Silver Peak Powers an SD-WAN Telemedicine Backpack

The software-defined wide-area networking (SD-WAN) revolution knows no boundaries. Now the technology has found its way into a telemedicine backpack that can deliver real-time communications between doctors and first responders on scene in the field.

Telemedicine pioneer swyMed, based in Lexington, Mass., offers a high-performance telemedicine backpack called the DOT — Doctors on Tap — which enables reliable, real-time video communications powered by the Silver Peak Unity EdgeConnect™ SD-WAN edge platform that can improve the performance of existing wireless network communications and connect even at long distances from wireless towers.

The DOT is an impressive package of technology. The lightweight mobile unit incorporates antennas, redundant dual-modem wireless connections, an all day battery, an integrated speaker/microphone, two digital scopes, and a ruggedized sunlight-readable tablet with an integrated full HD camera. It also includes the solid state Silver Peak EdgeConnect Ultra Small (US) SD-WAN appliance, which integrates SD-WAN into the backpack, and serves as a network-on-demand providing the capability to securely and directly connect to more than one wireless network simultaneously.

The result is a high-powered, mobile communications network that can be carried by medical professionals into the field to provide advanced communications capabilities that reach beyond what standard wireless services offer. SwyMed CEO Stefano Migliorisi says the DOT can enable medical professionals to communicate in hard-to-reach areas using an SD-WAN that can overcome connectivity issues and improve performance by tying together disparate communications networks.

“We use very powerful antennas, our own patented technology, and the Silver Peak EdgeConnect appliance to connect to towers far away,” says Migliorisi. “It uses SD-WAN technology, forward-error connection (FEC), and path conditioning to maintain communications quality by bonding multiple SIMs to combine signals. With sub-second failover, communications are maintained continuously should one of the signals experience congestion or an outage. You can have a very good connection to a tower that’s very far away.”

Migliorisi says the DOT and Silver Peak technology have helped paramedics improve patient care in the field when they need to urgently communicate with their doctors. In one example, the patient wanted to speak to the doctor to get a recommendation on a preferred hospital. After speaking directly to the patient and paramedics, the doctor instructed the paramedics to transport the patient to a different hospital than originally intended, ultimately providing the patient with better care that may have saved his life.

“When the patient arrived at the hospital he went into cardiac arrest,” says Migliorisi. “The medical staff was able to resuscitate him and rapidly perform an emergency intervention. The doctor’s remote assessment directed the patient to a hospital with more extensive capabilities, so he was where he needed to be to receive the right level of care.”

The DOT is used internationally in places that have wide variations in communications infrastructure. For example, Migliorisi says it’s currently being used in a region in India to connect rural mothers with doctors over wireless networks where the wireless towers are very far apart.

SwyMed says the combination of its own patented software and the Silver Peak SD-WAN platform has been shown to boost the connectivity of poor wireless connections. By adding the capability to use multiple carriers simultaneously, the SD-WAN can make real-time adjustments in the data transport to deliver the highest quality of experience by aggregating multiple SIM cards.

For example, Migliorisi said some recent tests on Long Island showed that when the DOT was connected to one tower that was yielding 50 percent and another one yielding 70 percent, the two connections could be combined to create an aggregate signal strength of 90 percent.

Migliorisi says the Silver Peak technology is unique to the delivery of the DOT because of the seamless switching capability it provides between networks. He says that swyMed looked at other mobile SD-WAN solutions, but they dropped connections when switching from one mobile network to another. That is not a big deal for email or web browsing where a few seconds of delay in switching is not noticed. But in live video communication, even sub-second delays are picked up because our eyes and ears are so finely tuned to detect variations.

“It was very difficult to find anything that was seamless. Silver Peak has much more granularity. It’s a very sophisticated product.”

Migliorisi said the key features that differentiate the Silver Peak SD-WAN product include:

  • Built-in security between the DOT and a termination point at a private data center
  • The capability to apply different policies based on the region
  • Automatic handling of IP address changes due to service provider network address translation (NAT)
  • Subsecond switching between wireless networks without delay or lost connections

“It’s very easy to change the policies,” says Migliorisi. “There is granularity. You can centrally configure business intent overlays with Unity Orchestrator™. You can have one for Europe and one for Asia. It’s very flexible.”

The bottom line is that Migliorisi sees the Silver Peak SD-WAN platform as key to the DOT offering, which is now being offered in a few dozen places across the US, Europe and Asia. Deployments are expected to scale exponentially over the next several years.