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New Years Resolutions - Video Conferencing and Training

January 5, 2010
by Joe Bormel
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New Years Resolution
How will YOU use video conferencing in 2010?

2009 saw a 50% increase in number of concurrent users of the popular video conferencing service called Skype. If my 'friends" sampling is an accurate indication, the growth is mostly due to families connecting over the miles. Daughters going off to college is a common triggering event, even though moms mostly get to watch their daughters text to others, while the daughter is video conferencing with mom! Unquestionably, kids and young adults view video conferencing as routine and have for several years now.

The business volume growth (including medical) in 2009 was less, but nevertheless quite notable. Our HR department started doing some screening interviews with a video conferencing service. This has been terrifically cost and time saving for all parties involved and welcomed by both. Of course, there is no substitute for physically being there. But as the world becomes more global, virtual, fragmented, and connected in new ways, video conferencing is an important tool for appropriate classes of work. Just like any tool.

Several healthcare-specific potential roles for video conferencing are nicely elaborated here. Cisco describes telepresence and connects it with several concepts, employer-based care delivery models, Medical Home, and the office visit of the future (essentially telemedicine). The vision and discussion of implications is an important one for all of us HCIT enablers. At times, our role is to be part of the 12-step program for a healthcare system addicted to dysfunctional behaviors!

My personal experience with Skype video conferencing is worth a sentence or two. I coordinated a conference track at AMIA this past year, staying connected to the chair who lives in Connecticut and works in NYC via video conferencing. It's been mutually therapeutic to connect with this friend when physically getting together was logically impossible. We got a lot of productive work done using video, which we followed up in email.

There is similar work-combined-with-relationship development that has occurred with friends in Toronto, Massachusetts, Colorado, California, Oregon, Connecticut, North Carolina, etc. The conversation quality is clearly better with video conferencing than mobile phone to mobile phone (which has become the standard). Perhaps one of my 2010 resolutions should be to Skype with a client, fellow-employee, or friend from every state or country I deal with?
 

Santa is using video conferencing (photo courtesy of Cisco)

I'd like to close by sharing what I've learned in 2009, and welcome your experience as well.

1. The technology works and is readily available:

- Free: one of the applications/services for computer to computer video conferencing is free, if you have a modern laptop or a desktop with a camera and microphone.

- Inexpensive-way to start: although inexpensive netbooks work great for video conferencing, the quality is typically only acceptable. Images are low resolution and motion isn’t smooth. I brought my mom into video conferencing last year for $300.

- Camera: switching from a cheap Web cam (like the internal ones in some netbooks) to a ~$100, auto-focus, 2+ megapixel Web cam makes a huge difference. Much better image, which improves the experience.

- Internet Connection:
- Remarkably, free, public access WiFi is often enough.
- We have Verizon FiOS (fiber-optic Internet service), and we're paying for an upgrade to service faster than 5 MBs.
- Dropped calls: Some calls drop frequently. Sometimes related to time-of-day. Sometimes related to distance. And often related to other concurrent network uses, such as VoIP. If you start with an expectation that you may need to reconnect every 15-20 minutes, and you may occasionally need to switch to voice, you'll likely be pleasantly surprised when video conferencing works for several hours at a time perfectly. If you expect it to be perfect quality of service, you'll be very disappointed at some point.

- Computer: running on a reasonably recent multi-core, fast computer also makes a difference (even in addition to the better camera point above). I've been able to vary camera, connection and computer, and have seen that great results can be achieved. Two days ago, for example, I was Skyping with a friend in San Diego from Washington, DC. We both had fairly optimal settings. The call quality was pretty much at a high def TV standard, in terms of picture quality and frame rate (picture smoothness with motion). It's amazing to see someone roll their eyes and smile; no words can communicate a point as efficiently and effectively.

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Thanks Tim.

By 2011, anyone who has not at least experimented with video conferencing is making a statement about themselves, if only "I've been busy with other things."

I have several friends who swear by ooVoo as well. I have used Skype, iChat and ooVoo, all of which advertise multi-way video conferencing. I have pretty good connectivity at home and at work (I video conference from both); multi-way video clearly requires a fast internet connection to work well.

My experience with them, as well as Google's Chat (which provides video) and Apple's FaceTime (which connects iPhones and Macs) is that they are all evolving rapidly. Skype has had screen sharing, region sharing and file sharing for a long time. I agree with you, these capabilities on top of video conferencing making distance interactions easier and friendlier.

In 2009, I did video conference demos over Skype from the HIMSS show floor. You may recall that the economy collapsed; travel budget's followed shortly there after, so I brought our booth to my colleagues who were hospital bound.  I also video recorded several of the live sessions for subsequent re-use.

Joe, I always thought we were on the same wavelength (scary thought!) and now I know it's true: I just posted my "stories I'm working on" the same moment you posted this. And my story number two that I'm working on? Video conferencing!

Joe: Love it! I use ooVoo.com as it has features that (in my mind) are much better than Skype. I can have up to 6 people (frames) on the line at any time and the video quality is much better - in my opinion. Plus - I can open a PowerPoint or Word document and share my desktop during the call. Really cool. Video is poised to really take off and I encourage all HCIT CIO's to embrace it as part of the hiring process. It really makes a difference!

Chantelle,

You're welcome.

Thank you for validating some of my observations and raising a few new and interesting ones.

You addressed my point two on Skype and self-management. There are times when Skype is very practical and times when it isn't.   Multi-tasking is a great example of that nuance.  There are times when multi-tasking precludes Skyping, and times when Skyping can enrich multi-tasking.

My wife and my mother-in-law rarely use Skype although they chat daily. It's much more common and practical for them to use the wireless phone, since they rarely enjoy the luxury of being able to sit at a computer without a work or home task to complete. Even a laptop, which they both have access to, wouldn't change the equation.  Fortunately, I know of no one who uses video conferencing while driving a car.  If you thought cell phone use while driving is dangerous (and apparently irresistible to some), video conferencing would clearly be more lethal.

On the other hand, I frequently use Skype video conferencing with my 80+ year old dad. He does sit at his desk and is not running around with childcare, household chores, and a professional "day job."  I try to Skype with him weekly; I'm the limiting factor.

Chantelle, I also appreciate your reference to international calls. As I mentioned in my original post, using Skype to close the distance can be fantastic, especially for infrequent but highly important strategic update discussions. There are about a half dozen hospital system CMIOs that I chat with this time of year or in response to major events (for example, an acquisition.) Video conferencing can be an ideal way, when there is a pre-existing trust relationship, to cover a lot of ground, deeply, and on a timely basis. This can be impractical or impossible with travel, email or even by phone.

So, again, for those of you who haven't experimented with Video Conferencing, 2010 may be your year!

A year later from beginning first writing of this post ...

I invite an old friend, let's call him Kyle, to video conference, and I get this reply:


Joe, I'm actually not much of a video conference guy… I like being on speakerphone and then having access to the web and taking notes at the same time
Mainly just use if we need to share a document…
So hopefully good old phone will work for you.
  -Kyle


Hmmm.  Here's my open reply, since Kyle's behavior is typical of most of us.  Our plate is full.  We don't want to do one darn new thing today; we're behind on too much other stuff.  Did I say our plate is full?  That would be nice, try "Our many plates are full!"  If this sounds like a change management fundamental obstinance situation, it may be.  It may also be a messy desk, grooming or visual shield issue for multi-tasking as described above.  Turning on video increases candor, intimacy, and vulnerability.  That's part of its huge, positive power.

In this case, I think it's probably more like the person who, having never skiied, has pre-decided that they don't like it.

My reply would be something like this:


Kyle, have you ever gotten married, bought a house, or had children?  Let's assume, for argument's sake, that you've done all three and it's worked out swimmingly well for you on every count. 

Before you decided to do any of those things, did you really know what it would end-up being like?  Let me help out your memory here.  No, you didn't.  Could anyone communicate how it would actually feel?  You get the idea.

It's called experiential learning for a reason.  If a true friend invites you to video conference, you might want to try it.  Especially if you consider yourself innovative.  Just sayin'
-Joe


Of course, I might never say that to his face.  You know, I actually would, but only over Skype video!





Video Conferencing in 2011

Here's a quick update:

1) In 2010, slowly but surely, I was able to drag all-but-one of my laggard business colleagues into the video conferencing world.  The majority were already there or needed no more than a simple ask.  Anna, we're still waiting on you!

2) Almost everybody I chat with, including outside of my company and outside of our industry has been a little stressed out at one point or another in 2010.  As I pointed out in an earlier blog post, face-to-face interactions are usually more than de-stressing (see recommendation #5 below; video conferencing can lower your stress level, and that of your colleagues and subordinates.)  There has been further confirmatory brain science since 2005 from several independent centers.




3)  Senior partner at Sanford Rose Associates Tim Tolan recently wrote a great article on the value of video conferencing in "Leveraging Technology in Your Hiring Practices - It's Prime Time for Video Conferencing."  Tim's experience parallels mine and my employer.  We've been sending webcam to candidates for several years, if they don't already have them. 

In the same spirit, I do much of my on-going career mentoring work with video conferencing.  With face-to-face communication, you can tell instantly whether the other person is connecting.  It can be a real waste of time to work without this feedback.  There's also an important emotional vulnerability that is essential to leadership that is simply impossible to convey and assess without video.  If you're authentically trying to serve others, video conferencing is the way to go.

4)  I've provided some critical best practices in the post above that are still valuable and true.  The SeeEye2Eye pictured and described above is one example.  Here's another.  Recently, in adding video conferencing capability to an older home computer, I went to purchase a webcam.  What I found astonished me.  For under $80 (eighty), including shipping, I purchased a Logitech HD Webcam (high def, 720p/1080p), with all the other stuff I've previously described as essential, such as auto-focus, low-light smarts, and stereo sound.   I plugged it into both a Windows laptop and a Mac and, without further ado, it was recognized and started working ... in high def, in Skype.  At this point, the visual quality more than rivals real life.

5) The remaining laggards and those unable or unwilling to play


Last week, I had a conversation with someone with whom I am in an early phase of relationship development.  We had a POTS call (plain old telephone service).  We started the call off on the right foot, with a quick review of the agenda and goals for the call. 

I listened carefully and blanked my local computer screen to assure that I fully attended. 

Although I didn't hear them typing, there was easily a five to ten second pause after several of my necessarily longer responses to their questions.  After a while, I got a strong sense that they were pretending to listen but more-than-likely, they were doing unrelated email. 

When they heard the pause in the conversation, they scrambled to "fake it," as though they had been listening.  They didn't do an adequate job.  Using video conferencing would have allowed a shorter call, better relationship development, and had the capacity to develop authentic trust.  The POTS experience was objectively inferior, and actually eroded trust


As well pointed out by Tim Tolan in point three above, you can raise the bar in your interactions with video conferencing, or, waste not only your precious time, but also waste your ability impress with the limited time we all have. 




Do You or Your Directs (direct reports) make
Training Videos?

Thanks to everyone who has sent me private responses to this post.  In following up, I tested the link for SE2E and the video there and was reminded of a related topic, very important to HCIT executives:  Training. In addition to one-on-one communication, capturing and recording video for "broadcast" has many overlapping issues with video conferencing.

Once you have a suitable computer outfitted with a camera, and have addressed lighting, grooming, etc from above, you are now in position to record training videos as well.  These can be watched by anyone you choose in your organization, on their computers, iPhones, and related devices.  These can be linked to your web pages, links sent in emails, or made identical to podcasts (automatically downloaded via RSS feeds). 

There are lots of examples of these video podcasts that I and others have been providing links to for several years now.  Click on the link in this post with the words "Mike Mandel's Tracking Intangible investments" as an example, or simply here.  Note the eye contact and the ability to communicate a complex topic in an easy, natural, communication format.
 


If you choose to experiment with this technology, the recommendation I just made to Jack above about seeing eye to eye (video conferencing with a mirror in front of your webcam) becomes more relevant.  In great videos, like the Mike Mandel example above, the speaker is looking directly into the camera.  Just like you want for your training videos.  If you buy the $60 video conferencing SE2E mirror product pictured above, you'll have everything you need to go one step further... teleprompting.  You or your directs can be directly reading your training script while giving the viewer eye contact.  The free software to do this is described below.


Every week in my role as CMO, clients described a shared frustration of bringing physicians in for a meeting or training.  Often, it's a simple as making them aware of some small, highly useful but little known and used feature of the existing software. 

Some have expressed interest in CBT (computer based training) for these needs.  For 2010, why not experiment with with brief, focused, video messaging?  You already have all of the tools you need to get started.  Here is an example of a video describing safe, on-line holiday shopping.  There are a variety of readily available tools for the video transitions and screen captures shown here (for windows, mac and linux, free-versions available for each.)  The production time for a good quality, five minute video, including scripting, production, and post production can be as little as eight hours of work.  The results, especially on an enterprise-basis can be well worth it.

Following the guidance for getting comfortable with video conferencing in this post is a great first step!

 






Joe,
Smile, you're on Candid Camera!

Guess it's time for me to dust off my camera and give VC another shot. For me, a past problem at or near the top of my list was so few of those I met with were willing to VC rather than using the phone or email, which they considered much easier and more efficient. But if market penetration has improved to the level you indicate, it may be time in 2010 to try to make this work.

In your experience, how important is eye contact within the context of video conferencing? Your comment about a "smile" and an "eye roll" was interesting. And as a follow-on question, do you find that the people with whom you seldom VC, versus regulars you know well, tend to suppress their visual emotions for whatever reasons? I'll admit that during in-person presentations, I try my best to appear engaged, even when the content is so boring my mind is in another galaxy. Just trying to be courteous to the presenter and all that.

Finally, are you familiar with using VC in the OR? About 12 or so years ago, I read that one region of the VA, I believe in the far Northeast, was using a PictureTel system (now Polycom) to have surgeons expert in specific types of complex procedures actually "sit-in" on such operations from remote sites. As I remember, a high-rez camera was mounted with the light on the primary surgeon's forehead. Seems to be an ideal application for this technology.

Jack

Jack,
Interesting observations on your part.

Regarding "How important is eye contact?", I'd suggest you watch the brief view here: http://www.bodelin.com/se2e/howitworks.php


High-end video conferencing systems put a lot of focus on creating eye contact. I consider how most people use Skype today as low-end. Just getting any video is like lighting a candle in the dark. It's delightful. It is possible and can be practical to achieve very good eye contact in this low end with a little attention to detail. The "SeeEye2Eye" product at the link above is simply two mirrors, one with a beam splitter; together, they put the image and eyes of your caller just in front of your camera. Your results may vary but it works for me to create an eye-to-eye conversational experience.  (I only use it for about 10% of my Skype calls for various reasons.)

Joe, Thanks for your interesting notes and beneficial suggestions.

I personally use this method of communication [Skype] because of the attractive zero costs especially for international calls.The use of video conferencing services, such as Skype, could be expanded into a recreational category where we could keep contact with family and friends from all corners of the globe.

However, after a busy day, followed by evening events, it is already challenging for some of us to multitask. To sit down in front of a camera and maintain attentive eye contact becomes almost impossible.

A solution for this would be the use of a laptop: placing it on the counter while preparing dinner could knock out two tasks at once. Although after mentioning this I wouldn't try paying bills and video chatting at the same time.

I just had another one of those conversations. I invited a friend to connect by phone or Skype. I pre-checked and found that they did have a Skype account. They shared with me that they didn't really use it or understand the need. Kind of like Facebook for some there's no clearly understood compelling case to do it.

I think that Skype (or any of the half-dozen IM and VC consumer services that have millions of subscribers) is roughly where cell phones were two decades ago. The phones were large, heavy and hokey the alternatives, e.g. phone booths, were relatively plentiful. And, the expectation of being able to make or receive a call anywhere and anytime was not out there. [Mail, incidentally, took 24 hours to "transmit", and it's creation involved stationary, stamps, a trip to a distant mailbox, etc. It was delivered once a day.]

I think the psychology of cell phones had a role, too. It was commonly joked that we hated those rare, few inconsiderate dogs who self-righteously and rudely used cell phones in public places. Of course, now, the only debate is at what age should be give cell phones to our kids. Last year, that number when I survey'd was twelve years old. It's ped, both in empiric practice, and in pop literature like "Diary of a Wimpy Kid" (see the Lock-In scene for those of you reading to your children.)

Skype is more virtual. We don't see other people using it, unless we are using it on the other end. When it is used by those who don't use it in business, it's used to connect family, often across states, the country or the pond.

Somehow, it seems not correspondingly relevant for business reasons.

The fact that the best business is conducted informally and often face-to-face is somehow not considered when people write off using Skype. There's still time to make it your resolution for 2011 !

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Joe Bormel

Healthcare IT Consutant

Joe Bormel

@jbormel

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