak bandwidth threshold would be.

… Hardwire virtual care devices whenever possible to reduce the potential for connectivity interruption.

… Empower patients to connect with their family, care team, and interpreters but consider that impact
on call volumes when multiplied across the entire hospital. Factor this into peak utilization because
what you don’t want is to have a lot of patients socializing with their families while your doctors can’t
access the tele-ICU because of bandwidth limitations.

… Remember that network conditions at clinician workstations will also impact virtual session
performance. Ensure nurses and physicians are allocated enough bandwidth to support multiple
concurrent connections.

… Isolate high-intensity connections like tele-ICU traffic to a VLAN virtual network where their bandwidth is protected. Leave concurrency available for high-profile locations and only allow so many ad-hoc calls to happen simultaneously to ensure high-priority sessions are maintained.

… Isolate video traffic in a VLAN if possible or create a wireless environment that’s only for virtual
communications. This is going to become particularly important as health systems deploy video
systems in every patient room to support enterprise-wide virtual nursing and patient engagement.

… Invest in tools that help you monitor and assess your network to quickly pinpoint and proactively
address issues.

… Get feedback from your clinical team. The easier you make virtual care to use, the less it becomes
technology and the more it becomes a tool for clinicians to provide better care.

… Bring the cybersecurity team, the network team, and technology partners in early on. Talk through the
impact of virtual workflows on the clinician and patient experience. Understand what you need to do
to meet cybersecurity and network demands within that environment.

Patient Video Tips

Find a setting that’s free from disruptions and noise, but make sure there is enough light. Shut the door to the room and, if necessary, let everyone know you are in a video visit.

Provider Video Tips

Remote Location