Table 2.

Videoconferencing Application Selection Criteria

1. Does the videoconferencing application have the image quality required for the telemedicine context? Some applications may be completely inadequate for certain types of telemedicine. For example, in dermatology, higher video resolution may be needed to show the patient's skin more clearly. However, others may provide more resolution than needed, often at additional costs (in terms of either pricing or technical support).

2. Does the bandwidth available accommodate the videoconferencing application? Some applications accommodate a range of bandwidths but reduce quality when set for lower bit rates. Consequently, the bit rate the network can accommodate has to be compared to the image quality required (criterion 1). Some applications, especially those uncompressed, may exceed available bandwidth.

3. Does the videoconferencing application have the functionality and performance required? For example, if providers need to control cameras at the distant end point and view input from other devices, does the application allow this? Similarly, some applications may have greater latency, making communication difficult, or they may be more vulnerable to network congestion.

4. Is the videoconferencing application easy to use and is there technical support? Generally, commercially available applications are easier to use and have company support. Open source applications evolve based on the work done by the community using them and in-house technical expertise may be needed to support them. Even when in-house technical expertise is available, some applications (e.g., uncompressed video) are very new and not well documented.

5. Is the cost of the videoconferencing application appropriate? An application's price must fit one's budget and hidden costs must be taken into account. A free, open-source software is attractively “priced,” but the technical support that is often needed may cost more than a commercial product. Moreover, commercial products often offer technical support and service contracts at a marginal additional expense.