Sunday, July 11, 2010

Telehealth Network Advancing

The FCC is going to fund up to 85 percent of the costs for 7 Oregon healthcare organizations at 12 sites to help build out or grow their respective broadband infrastructure to support telemedicine and telehealth applications. The seven healthcare organizations to receive funding include:

• St. Charles Health System, Bend, Redmond, and Prineville
• Siletz Tribal Health Clinics, Siletz
• Bay Area Hospital’s Women’s Imaging Center, Coos Bay
• Umpqua Community Health Centers, Drain, Glide, Myrtle Creek, Roseburg High School, and Roseburg Health Center
• Clackamas Community College’s Harmony Campus, Clackamas
• Outside in Medical Clinic, Portland

The Oregon Health Network (OHN) will fund the remaining 15 percent of the costs for the broadband construction and installation as part of the FCC Rural Health Care Pilot Program’s $20.2 million awarded to Oregon to build and improve their broadband telehealth network. Through the RHCPP, OHN plans to bring as many as 200 eligible hospitals, clinics, community colleges, and government facilities into a high speed broadband network.

As a geographically large state with a small population, coupled with the fact that the majority of the state’s population reside within a defined geographic region, the state has encountered difficulties providing high quality and cost effective broadband service both to healthcare providers and communities in general. The state’s size and disperse population in particularly remote regions has made construction of high speed internet and intranet connectivity not economically feasible in many cases.

A number of telehealth and telemedicine applications are already operating in the state. Some of the projects involve:

• Pediatric intensive care video consultation and monitoring (OSHU and Sacred Heart)
• Telegenetics counseling (OSHU, Medford, Bend, and Boise but currently suspended until payer reimbursement is activated)
• Psychiatric video consultations (OSHU with a prison and tribal clinic)
• Specialty telemedicine consults (Eastern Oregon and Idaho hospitals)
• Cardiology Stemi consults and data transfers (Southern Oregon Hospital, EMS ambulance and emergency departments)
• Trauma consults for triage patients
• Adult image interpretations and over reads (store and forward)

In July 2010, President Obama announced sixty six grants and loans for $795 million through the Department of Commerce and USDA to be matched by over $200 million in outside investments to bring broadband services to many communities. The state of Oregon was one of the grantees to receive funding for two specific broadband projects:

• Bend Cable Communications, LLC received $4.4 million with an additional $1.9 million match to construct more than 130 miles of new fiber in areas of central Oregon that lack adequate broadband connectivity
• County of Clackamas received $7.8 million with an additional $3.3 million match to bring high speed internet service to northwestern Oregon

Twenty one sites in Oregon are now live on OHN’s broadband telehealth network monitored 24/7. These sites include hospitals, community colleges, an FQHC, and a county data center. A number of additional sites have contracted with OHN that includes five integrated delivery networks, two hospitals, multiple FQHCs, and four additional community colleges.

Another OHN initiative is to work on a broadband mapping project led by the Oregon Public Utility Commission (PUC). The Oregon PUC is contacting the state’s community anchor institutions to develop a congressionally mandated national map also to be used as an Oregon-specific map. The state has contracted with BroadMap under a grant from Commerce’s National Telecommunications and Information Administration on this effort.

This broadband mapping initiative is going to provide data on infrastructure gaps and enable the state’s Health Information Technology Oversight Council (HITOC) to find ways to close the broadband gaps. According to the HITOC Draft Strategic HIE Plan made available for public comment in mid June, the HITOC over the next three to five years expects all communities in the state to have access to broadband internet to help support HIEs.

The Strategic HIE Plan outlines the priorities needed for the adoption of a statewide HIE. First, a high percentage of healthcare providers must be using electronic health records or using some form of electronic communication such as electronic prescribing. Secondly, there needs to be sufficient penetration of broadband internet connectivity to handle the transmission of healthcare information. Once these two pieces are in place, these systems need to be able to exchange data in a standardized format in a standardized way. In addition, a centralized organization with representation from stakeholders must define and set the standards by which data is shared.