DirecPC provides Internet access via a geosynchronous satellite that serves the continental United States. As shown in the figure below, the client computer gains upstream access to the Internet via a dial-up modem (or direct access, if his or her institution has a connection). Any Internet Service Provider (ISP) can be used, or DirecPC can be the ISP; data rates for uploading can range up to 56kbps, depending on the quality of telephone lines available to the rural user. On the downstream side, the Internet is accessed via the DirecPC Network Operations Center (NOC) and the DirecPC satellite; for downloading, data rates up to 400kbs are achievable, permitting real-time streaming of video of sufficient quality to support advanced, Virtual Practicum-type programs.

How DirecPC works with the HIV Program

The above diagram shows the way data is transmitted between the client computer, the website, and the DirecPC Network Operations Center.

Suppose an individual user is using the HIV Virtual Practicum program. The virtual mentor, Dr. Bartlett, has introduced the simulated patient, Laurie Matthews, and the learner can now begin to take a patient history. Questions are asked of the simulated patient by pointing and clicking on one of a variety of choices on the learner's computer screen. Suppose the learner wishes to ask about past medical history. The choice is transmitted via modem and telephone line to the Internet via the ISP. The learner's DirecPC software has put a label on the request that causes the request to "tunnel" rapidly to an Internet server system at the DirecPC NOC. The NOC has very high bandwidth connections to the commodity Internet. The request is passed at high speed to the Internet server that has the video scene of Laurie Matthews giving her past medical history. This server could be located anywhere on the Internet with sufficiently high bandwidth to stream video; it might be a server at Dartmouth, one at HRSA, or one at CDC. The server then starts streaming the video -- the high bandwidth connection between the Internet and the DirecPC NOC carries the video to the DirecPC NOC, which then transmits the signal to the DirecPC satellite, thence to the receiving dish of the individual using the program.

How to obtain and Install DirecPC

To assist those interested in setting up DirecPC service, we have provided a Photo Log of our installation process.

Cost

According to DirecPC, and from our own experience, the DirecPC system itself costs $299, and an additional $50-150 to install. There are various price plans, the least expensive of which is $19.99 per month for 25 hours of access, including land-line connection if the ISP is DirecPC. The most expensive service is for businesses, $129.99 per month for 200 hours of access time. There is no cost in using the system for the educational content provider; they may gain access to the Internet by any means available to them.

ISP Availability

Nearly all rural health care professionals have access to an Internet Service Provider.

• Some form of local dial-in access is available in nearly every local calling area in the continental US A brief check of only two national ISPs (AOL and Mindspring) shows 55 different dial-in numbers serving at least 20 different geographic areas in New Hampshire alone. This doesn't take into account any local, smaller ISPs
  
  
• DirecPC has their own ISP service with about 43 dial-in locations listed in New Hampshire alone
  
  
• Most telecommunications carriers (such as Bell Atlantic) have decided that bundling all services over TCP is more cost effective in the long run, and plan to offer all consumer services over TCP/IP in the near to medium future. For example, Bell Atlantic is looking towards making DSL service standard for all consumers in about 2 years. Thus, anywhere there's a phone, there will be some form of TCP/IP connectivity that is much faster than that which is available now with DirecPC
  
  
• Hughes Satellite / DirecPC is partnering with AOL for delivery of AOL TV content and other integrated media services, with new satellite systems permitting bi-directional transmission via satellite

Additional information about DirecPC can be obtained on the Web at http://www.direcpc.com. There are numerous local vendors listed on the Website, and online purchases can be made via the Web from such vendors as PC Connection. America Online is also able to bundle DirecPC services for its customers. In our case, we purchased the system from a local satellite TV retailer in White River Junction, VT. We installed the system ourselves by purchasing an installation hardware kit (hardware and sealant, etc.) for $50. In all, the experience was precisely equivalent to installing a satellite television system, an experience with which many rural citizens are very familiar.