The Big Bandwidth Theory

iStock_000006701987XSmallWhen a practice is split across several sites, can they expect their Dictation System to work across branches as fast as it would locally? Some say it’s only a matter of bandwidth, but the Equalizer doesn’t like taking questionable theories for an answer. So he investigated further.

When it comes to itchy subjects like data travelling back and forth between branches, expect to get utterly funny answers from vendors. Here’s a little best-of:

– “Oh well, you can expect a 15 second delay before getting a record response. I know that’s a bit frustrating but doctors will get used to it.”

– “How long before the note Doctor A. just dictated here reaches his secretary down the road? Well, I would say 4 hours…at least. Blame it on your bandwidth.”

So that’s it?

A practice spread across several sites would be doomed simply because…it has several sites and little bandwidth? That’s so 1990’s. It’s time for the Equalizer to put a name to the ugly face hiding underneath this wobbly theory.

Technically, all Dictation Systems should work fine across branches. But depending on which technology the system uses, time will either play with or against you. Indeed, most systems copy voice files from a location to another, resulting in pitiful delays upon both delivery and playback. The more jobs in the queue, the higher the frustration for secretaries trying to transcribe a sentence between staggers and cuts. It’s exactly like watching a video on YouTube without streaming. Patience had better be thy virtue, unless your brother-in-law works for BT and he got you fibre optics for Christmas.

The Crescendo system uses Voice on Demand (VOD) and never copies voice files from location to location. Therefore users do not suffer such delays.

Let’s say the server is at the Main Surgery and a doctor is dictating from Branch A: he’s recording the file in real-time to the main server. The file will not be copied anywhere but streamed as it is created, resulting in instant delivery and playback, just like a good old telephone system.

This approach makes the whole practice become one: the Practice Manager can see in real-time who is currently dictating at surgery A, typing at Branch B. And if B is busy, work can be redirected in real-time to C in order to ease the workload. Whereas in the other scenario, where files are copied back and forth, you can never know what’s going on or where since everything is in different places at the same time.

Real-life, real time

To confirm his findings, the Equalizer paid a little visit to The Limes Medical Centre in Essex. There he spoke to Debbie Bodhanya, Executive Director of this award-winning “Practice of the Year 2008”, looking after 20,000 patients and spread across 4 branches.

“Crescendo’s secure VOD technology allows dictations from the branch surgeries to be delivered in real-time across the N3 network to the central repository at the main surgery – where the secretaries work from. This gives me a full audit of every referral, practice wide.

Same observation at The Portsdown Group Practice: 5 branches with 30,000+ patients in Portsmouth and Paulsgrove. No matter where the voice files were created, secretaries are able to pick and play any dictation as if they were listening to their voice mail…(note to self: has my voice mail ever staggered or cut a message between two sentences? Nope. Even back in 1986 that was already bulletproof.)

Big bandwidth theory? Easily equalized when you’ve heard of something called VOD.

Speed of soundly yours,

The Equalizer

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CRESCENDO SYSTEMS LIMITED - Unit 1, Fiveways Business Centre, Feltham, TW13 7AQ - UNITED KINGDOM
Tel: +44(0) 1932 789433 -

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