1. NCREN Broadband for Healthcare David Kirby

2. For: MCNC Community Day –October 5 Moderator: Dave Kirby, NCTN Project Manager Dave@KirbyIMC.com 919.272.1157 1

3.  A dedicated broadband network with Internet and Internet2 connections to support health and care in NC.  First phases focus on public and non-profit health care providers.  Key design points: ◦Low cost (mostly via volume purchase and discounts) ◦Very high reliability (disaster-resistance) ◦High bandwidth with no over-subscription ◦Support key communications among health and care stakeholders. ◦High user community collaboration in building and operating

4.  Cabarrus Health Alliance  NC Association of Local Health Directors  NC Association of Free Clinics  NC Hospital Association  University Health Systems of Eastern NC  Albemarle Regional Health Services  Western Carolina University  Southwestern Commission  The e-NC Authority  NC Division of Public Health  NC Institute for Public Health (UNC)  Golden Leaf Foundation  FCC and USAC

5.  Conceived in late 2007  Phase 1 – ◦two rounds of recruiting of public health, free clinics, and (a few) community health centers ◦Operational – started late 2010  Phase 2 - ◦two rounds of recruiting of hospitals ◦Round 1 sites are being implemented now; round 2 sites are subscribing.  Funding : ◦85% Discounts for subscribers for broadband services from FCC’s RHCPP (4 years); USF source. $12.1M ◦NC Division of Public Health – admin startup for public health ◦Golden Leaf – admin startup for hospitals ◦Admin - Self-funded thereafter ◦Likely large discounts from FCC’s reformed Rural Healthcare Program indefinitely

6.  Dave Kirby, Kirby Information Management Consulting, LLC (Moderator) --  Layton Long, Health Director, Davidson County Health Department  Andy Anderson, UHSEast  Jeff Miller – CEO NCHIE  Mike Sullivan, Associate Director, Health Sciences, Internet2

7. NCREN Broadband for Healthcare Layton Long

8. NC Association of Local Health Directors  85 Local Health Departments  Broad array of Public Health services  Data reporting to Division of Public Health

9. Health Information System (HIS) Rollout  Replacement for the HSIS system  Pilots began February 2009  Statewide rollout - spring 2010  HIS significantly increased broadband needs  Many health departments did not meet minimum requirements to support HIS

10. Telehealth Network  Contacted by Dave Kirby January 2008  Discussions on the Telehealth Network were initiated with the Technology Committee  System implementation completed 2011

11. Challenges  Lack of understanding among health directors ◦Benefits? ◦Funding? ◦Broadband needs HIS would create  Communication between IT Directors and Health Directors  Local Governance – Commissioners

12. NCREN Broadband for Healthcare Andy Anderson

13. 13 Pitt County Memorial Hospital Heritage Hospital Duplin General Hospital Beaufort County Hospital Roanoke - Chowan Hospital Chowan Hospital Bertie Memorial Hospital The Outer Banks Hospital A University Health Systems of Eastern Carolina UHS Physicians Hospital Pungo District - Albemarle Hospital (managed)

14. 14 University Health Systems of Eastern Carolina FCC Rural Broadband PilotFCC Rural Broadband Pilot Access to business class broadband in rural areasAccess to business class broadband in rural areas Subsidized cost over several yearsSubsidized cost over several years NCTNNCTN Consolidated buying powerConsolidated buying power Private networkPrivate network Networked group of healthcare providersNetworked group of healthcare providers

15. 15 University Health Systems of Eastern Carolina Why is broadband important?Why is broadband important? Electronic Medical Record (EMR)Electronic Medical Record (EMR) ImagingImaging TelemedicineTelemedicine Broadband for healthcare must be:Broadband for healthcare must be: SecureSecure Highly reliableHighly reliable Provide for diversity and redundancyProvide for diversity and redundancy

16. NCREN Broadband for Healthcare Jeffrey D. Miller

17. NCREN Broadband for Healthcare Mike Sullivan

18. Supporting Broadband Health Networks NCREN Community Day, October 5, 2011 Michael Sullivan, M.D. Internet2

19. Internet2 Community Non-profit with a public purpose Member-owned, controlled, and directed 220 university & college members 33 regional network members 59 affiliate members (NIH, CDC, VA, DOE…) 47 corporate members 6 Rural Health Care Pilot Programs (RHCPP) 65,000 community anchor institutions

20. The National Broadband Plan (NBP) – facilities serving public purposes need broadband – a non-profit institution could focus on serving the broadband needs of public institutions. Community Anchor Institutions (CAIs) – public libraries – healthcare organizations – public safety organizations – primary and secondary schools – community and vocational colleges – museums, zoos, and aquariums Broadband for Public Facilities

21. Internet2 Network with 100 Gb Upgrade

22. Seven Strategic Focus Areas Advanced network and network services leadership Net+: services “above the network” U.S. UCAN National/Regional collaboration Global reach and leadership Research community development and engagement

23. U.S. UCAN An Internet2 project. Leverages the 100-gigabit Internet2 network backbone. Helps CAIs, BTOP networks, and regional networks connect. Extends and advances Internet2 Sponsored Educational Group Participant (SEGP) program. Enables CAI applications that require advanced networking.

24. Rural Health Care Needs Reliable Broadband Electronic Health Record (EHR) Virtualization SaaS-based EHRs mitigate limited IT resources in rural areas, but they require affordable, redundant networks. Multimedia Health Information Exchange (HIE) HIE with transport of large imaging and genomic datasets will require high-performance networks. Telehealth (HD Videoconferencing) Telehealth can bring high-quality specialty care to rural areas. Teleradiology Hubs (Imaging Clouds) Advanced networking can enable real-time radiological consults, e.g. triage of a stroke patient in the ED.

25. Future Challenges Share network infrastructure across CAI sectors. Connect BTOP, RHCPP, and statewide HIE networks to enable interoperable health information exchange. Connect national resources like SaaS vendors, telemedicine, and distance education.

26. General Information – Internet2: http://www.internet2.eduhttp://www.internet2.edu – U.S. UCAN: http://www.usucan.orghttp://www.usucan.org Internet2 Health Sciences – Home:http://www.internet2.edu/healthhttp://www.internet2.edu/health – Contact:Michael Sullivan, MD Associate Director msullivan@internet2.edu Thank You

27. NCREN Broadband for Healthcare Questions?