Telemedicine in Community Health Alliance
~HCP 44229~
Healthcare Connect Fund
Network Plan
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A. Goals and Objectives of the Network
The Telemedicine in Community Health Alliance (TCHA - HCP 44229) has been developed to
alleviate the universal problem of accessing adequate network bandwidth that hinders the
efforts of providers of telemedicine in community healthcare activities in Arizona and among
Alliance members. TCHA envisions an integrated interstate network of networks built upon
the extensive experience of key participants in rural and urban healthcare and telemedicine
providers beginning with Community Health Centers in Arizona, expanding in the future to
include similar providers of Telemedicine, Teledental, Telepharmacy, Telepsychiatry and
Behavioral Health Support, Mobile Medical, Mobile Dental, Mobile Mammography, HIV and
Hepatitis C Education and Treatment, Staff CME Training, and Internet access.
This network creates the platform to more effectively share, distribute, and coordinate
Telemedicine-based clinical services, education, and training programs among member
healthcare provider organizations, thus more easily and effectively filling the gaps in meeting
the healthcare needs of communities throughout the network. This is a growth-oriented
endeavor not intended to be time-limited. Rather, it is open-ended to allow continual growth
and expansion of the network as new Consortium members are added.
The Telemedicine in Community Health Alliance consists predominantly of rural providers.
These providers are in dire need of access to broadband connectivity for Telemedicine services
and Electronic Health Records access. Many of the HCPs are limited in their capability to
provide their mandated scope of services or implement Electronic Health Records systems due to
their remoteness and lack of existing network services. Without financial assistance, acquiring
services is cost prohibitive for the majority of Consortium members.
Goals
Introduce FCC-defined broadband data services to the Consortium's member health care
providers. The network is foundational for providing access to Telemedicine, Teledental,
Telepharmacy, Telepsychiatry and Behavioral Health Support, Mobile Medical, Mobile Dental,
Mobile Mammography, HIV and Hepatitis C Education and Treatment, Staff CME Training, and
Internet access that is sorely lacking.
Provide sufficient broadband access to Consortium members allowing them to implement EHR
in traditional clinics, on their mobile units, and for their mobile health workers, while
providing the security required to ensure compliance with Health Insurance Portability and
Accountability Act (HIPAA) requirements for the exchange of Electronic Personal Health
Information (ePHI).
Provide additional bandwidth needed to deliver care to our patients in a timely and efficient
manner over resilient networks. Installing redundant data connections helps alleviate business
continuity risks.
Objectives
The objectives of the network include laying new fiber or equivalent to rural health care
providers where economically feasible. Replacement or installation of copper network
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pathways remains a viable secondary choice. Expanding funded networks incentivizes service
providers to cover the costs of laying new or improving the stability and bandwidth of existing
fiber optic network cable.
Most rural health care providers have access to DSL, cable, or T-1 technology. The capability
of these services is not suitable for broadband communication, particularly as the mandate for
telemedicine expands. Existing broadband communication services and equipment will be
replaced with up-to-date, cost-efficient, and remotely manageable networks.
B. Strategy for aggregating the specific needs of health care providers (including
providers that serve rural areas) within a state or region
North Country HealthCare, Inc. (NCHC), the Consortium Leader, is incorporated as a nonprofit Community Health Center with FQHC designation, offering a full range of medical,
dental, behavioral health, and pharmacy services at 18 stationary and eight mobile medical and
dental clinics and sites across Northern Arizona, one of the most remote regions in the USA.
NCHC has been in operation since 1991 and understands thoroughly the challenges of
obtaining and provisioning sufficient connectivity and bandwidth to effectively meet its
mission.
Through NCHC and its members, the Consortium has sufficient size and experience obtaining
connectivity by addressing connectivity issues in unique ways by flexibly working with
service providers to deliver satisfactory solutions. The Consortium is growing rapidly, with
HCPs in five states already, and adding more diverse members continually. The Consortium
will leverage this growth and diversity to pressure service providers to offer a better array of
broadband alternatives and lower costs throughout the Consortium footprint.
C. Strategy for leveraging existing technology to adopt the most efficient and cost
effective means of connecting those providers
Many of the Consortium’s member HCPs have relatively new technology within their facilities
and have many of the building blocks necessary to deliver the Consortium’s envisioned
network of broadband Ethernet and wireless handoffs. Whenever possible, this technology will
be used in developing and deploying endpoints and data centers. Where not feasible,
technology bids will be sought using State, Federal, or Tribal Master Service Agreements, and
competitive bidding from multiple, well qualified vendors.
D. How the supported network will be used to improve or provide healthcare delivery.
The main issues facing Consortium members, particularly in Telehealth and Mobile
environments, is sufficient continuous, synchronous bandwidth to implement EHR, conduct
Telemedicine-based services, and real-time radiological services. This network permits
healthcare providers in the Consortium to obtain access to their EHR databases, radiology
support, and uninterrupted bandwidth for routine clinical services, thus improving the quality and
reducing the cost of care. Providing adequate broadband service that enables reliable telemedicine
application enhances patient care in a number of significant ways, including more effective
medication management and more accurate prescriptions, reduced redundancy and errors in
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laboratory testing, better coordination of patient care among multiple HCPs, real-time
radiological diagnostics and screening, and ad hoc access to medical and dental specialists.
E. Indicate previous experience in developing and managing telemedicine programs
North Country HealthCare, Inc.’s technology team has over seven years’ experience in
researching, developing, implementing, and maintaining telemedicine systems across the State
of Arizona. NCHC has been a leader in the field of telemedicine, working closely with the
University of Arizona and the Arizona Telemedicine Program to test and implement enhanced
technologies and services. NCHC has hosted telemedicine systems for Northern Arizona
University, and regularly hosts multi-site Hepatitis C education via telemedicine for providers in
the Southwest region.
NCHC hosts the AT Still Medical School, Northern Arizona Campus, which relies heavily on
NCHC supported telemedicine and teleconference services. NCHC’s HIV provider uses
telemedicine to manage over 400 patients. NCHC also has implemented and manages a
Telepharmacy system allowing the organization to provide pharmacy services at remote clinics
with one central staff pharmacist. NCHC also uses telemedicine to provide much needed
behavioral health services to patients in the remote communities that it serves. NCHC is often
featured for its leadership in the discipline by the Arizona Telemedicine Program.
F. Provide a project management plan outlining the project’s leadership and
management structure, as well as its work plan, schedule and budget.
North Country HealthCare, Inc.’s Information Technology Manager will be the lead on the
project with oversight from the Director of Information Technology Services, the Corporate
Compliance Officer, and the Chief Financial Officer.
The project will consists of these basic steps:
 Post RFP (January 2016)
 Review RFP responses/bids (3 days)
 Sign contract for services within (5 Days)
 Network installation starts within ( 30 Days)
 Test and turn up to live at each site (3 Days)
Budget
Telemedicine in Community Health Alliance, through North Country HealthCare, Inc., currently
has an annual budget of about $700,000 for telecommunications and network connectivity.
Project funding will be provided by Consortium member organizations and other funds deemed
eligible by the FCC, along with reimbursements from USAC programs.
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