1. Internet2 Health Sciences Networking Michael McGill, Ph.D.

2. McGill2 Brief review of Health Activities at Internet2

3. McGill3 Health in the U.S. Approximately 5,000 Hospitals in the U.S. with about 20% of those in the $1B budget range. Approximately 120 Medical Schools in the U.S. with most but not all at major universities. In 2005 the NIH made grant to 2,500 institutions, universities, medical schools, research institutes and for-profit and not-for-profit organizations. This distributed as: $1M to 663 institutions $10M to 200 institutions $100M to 40 institutions Healthcare is estimated at $1.7 Trillion or 15.3% of the GDP or 4.3 times the amount spent on National Defense.

4. McGill4 Key Health Science Members 112 Academic Medical Colleges (AAMC) and their medical centers 130 Health Science related colleges Public Health, Nursing, Dentistry, Pharmacy Affiliate Members NIH, NSF, NASA, NOAA Howard Hughes Medical Institute Pharmaceutical Companies Johnson & Johnson, Pfizer, Eli Lilly Industry Prous Science, Cisco, IBM, Microsoft, SUN, Polycom, Haivision Partnership with Health Information Management Systems Society (HIMSS)

5. McGill5 Why Health Professionals Participate in Internet2 Distributed data sharing Electronic Health Record National Health Initiatives (ONCHIT) Remote Instrumentation Real time access to remote images Collaboration independent of boundaries Geography: Second Opinion Networks Time: Learning Technology (Distance Education) Computation: Knowledge Management New techniques and procedures Surgical Planning Remote and Assisted Surgery Telepathology Teleradiology Digital Anatomy Clinical:

6. McGill6 Biotech Data's BIG BANG It's like Moore's Law on steroids: The total volume of biological data worldwide, having doubled every 18 months in recent years, is now doubling every half a year to three months. And this isn't a momentary spike, but a long-term trend that may require new ways to measure, analyze and mine biological databases. Chappell Brown EE Times EE Times (04/25/2005)

7. McGill7 EACH BRAIN REPRESENTS A LOT OF DATA Comparisons must be made across several image sets Slide courtesy of Arthur Toga (UCLA)

8. McGill8 Some specialties disappearing

9. McGill9 Patient Notes on a PDA †Gregory B Quinn, Ph.D. and ‡C. Michael Wright, M.D., F.A.C.C. University of California, San Diego †San Diego Supercomputer Center and ‡Division of Cardiovascular Disease, College of Medicine

10. McGill10 Recent FCC Order (Key points) establish a pilot program to examine how the rural health care (RHC) funding mechanism can be used to enhance public and non-profit health care providers’ access to advanced telecommunications and information services

11. McGill11 Recent FCC Order (Key points) continued the pilot program will provide funding to support the cost of connecting the state or regional networks to Internet2, a dedicated nationwide backbone. By connecting to this dedicated national backbone, health care providers at the state and local levels will have the opportunity to benefit from advanced applications in continuing education and research.

12. McGill12 Recent FCC Order (Key points) continued This program will provide funding for up to 85 percent of an applicant’s costs of deploying a dedicated broadband network, including any necessary network design studies, as well as the costs of advanced telecommunications and information services that will ride over this network.

13. McGill13 Proposal Contents Identify the organization that will be legally and financially responsible for the conduct of activities supported by the fund; Identify the goals and objectives of the proposed network; Estimate the network’s total costs for each year; Describe how for-profit network participants will pay their fair share of the network costs; Identify the source of financial support and anticipated revenues that will pay for costs not covered by the fund; List the health care facilities that will be included in the network; Provide the address, zip code, Rural Urban Commuting Area (RUCA) code and phone number for each health care facility participating in the network; Indicate previous experience in developing and managing telemedicine programs; Provide a project management plan outlining the project’s leadership and management structure, as well as its work plan, schedule, and budget. Indicate how the telemedicine program will be coordinated throughout the state or region; and Indicate to what extent the network can be self-sustaining once established.

14. McGill14 Network Approach (Draft for Consideration) Encourage healthcare provider networks to collaborate with Internet2 connectors to gain access to the Internet2 backbone. Healthnets negotiate their physical connectivity with the Internet2 connector Based on the input from telemedicine practioners, it is suggested that individual institutions be connected at 100Mbps or higher. Healthnets are likely to require commodity Internet connectivity and given the complexity of insuring optimal routing, connectors are the logical provider Engineering an appropriate connection from the Internet2 backbone to the healthnet is the responsibility of the connector. Internet2, probably through FiberCo/WaveCo, may be able to offer professional engineering services

15. McGill15 Internet2 Approach Step towards building a community Step toward use of clinical applications that take advantage of advanced networks More than just a need for connectivity Vision is to advance health Research Education Clinical care Help to bring together activities E.g. VA, IHS, ONCHIT, HHS, NIH, etc.

16. McGill16 Membership approach (Draft for Consideration) 2-year pilot program designed to bring regional health networks into the Internet2 community in accord with the FCC program Planning group of connectors Define and expand vision Connectivity approaches Cost Group of 4-5 Parallel discussions with involved members

17. McGill17