Case Study: NCTN

Broadband brings life to North Carolina TeleHealth Network

As modern health care depends more and more on high-speed broadband connectivity for better access to diagnose, care and research the next great cures, the North Carolina TeleHealth Network will serve the high-bandwidth, low-latency needs of health practitioners and researchers for years to come with affordable services.

BUSINESS DESCRIPTION

The North Carolina TeleHealth Network (NCTN) is a dedicated network for public and non-profit health care providers leveraging both the North Carolina Research and Education Network (NCREN) and the North Carolina Department of Information Technology Services (DIT) infrastructure to provide high-capacity, reliable, cost-efficient, and very high-speed broadband connectivity and other network services. The NCTN began in 2007 and is coordinated through the Cabarrus Health Alliance (CHA). The NCTN is subsidized through the FCC’s Rural Health Care Pilot Program (RHCPP). To date, the NCTN has been a $14.2 million program. This figure represents the total cost of broadband connectivity by NCTN subscribers, who pay approximately 15 percent of their connectivity costs out of pocket while the other 85 percent comes from the FCC through the RHCPP. There are three parts to the NCTN – the NCTN-PH phase for public health, free clinics and some community health centers; the NCTN-H for non-profit hospitals; and the NCTN Extension, which focuses on broadening and extending services for existing NCTN-H and NCTN-PH sites as well as adding new sites. A fourth phase is on the immediate horizon, which will leverage the FCC’s permanent Healthcare Connect Fund (HCF), providing 65 percent of the funding for health care provider broadband connections. MCNC, in collaboration with ITS, won three competitive bidding rounds to provide NCTN-PH, NCTN-H and NCTN Extension services. As part of these services, MCNC also works with private broadband service providers including AT&T, TimeWarner Cable, and CenturyLink to supply last-mile transport services.

"We are pleased to see this network coming alive now, and expect it to help many health care providers meet the new challenges in using information systems to support health and care, especially for non-profit and rural providers. The Golden LEAF Rural Broadband Initiative provides the NCTN with the essential core resource needed to stitch these providers together into a statewide broadband network to support the current and future digital medicine needs in North Carolina."
--Dr. William F. Pilkington
CEO and Director of Public Health
Cabarrus Health Alliance

BACKGROUND

The NCTN is a collaborative effort among several parties supporting the improvement of broadband for health and care in North Carolina. The state initially received four regional “awards” from the FCC to support connectivity for rural non-profit hospitals and rural public health agencies/free clinics under the RHCPP. These award winners with FCC approval combined the funding so it could be used to support enhanced connectivity for non-profit hospitals, public health agencies, free clinics, and other health care providers eligible under RHCPP. The CHA is the public health authority in Cabarrus County and became the program coordinator of the NCTN pilot project when it was proposed in 2007. The three other FCC awardees – Albemarle Regional Health System, University Health Services (now Vidant Health) and Western Carolina University – later merged their pilot program awards to help fund the NCTN-H phase. As part of the merging of grants, the CHA was designated to administer the program at which time they put out competitive RFPs seeking a network provider who could connect eligible sites. MCNC worked with ITS as well as AT&T, TimeWarner Cable, Century Link, and other telecom carriers to respond to those RFPs with operative networking solutions, and successfully won agreements through the competitive bid process.

CHALLENGE

"We have created a robust network to support the health care needs of North Carolina citizens for years to come."
--Dave Kirby
President of Kirby Management Consulting and NCTN project manager

Broadband continues to revolutionize health care in this country. Today's health care environment increasingly depends on electronic connections that assure high-quality care is provided efficiently, effectively, and at an acceptable cost. Accessing remote experts on a moment’s notice, sharing information among a patient's physicians quickly and easily, keeping parents up to date on the details of their child's doctor visits, and providing continuing education to health care providers all depend on highly-reliable, cost-effective, and very fast broadband connections. Meeting this challenge at an affordable cost for North Carolina’s public health agencies, hospitals, and other public and non-profit health care providers is the primary mission of the North Carolina TeleHealth Network.

SOLUTION

MCNC offered NCREN as a broadband-based foundation to be utilized in the transformation of health care delivery in North Carolina. The vision of state health care professionals is for North Carolina to become a leader in the adoption of sharing electronic medical records, telemedicine-enabled health services, and seamless health information exchanges. MCNC provided a fully-managed suite of network services including installation, 24x7x365 customer support, maintenance, proactive fault and performance management, and near real-time reporting of service-level metrics. In collaboration with ITS and other private telecom carriers, these services continue to meet or exceed the requirements of the NCTN. The network takes advantage of MCNC's proven, highly-reliable core architecture and utilizes leading-edge, scalable network technologies to connect customer locations to a resilient fiber backbone. The completion of the three-year, $144 million expansion of NCREN through the Golden LEAF Rural Broadband Initiative in 2013 further boosts the capabilities and bandwidth for the NCTN as well as lowering costs.

"MCNC has helped create a public benefit ecosystem designed specifically for health care institutions in North Carolina that involves economic gain for private-sector providers, enhanced connectivity for those health care institutions, and a broadband foundation for the use of telehealth solutions that can scale to the future."
--Joe Freddoso
MCNC President and CEO

BENEFITS

The NCTN provides the critical broadband infrastructure non-profit health care providers need to properly conduct their business in the 21st century. As health care begins to depend more on telemedicine, health information exchanges, electronic medical records and research by geographically-diverse health care institutions for the next great cures, the NCTN will provide affordable, high-bandwidth, low-latency network services to meet the needs of health practitioners and researchers throughout North Carolina for years to come. Many areas of the state now have the capability to provide diverse and redundant connectivity to non-profit health care organizations. This helps ensure they are rarely, if ever, "down" or interrupted from connecting to their remotely-hosted, business-critical applications. For many regions, this capability has never been financially feasible nor has a diversity of broadband providers been present. This means the NCTN will continue to use broadband connectivity to even the playing field when it comes to high-quality health care in rural areas of the state. The RHCPP-discounted phases of the NCTN support 120 sites. It is expected that about 125 sites will be in operation on the NCTN by early 2014, all of which have indicated an interest in subscribing to the new and more permanent NCTN Healthcare Connect Fund phase (NCTN-HCF) soon to begin. Another 700 health care sites and providers in North Carolina also have presented initial information as a first step towards subscribing to the NCTN-HCF.

At a glance

What they needed?

• A statewide backbone network for health and care in North Carolina serving public and non-profit providers
• Affordable, reliable, high-speed connections and bandwidth able to transport critical information in real-time
• An integrator and provider of services who can work with commercial telecom providers anywhere in the state
• Enduring partners in recruiting sites, developing solutions to service needs, and managing quality
• Managed, ubiquitous broadband solutions for the entire geography of North Carolina

What they did?

• Leveraged an expanded NCREN infrastructure to broaden and scale the NCTN’s capabilities
• Constructed a robust network through public-private partnerships dedicated to improving health care
• MCNC expanded NCREN approximately 2,600 miles to support increasing bandwidth needs in the state
• Created a scalable, reliable, resilient, and secure broadband infrastructure for digital health care delivery

What they accomplished?

• Leveled the playing field for health and care for many in North Carolina, especially in rural areas of the state
• Created a new community-driven model for broadband service in the area of health care
• Grew the network to 120 total sites and positioned it have about 125 sites by early 2014
• Developed a fourth and more permanent phase of the network (NCTN-HCF)
• Established a sophisticated broadband infrastructure ideal for the future of health care in North Carolina