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Improving Broadband Infrastructure
  For West Virginia’s Health Care

         Larry Malone and Jack Shaffer
               November 27, 2012
RHCPP Objectives
– Interconnect state and region-wide broadband health care
  networks
– Aid greater use of telehealth applications and learning
– Facilitate electronic health information exchange and EHRs
– Provide Internet2 connectivity


= Improved rural health care and outcomes
Eligible Entities
- Rural health care centers
- Critical access hospitals (non-profit)
- Mental health clinics (non-profit)
- Medical teaching institutions (Marshall, CAMC,
  WVU and the West Virginia School of Osteopathic
  Medicine)
- County health departments
- School-based clinics
- Free clinics
- ERs in for-profit hospitals that provide Medicare
WV Telehealth Network
Accomplishments
•   Organized a statewide coalition focused on telehealth and health IT
•   Formed a non-profit organization and dedicated board of directors
•   Secured multi-million-dollar FCC grant to improve telehealth and
    broadband infrastructure
•   Secured $600,000 Benedum grants
•   Secured $800,000 in additional funding from state (HCA and DHHR)
•   Developed a first-rate technical implementation plan – nearly $10
    million project
•   Aggregated need/demand from health care locations across the state
     – Group purchasing power
     – Enhanced service agreements and quality
     – Improvements in rural connectivity
•   Completed projects –
     –   Metro Fiber Build
     –   Advanced broadband connections to 90+ locations
•   Telehealth outreach project
•   Participating in state’s HIT coordination council/strategic HIT plan
RHCPP Project #1
Metro Fiber Project
•   Marshall University (for its health education programs, courses)
•   Marshall University Joan C. Edwards School of Medicine
•   St. Mary’s Medical Center
•   Cabell-Huntington Hospital

Benefits:
• Provide advanced broadband interconnection among these
  institutions for the exchange of health information and health
  education purposes
• Will allow rural health centers added remote access
  capabilities (via telehealth) to the physicians and specialists at
  these interconnected organizations
• Will provide a fiber connection point to bring Internet2 service
  into the state, particularly into southern and central West
  Virginia
Huntington Metro
                       Fiber Build Project
                       Fiber Routes




– New Fiber   – Existing MU             –
                  Fiber          OARnet/Internet2
Huntington Metro
                                            Fiber Build Project
                                            Fiber Routes

1 Gig Connection to Internet2




    Rural
    Health
    Clinics                                           10 Gig Fiber Connections




              – New Fiber       – Existing MU Fiber   – OARnet/Internet2
Image Transfer Speed
Comparison                 : 10
                             00
                             01
                             02
                             03
                             04
                             05
                             06
                             07
                             08
                             09
  •••••••••••••••••       •••••••••••••••••




     – Huntington Metro          – Regular
           Fiber                Connection
RHCPP Project #2
Telco Services/WAN Procurement

90+ locations opted to participate and sign contracts

Purchasing Groups:
   Partners In Health/CAMC
   Community Health Network of WV
   Valley Health
   WV United Health System/ University Health Associates
   Wheeling Hospital
   Minnie Hamilton

Winning Vendors:
    – Comcast
    – Frontier
    – Lumos/nTelos
    – Verizon
W.Va. RHCPP Participants
    Provided are the entities that signed RHCPP contracts:

Beckley Health Right                   Primary Care Systems, Inc.
Belington Community Medical Services   Roane General Hospital
Cabell Huntington Hospital             Stonewall Jackson Memorial Hospital
CAMC                                   Tri-County Health Clinic, Inc.
Community Health Network of WV         Tug River Health Association
Family Care                            University Health Associates
Highland Hospital Assoc.               Valley Health System
Lincoln Primary Care Center            Webster County Memorial Hospital
Minnie Hamilton Health System          West Virginia Health Right, Inc.
Monroe Health Center                   West Virginia United Health System
Pendleton Community Care               Wheeling Hospital, Inc.
Preston Health Care Corporation
RHCPP Benefits
WVTA has met and exceeded its goal of providing at least T-1 service to
all healthcare sites, with 40 % of participating locations signing up for T-1s.
Moreover, 54 % of participating locations are purchasing service that is at
least six times better than T-1 service. Some locations (15 %) are even
purchasing 100 Mbps or 1,000 Mbps service.

          WAN Bandwidth                           # Sites

          Internet Only                           3

          1.5 Mbps WAN                            40

          3 Mbps WAN                              3

          10 Mbps WAN                             37

          100 Mbps WAN                            13

          1,000 Mbps WAN                          3
RHCPP Benefits
Improved broadband connectivity will provide a number of benefits:
• Enable greater use of telehealth services and connections that will
  enable improved diagnostic capabilities and specialty treatment
  options:
       • Peri-natal project
       • Tele-stroke
       • Tele-psychiatry/therapy
• Transmission of medical data for diagnosis, treatment or follow-ups;
• Enable better group purchasing power and enhanced reliability and
  quality of service
• Foster tele-training and educational opportunities; and
• Dedicated virtual private networks to ensure security, reliability and
  connectivity
Major RHCPP Beneficiaries
•   CAMC
•   WVU Hospital System
•   Wheeling Hospital
•   Metro Fiber
    – St. Marys
    – Cabell-Huntington
    – Marshall School of Medicine
• Community Health Network
Telehealth In Action
• St. Mary's Medical Center Remote Presence Telestroke Care
http://www.youtube.com/watch?v=E7c7LIxnX-A

• West Virginia Perinatal Project
    – Perinatal consults
    – Consults in pediatric cardiology, neurology, and neuro surgery

• WVU Telepsychiatry Program
http://www.mnn.com/money/green-workplace/blogs/wvu-expands-
telepsychiatry-program

• Valley Health
    – Remote site behavioral health telemedicine
RHCPP Project #3
Intercarrier Metro/MPLS Hub Project

  Hub will serve as the backbone for the entire
  WVTA’s network of networks:
  1) allow health care providers to connect to the West
     Virginia Telehealth Alliance network regardless of
     broadband vendor
  2) allow for other hospitals and health care education
     facilities to connect seamlessly to the larger telehealth
     network
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WVTA Presentation to key stakeholders - 11/2012

  • 1. Improving Broadband Infrastructure For West Virginia’s Health Care Larry Malone and Jack Shaffer November 27, 2012
  • 2. RHCPP Objectives – Interconnect state and region-wide broadband health care networks – Aid greater use of telehealth applications and learning – Facilitate electronic health information exchange and EHRs – Provide Internet2 connectivity = Improved rural health care and outcomes
  • 3. Eligible Entities - Rural health care centers - Critical access hospitals (non-profit) - Mental health clinics (non-profit) - Medical teaching institutions (Marshall, CAMC, WVU and the West Virginia School of Osteopathic Medicine) - County health departments - School-based clinics - Free clinics - ERs in for-profit hospitals that provide Medicare
  • 5. Accomplishments • Organized a statewide coalition focused on telehealth and health IT • Formed a non-profit organization and dedicated board of directors • Secured multi-million-dollar FCC grant to improve telehealth and broadband infrastructure • Secured $600,000 Benedum grants • Secured $800,000 in additional funding from state (HCA and DHHR) • Developed a first-rate technical implementation plan – nearly $10 million project • Aggregated need/demand from health care locations across the state – Group purchasing power – Enhanced service agreements and quality – Improvements in rural connectivity • Completed projects – – Metro Fiber Build – Advanced broadband connections to 90+ locations • Telehealth outreach project • Participating in state’s HIT coordination council/strategic HIT plan
  • 6. RHCPP Project #1 Metro Fiber Project • Marshall University (for its health education programs, courses) • Marshall University Joan C. Edwards School of Medicine • St. Mary’s Medical Center • Cabell-Huntington Hospital Benefits: • Provide advanced broadband interconnection among these institutions for the exchange of health information and health education purposes • Will allow rural health centers added remote access capabilities (via telehealth) to the physicians and specialists at these interconnected organizations • Will provide a fiber connection point to bring Internet2 service into the state, particularly into southern and central West Virginia
  • 7. Huntington Metro Fiber Build Project Fiber Routes – New Fiber – Existing MU – Fiber OARnet/Internet2
  • 8. Huntington Metro Fiber Build Project Fiber Routes 1 Gig Connection to Internet2 Rural Health Clinics 10 Gig Fiber Connections – New Fiber – Existing MU Fiber – OARnet/Internet2
  • 9. Image Transfer Speed Comparison : 10 00 01 02 03 04 05 06 07 08 09 ••••••••••••••••• ••••••••••••••••• – Huntington Metro – Regular Fiber Connection
  • 10. RHCPP Project #2 Telco Services/WAN Procurement 90+ locations opted to participate and sign contracts Purchasing Groups: Partners In Health/CAMC Community Health Network of WV Valley Health WV United Health System/ University Health Associates Wheeling Hospital Minnie Hamilton Winning Vendors: – Comcast – Frontier – Lumos/nTelos – Verizon
  • 11. W.Va. RHCPP Participants Provided are the entities that signed RHCPP contracts: Beckley Health Right Primary Care Systems, Inc. Belington Community Medical Services Roane General Hospital Cabell Huntington Hospital Stonewall Jackson Memorial Hospital CAMC Tri-County Health Clinic, Inc. Community Health Network of WV Tug River Health Association Family Care University Health Associates Highland Hospital Assoc. Valley Health System Lincoln Primary Care Center Webster County Memorial Hospital Minnie Hamilton Health System West Virginia Health Right, Inc. Monroe Health Center West Virginia United Health System Pendleton Community Care Wheeling Hospital, Inc. Preston Health Care Corporation
  • 12. RHCPP Benefits WVTA has met and exceeded its goal of providing at least T-1 service to all healthcare sites, with 40 % of participating locations signing up for T-1s. Moreover, 54 % of participating locations are purchasing service that is at least six times better than T-1 service. Some locations (15 %) are even purchasing 100 Mbps or 1,000 Mbps service. WAN Bandwidth # Sites Internet Only 3 1.5 Mbps WAN 40 3 Mbps WAN 3 10 Mbps WAN 37 100 Mbps WAN 13 1,000 Mbps WAN 3
  • 13. RHCPP Benefits Improved broadband connectivity will provide a number of benefits: • Enable greater use of telehealth services and connections that will enable improved diagnostic capabilities and specialty treatment options: • Peri-natal project • Tele-stroke • Tele-psychiatry/therapy • Transmission of medical data for diagnosis, treatment or follow-ups; • Enable better group purchasing power and enhanced reliability and quality of service • Foster tele-training and educational opportunities; and • Dedicated virtual private networks to ensure security, reliability and connectivity
  • 14. Major RHCPP Beneficiaries • CAMC • WVU Hospital System • Wheeling Hospital • Metro Fiber – St. Marys – Cabell-Huntington – Marshall School of Medicine • Community Health Network
  • 15. Telehealth In Action • St. Mary's Medical Center Remote Presence Telestroke Care http://www.youtube.com/watch?v=E7c7LIxnX-A • West Virginia Perinatal Project – Perinatal consults – Consults in pediatric cardiology, neurology, and neuro surgery • WVU Telepsychiatry Program http://www.mnn.com/money/green-workplace/blogs/wvu-expands- telepsychiatry-program • Valley Health – Remote site behavioral health telemedicine
  • 16. RHCPP Project #3 Intercarrier Metro/MPLS Hub Project Hub will serve as the backbone for the entire WVTA’s network of networks: 1) allow health care providers to connect to the West Virginia Telehealth Alliance network regardless of broadband vendor 2) allow for other hospitals and health care education facilities to connect seamlessly to the larger telehealth network