Software Considerations

Complementing the hardware is the computer software, or the programs that are put on and used by the computer systems. Many aspects of software should be considered. First and foremost is the computer’s operating system (OS), which can include Microsoft Windows, iOS, and Linux, among others. Further, each OS has different versions (e.g., Microsoft Windows Vista, Windows 7, Windows 10), with each coming with new updates. The OS is not only important due to some videoconferencing platforms requiring specific versions to run at all, but also to ensure the compatibility with certain internet browsers, such as the popular Chrome, Safari, and Internet Explorer, which are often required to run browser- based videoconferencing platforms (i.e., running the videoconferencing from the internet browser without having to download additional programs to the computer). While many platforms have both downloadable and browser-based versions, some patients may not want to download additional software to their computer if not needed. This is especially true if their computer is already running slower than desired. As such, evaluating both the provider’s and patient’s OS and browsers can help prevent later issues with the software of choice, or if the videoconferencing platform must be unexpectedly changed due to technical issues with the primary selected program.

While a computer’s OS is important for running software, it is also important for security reasons. Updated versions of the OS often improve the computer system’s firewall. This firewall is a form of network security controlling data coming in and out of one’s computer system, as based upon set rules. Essentially, it is governing the communication between the user’s trusted system and the outside untrusted networks in efforts to protect against attacks to the user’s computer network (Cisco, n.d.; Encyclopaedia Britannica, 2020). Although firewalls help improve security, they are only one part of needed protection for a videoconferencing provider. The provider should also evaluate their security software, and that of the patient. Not having adequate security places a computer system at risk of threats caused by malicious software, commonly referred to simply as malware. Malware is broadly defined as computer software designed to damage a computer system, or make it susceptible to others, thus placing the patient’s e-PHI or other information on the infected computer at risk (ESET, n.d.; Norton, n.d.). Examples of malware can include computer viruses, adware, spyware, rootkits, or ransomware. To protect against malware, specialized security software should be installed on all computers used for the videoconferencing processes. While a provider cannot always control the patient’s system, they can provide guidance on what types of antimalware software should be installed, as well as suggestions for what features a patient should look for. For example, one would desire real-time screening of data to protect from attacks that could come from visiting the wrong website, or clicking on an email link that the provider or patient thought was from a respectable source, but really attempted to install a malware program on the computer. In addition to real-time monitoring, the ability to schedule deep scans of the full computer system can be helpful. These scans can review the entire system, including both common and less accessed files, to ensure that the system is free from malware that could create problems or security threats. Further, they can be scheduled at times when they would not significantly interfere with one’s work (i.e., some scans utilize significant RAM, thus increasing the potential for the computer to slow). While important features, none would be very useful if they did not have the most up-to-date malware definitions allowing for detection of the ever-increasing number of malicious programs. As such, having an antimalware program that has ongoing and frequent database updates is essential. Unfortunately, more features and better databases often require antimalware programs that are subscription-based, potentially precluding use for some patients who have financial restrictions. Nevertheless, if one is unable to purchase a higher-level package, there are many antimalware programs that are free, have tiers of subscription costs, and/or have frequent sales, making them more affordable options. While providers are encouraged to review the benefits and limitations of each possibility, common options include McAfee, Kaspersky, Bitdefender, Norton, Webroot SecureAnywhere, Avast, Malwarebytes, ESET, Microsoft Defender, and ZoneAlarm,