Not quite sure I understand - what do hospitals need a ton of bandwidth for? Why would those bandwidth requirements rise significantly during the pandemic. Sure there were a bunch of people on vents in the MICU, but pretty much every elective procedural service plummeted.

I'd imagine telehealth played a fairly large roll. White crispy video calls are not that demanding individually 10s to 100s of them at scale per location (and an exponential increase of calls in general) might be something more of a problem for that sort of infrastructure.

There are very few medical centers where there are 100s of simultaneous clinic visits. During the pandemic a lot of providers did home telehealth. Even 100s of simultaneous telemedicine visits don’t take much bandwidth compared to HD video streaming.

It might have been difficult relative to the infrastructure at some hospitals - but that is to my point that hospitals in general are not very demanding bandwidth wise and I would be a bit surprised they’re more than a rounding error on the Internet2 in general - especially compared to all the academic research involving large models and just video streaming in general that blew up during the pandemic.

Other than telehealth, we also use the bandwidth for remote desktops/apps and lossless high-resolution radiographic images. While one might expect this traffic to occur over local networks, many hospitals have multiple sites and partnerships that are connected over the internet. So, for example, one might operate the hospital's apps while sitting in the library at the affiliated university.

I’m aware. But these arent particularly bandwidth intensive (compared to 4K HDR video and the like). How many gigabytes of lossless DICOM is one usually pulling over the course of a day.

> So, for example, one might operate the hospital's apps while sitting in the library at the affiliated university.

Remote Desktop and even PACS are not huge bandwidth consumers in this day and age of 4K streaming. At my large academic institution usually only the radiologists use the PACS client directly on workstations - all the other clinicians are using a “zero footprint” viewer over Citrix like everything else.

That "zero footprint" viewer over Citrix is susprisingly resource-intensive, even at 1080p with lossy compression. If everyone used it (say, if every workstation were a Citrix client), it quickly adds up. During peak hours, it positively chugs. Not sure if networking or compute is the bottleneck here. Perhaps you're right: some institutions have not caught up to this day and age of 4K streaming, and their pre-Netflix infrastructure is buckling under the weight of all these Citrix streams.

At my current institution the bottleneck is compute - Epic slows to a crawl midday no matter off prem or on. And unfortunately the only constant is academic healthcare IT is a trash fire.

> If everyone used it

Like many large facilities I’ve been in the US, the EMR and PACS viewer (for non rads) are often over Citrix (ie every workstation is a Citrix client). But how many people are simultaneously viewing images - it’s only a minority of users (both in general - the ancillary staff is not) and at any given time (most clinicians are not viewing images at any moment)

This is a large university affiliated center - the bandwidth used by the medical center is a drop in the bucket compared to the size of the pipes they (the uni) have.

I've worked at two hospitals. Both of them "had" Internet2. I was excited, as I had not heard about it in ~20 years.

Neither of them actually ran any traffic over it.