The options available to cable TV systems operators to upgrade their cable distribution systems to IPTV include providing IPTV services over cable modems (DOCSIS), sending IPTV over a reduced version of cable modem systems (DOCSIS Lite) or to provide IPTV services that bypass traditional cable transport systems.

If you consider Internet TV to be an IPTV services (such as NetFlix), there are many users that are already receiving IPTV services over cable modems. While DOCSIS is well designed for Internet data services, it adds a layer of complexity (and cost) when providing switched IP video services. To overcome this challenge, some cable systems implement IPTV services over a more basic cable data service (DOCSIS Lite) or they bypass the DOCSIS system entirely for IPTV services.

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References:

http://www.fierceiptv.com/story/bigband-pitches-iptv-alternative-docsis/2009-03-05

http://www.fierceiptv.com/story/harmonic-performs-iptv-bypass-cable/2009-11-21