Virtual Docs, BC Government and Inversion

Unfortunately my daughter has a fever. Here in BC, Canada, we can call 8-1-1 to speak with a pediatric nurse for free thanks to Healthlink BC (https://www.healthlinkbc.ca/). We called and the nurse felt we needed to speak with a doctor, so we made an appointment for just 40 minutes later! The nurse said the doctor would call us on the phone and give us instructions for a video “visit”.

Forty minutes later the phone rang. We answered and a voice said “Please hold while we connect you to a Zoom Phone call”! This means at least this part of the BC government is using Zoom Phone, not just Zoom!

We spoke with the doctor for a few minutes to give him some history and then he said we should start video. We expected the normal experience of everyone hanging up to join a meeting, but we were surprised by something new… Without hanging up, we switched to email and tapped a link (it was sent while the phone call was in progress) and the doctor told us the passcode to enter and the call converted to a Zoom Meeting!

Think about that for a moment. We got a call on our mobile number (so we were on our regular phone) that was transferred in to the Zoom app without any hiccup. We did have to tap the normal “join with internet audio” button upon entering the meeting but that was it. His audio was not interrupted since he was already in Zoom. Very impressive!

This is the power behind the “video first” approach. I believe this has the potential to create a future where a company like Zoom can be a major disruptor of communications technology and user experience. Let me make the case…

I think we may be witnessing a soft form of infrastructure inversion. For example, when the internet started it was forced to fit through the old phone infrastructure. Remember dial-up modems? everyone thought the idea of doing more than simple statically delivered text was already more than could be handled, EVER, and the internet would never work. Eventually however, we became able to send not only text but digital voice using a Voice-over-Internet-Protocol (VoIP) through the phone lines…what a waste that must have seemed when you could just talk the normal way (by the way, at this point video was thought to be impossible, EVER). Fast forward and now the infrastructure has completely inverted and all phone calls are digital and go over the internet. If you haven’t read anything about this phenomenon, it is one of the most interesting recurring concepts I’ve ever been exposed to (By this I believe: https://www.goodreads.com/book/show/31869077-the-internet-of…). For example, cars started out on roads made for horses and they looked very inefficient, today that infrastructure is designed for cars and horses are widely accepted as less efficient. Continue to fast-forward and companies like Netflix have proven that even full resolution films can be “broadcast” through the internet. This, plus device tech and other innovations, paved the way for a combined technology, video + voice, in real time, by anyone anywhere. Ok, so obviously I’m heavily paraphrasing history here, but you get the point (I hope).

That was a long paragraph and you might be wondering where I am going with this and what Zoom has to do with it all. Well until Zoom’s video-first approach, what we had was essentially chat or audio apps adding video as a feature. It was something dropped in on top of existing infrastructure and it wasn’t very efficient. The quality was bad. Calls froze so often that we would take pictures of people’s “bad-connection-faces” and email it to them to piss them off. It became common to switch video off so the call would at least have a chance of continuing. Enter Zoom. Zoom was built from the ground up to deliver great video. Once you have that nailed, think how trivial simple voice-only calls become. Zoom has essentially inverted the soft infrastructure. It can carry the old infrastructure on the new. That is inversion!

There is another extremely important part of infrastructure inversion: once the inversion occurs, new use-cases begin to emerge that were not possible before. This brings me back to the beginning of this post. Remember that seemingly normal phone call we were on that suddenly turned in to a Zoom Meeting? That took a lot of hard and soft technological innovation, working together, but the end result felt simple and fluid. The end result was only possible because Zoom is video first and can run a phone system on top of their video system, rather than the other way around, so the two can be seamlessly integrated in new ways. To think of it this way: We did not experience a trick of being transferred from a phone call to a video meeting. We were already in a Zoom meeting, we just didn’t know it yet on our end. Granted we were indeed transferred, but the other side was not, and even so, it was still handled with minimal interruption on our end.

I know I’ve taken some liberties here to paint a picture. I do however think this is an obvious but also easily overlooked aspect of the Zoom growth story. Feel free to debate with passion.

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I hope your daughter is ok.

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The company i work for a large non profit just yesterday moved the whole enterprise from webex to Zoom.
This is because due to COVID there are plans for a long term remote culture and a ‘Flex model’. So the company wants to use zoom to facilitate that.

Long ZM
Praveen

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That’s a cool experience. My company is going strong into telemedicine, which is a new frontier that will have tremendous value for other industries too. We are working through various kinks and customer feedback, which is rapidly evolving and changing the patient/doctor experience.

The ability to switch a phone call to a video call is not exclusive to Zoom, but it is cool. We are seeing rapid innovation in this space, including the ability to expand a video call into a three-way video call, or the ability to transfer a video call from one person to another.

Unfortunately, our company and several of our partners are switching away from Zoom because of their security issues. Zoom is now officially blocked on our network, and some of partners are doing it too. Many of our partners have switched to Microsoft and Google. But I still think Zoom has established a solid presence in the market.

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My daughter woke up feeling much better this morning. The peace-of-mind we got from the touch-point with the doctor was really great. Normally it is such a hassle to see our family doctor or wait an hour or more at a walk-in clinic (these are common in BC, Canada). Plus travelling when you aren’t feeling well is the worst, and exactly the opposite of resting! I doubt I’m alone when I say the majority of the time I choose to just suffer, in ignorance, rather than spend the effort to get to a doctor. I’m going to actively look for a family doctor that will do video calls. I bet there is pressure across the world for small medical practices to provide this service.

Now if we just had a few more things to give the doctor more data, like heart rate and blood pressure. I wonder how long it will take to reach a point where every household has a digital first naid kit for a remote doctor to help diagnose complaints. I wonder if Livongo or Masimo will fill the need.

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“switching away from Zoom because of their security issues” . Is the Zoom of today ,the paid versions, really a security risk? There is so much contradictory information, I wonder if some companies are listening to rumors rather than facts.

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Thanks for sharing. Is this a review for Zoom or Teladoc :wink:

Actually I thought Zoom was over priced and I was concerned about the competition from Google Microsoft etc. Then I HAD to use Google on a conference video: two participants could not join because they were forced to download google chrome etc. The whole call was a poop show…hard to tell it was even video with so many stoppages/freezes.

Went right out and bought ZM. Who are you going to believe…the pundits or your lyin’ eyes???

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Definitely not what I experienced with Google meet/hangouts. I use it daily, it’s required by our company. But I’ve used it on both Chrome and Firefox on my Mac, and it has been effortless and flawless. I have video conferences with my kids every week on it too, and it works just fine. I have used Zoom too, and didn’t find anything wrong with it. Lately I have a lot of customers on Microsoft, which works pretty flawlessly also. I would use any of these without hesitation.

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“Thanks for sharing. Is this a review for Zoom or Teladoc ;-)”

Zoom…what’s this Teladoc thing? Never used it :wink:

Thinking more about this thread, and the difference direct access to a doctor made to my family yesterday…I wonder if history “books” will show these months as the start of the next medical revolution. I don’t mean cool new tech. I mean the next phase where human life expectancy is once again extended, on a massive scale, because of more data from active monitoring, earlier detection of issues and more rapid and wider data availability.

I know the idea of using tech to help humans be healthy or diagnose issues has been in progress for quite awhile now, especially in the realm of science fiction, but now, in these couple of months, we are at the perfect moment in history; with compounding factors that haven’t met before:

  • COVID-19, the most significant global medical event in human history. This is important for so many reasons: Awareness that pandemics are real. Forced distancing has made medical monitoring critical for chronic patients but also a need to move more casual interactions to remote tools like Zoom.
  • Force-accelerated migration to the Cloud. Perhaps this is too narrow. This could be viewed as a new openness to technology where resistance was found before.
  • Small, extremely powerful computing devices capable of monitoring the human body and producing data.
  • Machine learning and access to the massive datasets that make it useful. Still early days here and why I love the Livongo story.

…really this is the perfect storm to blow humanity in this direction. If this happened 10 years ago it would have looked very very different!

We spend a lot of time talking about cloud acceleration in this forum but it isn’t just about companies that were previously dragging their feet being forced to make the move. It feels like there is a critical-mass being reached by some of these technologies that should launch us in to the next phase of adoption. Where the original tech becomes trivial (expected; taken for granted) and the next unforseen use-case can emerge.

This is probably the limit of acceptable musings for this board. I’ll use the excuse to cap this with some thread-relevent humor, for perspective, by Louis CK: https://www.youtube.com/watch?v=kBLkX2VaQs4

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