Abstract
Abstract
Background:
Conferences and meetings bring together thousands of doctors from diverse locations. However, the traveling, accommodation, and arrangement of venues for conferences and meetings are expensive and a lot of time needs to be devoted to these logistics. The purpose of this article was to present our own virtual live conference experience using web conferencing and to briefly outline the basics and advantages of this technology in organization of healthcare conferences.
Methods:
Web conferencing technology was used to organize an international bariatric surgery conference, allowing a large number of attendees to participate and interact from wherever they were, using merely an Internet connection with a video player on their personal computers, laptops, or smartphones.
Results:
A virtual live conference saves a lot of time and cost and simplifies the logistics needed to organize a learning conference with worldwide participation.
Conclusion:
As far as we know, this is the first report of a virtual live conference in healthcare. We see it as the future of organizing experts as well as medical teaching conferences.
Introduction
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Every year, thousands of doctors travel to conferences and meetings at distant locations both nationally and internationally. 2 The purpose of conference attendance is to keep up to date with research advances in our specialties, thereby improving our day-to-day practice of patient care.3,4 Other methods also exist to disseminate research findings such as reading published research journals. 5 However, dissemination obstacles include nonpublication, vast amount of information, and limited open access journals available. 6 These drawbacks can be addressed by conference attendance. The personal impact of a face-to-face two-way communication of research presentations makes it a better way of conveying knowledge. 7 Moreover, meetings may be the only place to work out sensitive or controversial topics wherein people are more likely to discuss issues they will normally not put into publication. However, organizing and attending conferences and meetings take a lot of time—time to arrange, time to travel, and time to participate undivided on a day-to-day basis. Besides, the accommodation of participants and arrangement of venues are expensive. In addition, researchers and scientific organizations are becoming aware of the greenhouse gas emissions associated with attending scientific conferences. 8 Virtual meeting technologies of video conferencing and now web conferencing can save time and resources in all of these areas and allow meetings at the convenience of the participants comfortably wherever they may be stationed.
Briefly, video conferencing uses audio and video through the Internet to connect two people or several people at one or more locations at the same time to bring people together for a meeting (i.e., point-to-point or multipoint, the latter being uncommonly >6 locations). 9 On the other hand, web conferencing delivers live images and sound with two-way interaction on the Internet allowing a login to bring together a large number of people at a time, culminating into a virtual live conference. Although web conferencing solutions have existed since the 1990s, now with advances in Internet technology, they have become more efficient, easy to use, and nonexpensive. Several providers offer products and services. This technology has a lot of scope for healthcare conferencing because it eliminates absence from work.
The purpose of this article was to present our own virtual live conference experience with web conferencing as a tool and to briefly outline the basics and advantages of this technology in organization of healthcare conferences. As far as we know, this is the first report of web conferencing with a large virtual gathering in healthcare. In our opinion, web conferencing has great potential to replace clinical meetings, retaining the advantages of in-person meetings, doing away with expense, pollution, and hassles of logistics with added advantages of convenience and comfort.
Methods
As this was a descriptive study on web streaming technology and web conferencing, no institution review board approval was needed. This article does not contain any studies on human participants and no consent was required.
Web streaming (also known as webcasting) is the technology to deliver live images and sound on the Web (Internet or Intranet). This technology allows participants to follow a meeting, conference, workshop, etc., from the comfort of their own offices or homes using their personal computer or smartphone with an Internet browser and a video player (Flash/Quick Time) to view the streamed images.
The parties involved in a healthcare conference are the organizers, the expert faculty, and the delegates. Web conferencing allows the organizers control over the content and execution of the entire meeting. The organizer of a virtual live web conference can manage the expert faculty and the delegates in several different ways. Presentations for the meeting can be made at the organizers venue by in-house expert faculty. Live surgeries can be demonstrated from the organizer's venue. When the scheduled expert faculty is at another location, temporary control of the meeting can be given to them so that they can make their presentations from their personal computers or laptops wherever they are stationed. Delegates are provided with a web link after registration to participate in the meeting. They can use a raise-hand feature at any time or during an allotted question and answer session to notify the chairperson or presenter if they have comments or questions. To convey comments or questions, the delegates can communicate through audio lines, which can be selectively muted and unmuted by the moderators. They can also communicate by text through a chat utility. Polling features allow the organizer or the chairperson to collect information from all the delegates during the conference. Last, web conferences can be recorded. This allows participants and faculty, as well as those who were unable to participate in the original web conference, to replay the meeting at their convenience or to refer back to the recordings later if necessary. For the organizers, meeting notifications and registration can be managed online. Many tasks can be automated, for example, sending out meeting reminders. Pricing plans can be pay-per-use plans or flat-rate plans, that is, a monthly or yearly subscription with a onetime hardware cost.
Results
We organized our first surgical conference meeting called Laparosurg in the year 1997 at Coimbatore, which included lectures and live surgery demonstrations, and ever since have organized numerous national and international conferences and meetings over the years. From the year 2002 onward, we started using video conferencing to relay lectures and live surgery demonstrations from our center to hospitals and teaching institutes around the world. We slowly progressed from point-to-point to multipoint video conferencing (up to six locations). From the year 2012, we started using web conferencing technology to web stream lectures and live surgery demonstrations wherein we could connect to any number of locations at a time. All this experience culminated into the concept of a virtual live conference.
SurgiLink is the webcast portal used by GEM hospital where live demonstrations, lectures, and discussions are made available to the user through web streaming. The cost of setting up web streaming was a onetime hardware cost of Rs. 80,000 (∼1200 USD) and an annual cost for cloud server and CDN (content delivery network) of Rs. 200,000 (∼3000 USD). We first conducted a virtual live conference called Laparofit 2014 where the virtual conference was conducted on this webcast portal. Experts from 14 countries and 1026 delegates from all over the world were a part of SurgiLink-mediated Laparofit 2014. These included practicing surgeons, diabetologists, endocrinologists, postgraduates in medicine and surgery, and paramedicals from the private sector, corporate sector, and medical colleges/teaching institutes.
Once the conference/live surgery workshop event was planned, an announcement was put in the portal in the area, “Upcoming events”. Mailer/Email invitations were sent to medical institutions and practicing surgeons. All faculties who were scheduled to make presentations had software installed on their personal computers, laptops, or computers to enable them to connect to the cloud server. They were educated on how to use this software and its features to make their presentations before the event. Briefly, this involved education of how to broadcast the PowerPoint slides and changeover from a slide view to camera view. They were also advised to view simultaneously the muted/unmuted webcast on another laptop or personal computer to have an idea regarding their transmitted presentation. This also allowed them to see questions typed into the chat utility, which they could answer at the time of the presentation or later during the question and answer session. On the day of the event, the expert surgeon connected his video/audio and presentation to the cloud server at the allotted time to deliver the lecture/transmit the live surgery.
On the day of the event, the delegates logged in at www.surgilink.in through a web link that was provided at registration and started viewing the presentations/live surgeries using Internet browsers on any device. For a mobile user, a 3G bandwidth and, for laptop/personal computers, high-speed Internet of minimum 1 Mbps were recommended. Because cloud-based media servers create several lower bitrate streams in real time during a broadcast, each receiving site can move up or down to a stream that their connection can maintain; however, video quality was based on consistent download speeds. Chatting allowed the user to ask questions either during the event or during the question and answer sessions, which were answered by the expert verbally during the presentation/video or typed into the chat utility. Chat utility allowed that other delegates or experts could also answer/discuss raised questions. Presentations were viewed with time-shift also, that is, the late to login users could view the live conference from the start of the event. It was not necessary to view the webcast at one time. If temporarily away from the computer, the webcast could be paused and viewed when ready from the point it was paused. The virtual conference was also recorded in the same utility for postconference viewing.
Delegates and national experts from all parts of India were a part of Laprofit 2014, which was conducted from Coimbatore in South India. The cost benefit for the delegates and national experts was the total cost of a round-trip airfare, car rental (hotel to airport and back), hotel accommodation, and meals for 2 days and nights, which was approximately Rs. 55,000 to Rs. 70,000 INR (∼800–1000 USD).
Organizers usually sponsor three to four international expert faculties as part of a conference because of cost limitations, which need to be balanced with a reasonable conference registration fee. The total cost of a round-trip airfare, car rental (hotel to airport and back), hotel accommodation, and meals for 2 days and nights for each faculty requires approximately Rs. 3,00,000 to Rs. 5,00,000 INR (∼4500–7500 USD). However, Laprofit 2014 included experts from 14 different countries because of its cost benefits. The cost benefit to the organizers also included the cost of conference hall rental charges, power consumption of air conditioning/lighting, and an LED wall, approximately Rs. 1,00,000 to Rs. 3,00,000 INR (∼1500–4500 USD).
An additional cost benefit for the delegates, expert faculties, and organizers included the amount equivalent to the salary or income for two to three working days needed to travel to and participate in the conference.
Discussion
The fundamental use of web conferencing in healthcare is to simplify the logistics needed to organize a learning conference with worldwide participation. The organizers are concerned with the complex logistics, the faculty with their schedules, and the delegates with the burden of traveling and spending for attending the conference. Advantages of web conferencing in healthcare are detailed below.
Saves time
Conferences and meetings take a lot of time. For organizers, this includes time to make prior arrangements and time to organize the event. It also includes time for repeated meeting reminders and invitations. For expert faculties and delegates, this involves time to travel to and fro from the conference and time to participate and sit through the conference. Web conferencing can save time by eliminating travel and eliminating being stationed at the venue after meeting hours for all of the participants, that is, the organizers, the expert faculty, and the delegates. For organizers, it saves time for arrangements at the conference venue that can be made from wherever they are in web conferencing. Saved time could be spent doing work or for leisure activities or with family.
Saves money
Web conferencing eliminates travel and accommodation and this is one of the first costs cut for all of the participants, that is, the organizers, the expert faculty, and the delegates. Additionally, the organizers are relieved from the costs involved in setting up the conference venue. Saved time also translates to saved money for employed people. There does exist a onetime hardware cost of setting up web streaming for web conferencing with yearly subscription costs, which is far less than the cost of renting a conference hall alone. This is, however, set off by savings made on time, travel, and accommodation. In simple terms, web conferencing brings together experts and learners from all over the globe at the mere cost of an Internet connection at both ends.
Comfort and convenience
Expert faculty complain about too many invitations for conventional meetings.2,10 People can be involved in web conferencing from wherever they are stationed at that point of time. This makes this the concept very convenient for all, that is, the organizers, expert faculty, and delegates. Participation in web conferencing can be from the comfort of their living rooms, offices, hospitals, hotel rooms, airport lounges, and even holiday spots. In our Laparofit 2014 experience, we found that participant delegates as well as experts were found to be in all these places and more. We even had faculty following the conference and interacting while traveling to the organizer's venue.
Importantly, participants can still attend meetings they would otherwise miss because of time constraints or work/family priorities. This would also bring more experts to the conference as they could deliberate from the comfort of their home or medical center. In case of live demonstrations of surgeries, surgeons can avoid the fatigue of travel before surgery. When they operate from their hospitals, they can easily conduct a full assessment of the patient's case as per their choice and with familiarity of the surgical setup and instruments provided.
Environmental benefits
Global warming is a major threat to public health. Doctors are now measuring the carbon footprint of their conference activities. Julian Crane estimated that 17,000 delegates generated about 4000 tons of carbon dioxide from air travel. 11 Mathew Callister and Mark Griffiths estimated that 15,000 delegates generated about 10,000 tons of carbon dioxide from air travel alone, requesting compensation in registration fees to bear the environmental cost of the journey. 12 web conferencing creates a huge environmental benefit by totally eliminating travel, thereby reducing carbon dioxide emission. As suggested, doctors must lead by example and participate in minimizing the carbon footprint. 13
Expanded reach
Importantly, web conferencing can attract an audience that cannot be reached due to travel restrictions (remote areas), thus web conferencing can benefit people as well as teaching institutes even in remote areas, that is, reaching the unreached medicos. Besides, the number of participants could be huge and is limited only by the numbers allowed by the organizers.
While web conferencing is characterized by many advantages, it does have its shortcomings in comparison with traditional meetings.
Impersonal
The personal impact of a face-to-face two-way communication is lost when a meeting is held virtually. Facial expressions and body language are communication cues, which are compromised. In traditional meetings, social factors require everyone to remain engaged within the meeting and to give their attention to the speakers. It is not as good for complex interpersonal communication among the members of the conference. Informal, one-to-one social interaction is limited.
Extra participant training
Web conferencing often appeals to technology savvy computer literate individuals. Many people, however, are uncomfortable with new technologies. It is difficult for those who are uncomfortable with web conferencing technology to use it efficiently. Web conferencing thus requires extra time for participant preparation to educate and familiarize them with the software and meeting skills. With good training and support, this transitioning can be well managed.
Technical expertise
Organizers need access to and expertise to use web conferencing technology. Poor web conferencing technology or inadequate training undermines success. Participants need access to suitable hardware and software, but this is as basic as a computer/laptop/smartphone with a good Internet connection. Technical issues such as power failure, Internet connectivity, disconnection, and audio/video clarity are potential problems for participants. A technical support line needs to provide for guidance during the event.
Conclusion
With web conferencing, a large number of participants can meet anytime and anywhere using merely an Internet connection on their personal computers or smartphones with a video player. Participation can be from the comfort of homes, offices, or any other location. Meetings can be attended, which otherwise would be missed because of time constraints and other priorities. Immense savings are possible by eliminating travel, accommodation, and organization at a conference venue. Web conferencing is a technology tool that provides a great opportunity to improve healthcare conferencing practices. Besides, the technology is accessible, low cost, and could be set up in a short time.
“… Is it realistic to expect people to attend virtual conferences? This would require a new mindset …. Huge international conferences will be as outdated and unsuitable for a modern world as the dodo, the fax machine, carbon paper, and the horse drawn carriage…,” commented Malcolm Green in the British Medical Journal in 2008. We see it as the future of organizing experts as well as medical teaching conferences.
Footnotes
Disclosure Statement
No competing financial interests exist.