m.Care supports video conferencing to connect subjects/patients with care team members. m.Care connects to existing video conferencing systems to provide this support. m.Care was constructed with a “plug in” architecture which allows the platform to be extended to support other video conferencing technology. As of this writing, the following video conferencing technologies are supported:
If a customer has an existing server software or licenses to the above listed technologies, m.Care can be constructed to use those services.
If a customer does not have access to any video conferencing capabilities, m.Care can be configured to use the access privileges that m.Care has set up with the above vendors on behalf of the customer.
If a customer has access to video conferencing technologies that is not one of the above listed technologies, it is possible to add the technology to the platform using the m.Care Video Conferencing Plug In technology, but this does depend on the API set of the vide conferencing vendor in question.
This section documents the features made available via the m.Care video conferencing technologies.
The video conferencing capability inside of m.Care supports a “patient room” metaphor. When a video conference is to be held with a patient, the patient “enters their assigned video conferencing room” and the care team members then join the patient in their room. So, each patient is assigned a room and that room assignment is known and managed by the m.Care software.
The video conferencing platform what m.Care is connected to determines the number of individuals that can enter the room at the same time.
The video conferencing technology presents the video conference and manages the video conference. m.Care wraps the video conference with features that are required for use and with buttons that enable various features for the subject/patient and care team.
Starting a Video Conference
From a subject/patient point of view, to enter their room, a subject simply taps on a “card” on their dashboard indicating that they want to enter the room. m.Care knows the subject/patient and therefore can route them to their correct room.
Once the patient taps on the video conferencing card, the conference is started and the patient is placed in their assigned “Room”.
For care team members, the monitor application is used to join the room. One of the features of a subject notebook is the video conferencing tab. On this tab are buttons that allow the care team to join the room.
Account Assignment and Pooling
Because video conferencing technology providers often charge a per-user license to the m.Care customer, the m.Care platform implements a video conferencing “pooling” mechanism. This pooling mechanism is used to assigned video conferencing credentials to subject/patients, not care team members.
The basic idea behind the pool is that when a new subject/patient enrolls, a new “room” must be created for that patient. The room is assigned to the patient at enrollment by m.Care. The m.Care software grabs the appropriate room credentials from a pool of pre-allocated credentials. When a patient leaves the customer’s program, the video conferencing credentials previously allocated to the customer are released and returned to the pool, thereby optimizing the number of video conference accounts needed, keeping costs down.
m.Care monitors the video conference pool for availability. Configuration parameters indicate how full the pool may get before a request is sent to extend the pool. If the assignment of a new video conference credential from the pool trips the pool over this parameter, then m.Care sends a note with a pre-allocated list of accounts that should be created to the administrator of the video conferencing tenant asking for the accounts to be allocated. At this point, the accounts are listed as “requested by unallocated” in m.Care. When the Tenant manager indicates the accounts have been allocated, m.Care marks those accounts as available for assignment.
When m.Care detects that the pool is nearing “empty”, as specified above, it formulates an email that is directed to the tenant manager. This email format is configurable in m.Care as is the format of the pre-established account names allowing the customer to dictate exactly how they want that email to look. The accounts are placed in a .CSV file that should be easily uploaded to the tenant for allocation.
As a reminder, care team credentials are NOT assigned video conferencing IDs out of the pool. Rather, those credentials are created outside of m.Care, but the credentials need to be specified in the m.Care profile for that user.
The m.Care platform may require the use of a web browser plug in to support the care team in attempting to join the conference. The requirement to use the plug in is based on the version of video conferencing technology in use and some configuration information inside of m.Care.
If a care team member requires a plug in, the m.Care software will display a notification indicating that the plug in must be installed before proceeding.
Subject/Patient Room Features
To ensure simplicity and ease of use, the features shown to the patient on their iDevice are kept very simple. Basically, a subject/patient taps a card to join their room. Once in the room, they have a simple “Hang Up” button that they can touch to disconnect from their room.
All other features are controlled by the care team during the conference.
Care Team Room Features
When a care team member joins a subject/patient in their room, the care team member has access to a selection of tools that allow them to control the way the conference proceeds. This section discusses these features.
The following is a screen shot of the toolbar as it displays at the bottom of a video conference.
The care team member can personally hang up from the call by clicking the red hang up button.
The following shows the menu options available on the “Command Menu” (second icon from the left). This button lets the user control the session as it is being presented to the subject/patient and care team.
Close This Videoconference For All – Closes the video conference, hanging up all connected users.
Restart User iDevice Session – Hang up and reconnect the subject/patient’s session.
Terminate User iDevice Session – Hang’s up just the subject/patients session.
Maximize Video Window – Maximizes the video window as shown to the patient.
Shrink Video Window – Shrinks the video window down so other screen elements can be presented to the patient
Minimize Video Window – Shrinks the video window to smallest size on patient iDevice
Show Chalkboard Only – Shows a chalkboard where the care team can draw pictures that the patient can see
Hide Chalkboard – Hides the chalkboard
Show URL in Chalkboard – Displays a specified URL on the patient’s iDevice
Toggle Camera – Rotates through the cameras available on the patient’s iDevice in sequential order.
Allows the user to change the way the video conference is personally working on their workstation.
Camera – Lets the user select the camera to use for the conference
Microphone – Lets the user select a microphone to use
Speaker – Which speakers should be used for audio output
Video Quality – The preferred video quality
Number of Preferred Participant – Numbers of people allowed to join
Preview Mode – How the video should display to the user
Show Participant Name – Whether the system should show the participants name above the window title.
Allows the user to specify if they’d like an interpreter to join the session, indicating the language and gender needed.
Turn Camera Off
Hides the visuals for the care team member, effectively turning off their camera.
Turn off Microphone
Mutes/Unmutes the microphone
Turn off Speaker
Turns Off Speaker
Allows the user to quickly choose which camera they’d like to use for the conference
Force Starting a Video Conference
It is possible to force start a video conference on a patient’s iDevice. This feature is to be used selectively for the obvious privacy issues. If, however, a patient were to be bedridden and unable to start the video conference, then this button can be pressed. When pressed, the system responds with a warning about what is about to happen. The user can choose to either force start the conference, or not to force start.
If a conference is to be forced started, the system notes this in the database for the patient. When the iDevice nexts contacts the server and sees the force start request, the iDevice software will immediately take the user to the video conference applet and log the subject/patient into their room.
As great as the internet is, in some locations, the performance just isn’t that great. In rural areas especially, internet performance may be sub-optimal. If the internet performance for a user is sub-optimal, then the video conferencing capabilities of the app may be impacted. It is wise to remember that video conference is really a very high bandwidth feature even for today’s internet.
Sometimes, internet performance isn’t the factor contributing to a video conference performing poorly. To help catch these issues, the monitor application allows a care team member to assess how the conference performed when last used with a patient. There is a button on the video conference tab that looks like a speedometer that lets the user provide subjective results of the video conference or in other words, do a bandwidth assessment. When clicked the care team member can assess the conference as they saw it proceed from a usability point of view. This information is then stored in the database for future analysis by tech team members.
These statistics along with actual metrics are copied to the Video Conferencing tab in the subject notebook as shown below.
Logging a User’s Session
A subject/patient’s video conferencing log can be useful in debugging performance and features of the video conference. As such, there is a check box on the patient’s user profile that when check will cause the log captured by the system to be posted to the patient’s “Documents” tab at the conclusion of the conference (shown below)
Session statistics are capture by m.Care automatically. The list of sessions held with a subject/patient is displayed on the Video Conferencing tab of the subject/patient notebook. A sample log is shown below. From the log you can see when the subject/patient was last contacted as well as some baseline stats of the conference.