CHAPTER 5. ORIGINATING SITE ROOM DESIGN

The room utilized at the Originating Site has several unique design considerations. First, the room must accommodate the telecommunication requirements for the telemedicine program.

Because of the special electrical, telecommunications and computing requirements of telemedicine, proper allowance must be given to the installation of required cabling in a way that assures access for maintenance and upgrades, while at the same time maximizing patient and user safety. Consideration should be given to work flow and patient activity within the room to avoid hazards which can arise from exposed cabling.

Medical devices used in telemedicine will capture images, data and sound and transmit the information electronically. These devices require a power supply, must transmit information from the device to the computing platform or video conferencing platform, which must then connect to the available telecommunications platform.

Another important consideration is lighting. Telemedicine programs which anticipate live transmission of video images must obtain proper color rendition and image brightness. This may require unique lighting to capture the best images.

It is also important to plan the location of video monitors in the Originating Site exam room. Unlike traditional medical practice where the practitioner focuses on the medical device (e.g. otoscope) to view the diagnostic image, in best telemedicine practices, the tele-presenter views the monitor to determine the quality of the image being captured. (In most instances, the image on the monitor will provide a wider field of view, with better image color and clarity, than obtained by viewing through the device. In addition, the tele-presenter has the benefit of binocular vision to conduct a more effective assessment.) The need to view the monitor during the examination requires that the patient be positioned between the tele-presenter and the monitor so that the tele-presenter has direct line of sight of both the patient and the monitor.

Finally, consideration should be given to the location of the room within a facility, the use of the room for non-telemedicine purposes, accessibility to caregivers, and the means of access and egress for patients. Ultimately, the goal is to mainstream telemedicine services into everyday clinical activity. Originating Site room design plays an important role in achieving this goal.