One of the biggest telehealth networks in the world is weeks away from a major expansion of its availability in Canada’s largest province.

The Ontario Telemedicine Network (OTN), which currently has some 2,200 videoconferencing endpoints in designated rooms in 1,200 hospitals and clinics, is turning to the Internet to let thousands of doctors and nurses access the network from their offices using personal computers.

Initially they’ll be able to more easily consult with colleagues and patients in medical facilities, but ultimately the medical practitioners will be able to contact seriously ill patients in their homes.

After spending several months integrating new software from Vidyo Inc. with its existing platform, 50 health professionals will be able to take advantage of the expanded system early in September, said Dr. Ed Brown, OTN’s chief operating officer. It will expand after that to add thousands of people to the network.

Security is ensured with end-to-end encryption. “If you’re a specialist operating in your own office with a couple of partners, spending $5,000, $10,000 or $20,000 for a piece of (videoconferencing) equipment is more challenging,” he explained in an interview Tuesday.

“So this is a way to get it out there in a lot more places, to make it simpler for them and to enable them to do this wherever they are and not have to trek out to a studio or organize a (telemedicine) room.”

OTN is a five-year-old organization largely funded by the province that leverages the private network run by eHealth Ontario and the Orion fibre optic education and research network. It also links to the Keewaytinook Okimahanak telemedicine program for remote first nations communities in northwestern Ontario.

Video conferencing is OTN’s major application, but the network also offers health professionals the ability to remotely monitor equipment like digital stethoscopes, cameras in clinics, as well as host educational Webcasts.

As one of the large telemedicine providers in the world, it handles 135,000 “patient events” plus 11,000 Webcasts a year so patients in remote areas can have access to experts outside their communities, while clinicians can keep on top of medical trends.

“We’re growing at least 20 to 25 per cent a year in terms of activity,” said Brown. “We have an implementation list of another 200 or 300 sites at the moment.”

OTN also wants to expand into tele-homecare for remotely monitoring seriously ill patients who can’t get to a clinic. From a pilot project involving people with chronic heart problems, the organization learned that, with the coaching from a nurse, hospital stays can be cut by 65 per cent and trips to an emergency ward cut by 70 per cent.

The existing network is based on core and endpoint technology from Polycom Inc., Cisco Systems Inc. and Tandberg SA, (now a division of Cisco) but OTN felt it had to leverage the Internet to keep costs down.

And it wasn’t necessarily the increasing ability to use HD video on PCs that drove the decision. A typical video conference consumes 512 kilobytes per second of bandwidth, Brown said, more than enough for most users’ needs – particularly because in rural areas they don’t yet get bandwidth to support HD.

OTN is able to accomplish the network expansion cost-effectively after awarding a contract to Vidyo Inc. earlier this year for the New Jersey company’s software after a competitive bidding process.

Vidyo won in part because its software stack includes APIs (application programming interfaces) that can link to OTN’s video conferencing management application, Brown said, as well as its ability to interoperate with other VC equipment. “The price was good as well,” he added, although OTN hasn’t detailed what that is.

In addition to Vidyo routers and gateways, the deal also includes licences for the PC software that has to be downloaded to end users.

They’ll get it by logging into OTN’s secure portal to set up for an online meeting. The software is a little over two megabytes, said Amnon Gavish, Vidyo’s senior vice-president of vertical solutions, and shouldn’t take more than 30 seconds to download.

When it comes to the actual videoconference, the Vidyo software automatically scales to the available bandwidth.

The contract is one of the biggest in telehealth in the world, says Viydo. “Very few organizations in the world have that scale of existing videoconferencing deployments,” he said.

The deal, said Brown, is a step to making telemedicine in Ontario a commonly-used medical tool.

“Clearly the virtual health care system is growing, and we think it’s going to be every bit as important as face-to-face health care,” said Brown, “though there’s an enormous way to go to make this fully mainstream.”