When you're working from home for a variety of reasons doing a telehealth session and it the "Internet" drops out it not only looks unprofessional but it could do serious harm to the therapeutic relationship. Even when you are looking for an office you might do what we recently did and test the shared Internet speed before signing the lease then discover that it was woefully patchy.
- Consider a separate connection even if it's a 4G or 5G wireless service or use a firewall that will prioritise your telehealth traffic. Aussie Broadband and Internode come highly regarded from NBN insiders. Consider a 4G or 5G connection.
- Test! Simulate a flatmate or two on Netflix to load up the shared connection see what speeds you get. You should aim for 2.6Mbps up and 1.8Mbps down on your results if you want to run a couples type session at reasonable screen resolution or 1.2Mbps if you're primarily doing one on one sessions.
- Always run your test at the router and then do it again over WiFi. If it's significantly different then upgrade your WiFi.
- Have a backup plan. Even if it's your 4G personal hotspot from your phone you need to know how to swap Internet connections when something goes wrong.
House to Internet connection type
Your common connection options in Australia at the moment are 4G or 5G wireless type connections or some flavour of NBN, either HFC, FTTP, FTTC / FTTN / FTTB etc. All of the FTTX are far superior to the Hybrid Fibre Coaxial connections but even fibre to the basement or fibre to the node end up sharing connections like a multi-lane 110 limit highway can bog down if there are two many people trying to get away for the long weekend. If you can get some form of personal link such as fibre to the premises or fibre to the curb then you're doing well. Not all connection types are available everywhere. Use the address availability lookups on a couple of different provider websites to figure out if you can even consider using say 5G or perhaps you'll be limited to choosing Telstra 5G or forced to use HFC type NBN. Hopefully no one has to worry about the old ADSL copper cables anymore!
Once you know what connection options you have it is down to choosing what you can afford and what you consider to be good value. If you were doing NDIS home visits in the country your only realistic option might be Telstra regardless of price for instance. But don't think that if you can get a 100Mbps NBN connection from Spintel for half the price of the Telstra 100Mbps NBN connection that they are the same - that's like saying that both are offering an asphalt 4 lane highway but one is more expensive so I'm going with the cheapest 4 lane asphalt highway. How much traffic these companies put down their highway is critical and you will find yourself suffering from traffic jams with some of the cheaper companies. I have used Internode for years and I have it on good authority from senior NBN staff that Aussie Broadband is probably on of the best providers in terms of minimising congestion.
A lot of providers are doing unlimited plans but particularly if you're considering a mobile data plan you'll want to allow for the GB per month to fit your likely usage. Expect to pull half a GB per 1 hour session on Zoom. so if you see 25 clients pw or maybe 100 clients per month then you might need at least a 50GB plan just to cover the telehealth data usage.
|At the start of the pandemic I quickly setup my wife with her own 4G connection to stop the kids hammering the NBN and causing problems with my wife's sessions. We could have increased the data plan on her phone but I opted for a separate device with it's own sim card and plan because phone calls wouldn't disrupt the session and having a WiFi connection was a convenient format as well.|
Traffic shaping and firewalls
Some firewalls allow you to prioritise different traffic or even different services that use the same ports depending on the destination. This is generally beyond most home IT enthusiasts but it is possible and you should think about automating internet redundancy so that if the NBN lines are cut by an excavator that your wireless connection cuts in but both are part of your firewall protections and the firewall manages whether the kids / flatmates / co-workers can swamp your telehealth session or not. Talk to us if you need help with a reliable and secure internet firewall setup.
Quite often we hear that the Internet is down but when we troubleshoot we find that the Internet to router/firewall connection is fine but the computer to firewall connection over Wi-Fi isn't working or isn't working reliably. Again there are things you can do to remedy bad Wi-Fi that are generally beyond most people but try connecting with a physical cable and turning off your Wi-Fi and seeing if the problems persist before replacing your NBN provider. Call us if you need a hand with troubleshooting or upgrading your Wi-Fi.
Test, Test, Test
Speedtest.net is great, just use them and do it at many different time points if needed. For instance here is a comparison between two different 4G connections...
Also some connections might be flaky and be dropping data packets. From a PC you can run a command prompt from the start menu using the application name cmd and then test for connection to one of Googles main servers with the command ping -t 126.96.36.199:
A 34% loss rate is extraordinarily bad. But it was connected!