Major Telehealth Initiative Under Way
For several decades, debates have raged in the United States on the topic of health care, from the desire of some for universal health care coverage to the concern about the rising cost of quality medical care. According to a study by the Kaiser Family Foundation, health care spending will reach more than 20 percent of the national income by 2018 if the current pace is sustained. The implications of this estimate are huge. Many of the plans to reform health care center on the integration and use of a variety of telemedicine and health information technologies to accomplish a reduction in cost while improving health care outcomes and prevention. U.S. Senator Jay Rockefeller states that “Expanding broadband access across the entire state can transform education and improve health care and the state’s economy.”
Although there may be disagreements related to privacy issues, most agree, however, that streamlining access to patients’ medical records would have an enormous impact on providing quality medical care and keeping costs in check. One factor driving up health care costs, for instance, relates to the lack of access to medical records and subsequent wasteful duplication of services. The next generation of health care networks needs to be smart and highly connected in a secure manner.
A recent IBM commercial proclaimed that “by 2010 30 percent of data stored on the world’s computers will be medical images.” That amount of data, which will continue to increase exponentially, presents health care providers and researchers with a significant dilemma – how can they obtain quick and reliable access to these images and other medical data when treating a patient, developing prevention plans or conducting research? Telehealth, the delivery of health-related information and services through high-speed networks, has emerged as a powerful tool in addressing the need for such access.
In Huntington, a major telehealth initiative to provide more efficient access to medical data is under way. The Huntington Area Metro Fiber Build project is the first of a series of projects under the Federal Communication Commission’s Rural Health Care Pilot Project (RHCPP). In this first phase, Marshall University designed a fiber ring connecting area hospitals (St. Mary’s Medical Center, St. Mary’s Center for Education, which includes the School of Nursing, the School of Medical Imaging, and the School of Respiratory Therapy and Cabell Huntington Hospital), Marshall University and the Marshall University School of Medicine. These Huntington area stakeholders soon will be connected to a telecommunications co-location facility that can provide access to an Internet2 connection and interconnectivity to many rural telecommunications providers.
A high-speed Internet network initiative that began in the 1990s, Internet2 is designed to be used by major universities and research centers. Researchers and other users of Internet2, for instance, do not have to compete for bandwidth with Ebay users, bloggers, YouTube aficionados, virtual reality gamers or any number of other social networkers.
The construction of the Huntington Telehealth fiber network began in the fall of 2009 and will be completed this summer. This new network promises to revolutionize access to health care records, thereby improving health care delivery and potentially, prevention measures. By providing a redundant fiber ring around the city, the network connectivity continues even if there is a break in the fiber connection.
History
Huntington’s fiber ring is one of the projects made possible by a grant from the Federal Communications Commission (FCC). On November 19, 2007 the FCC announced an initiative of over $417 million for the construction of 69 statewide or regional broadband telehealth networks in 42 states with a goal of expanding cyber-infrastructure in rural areas. West Virginia formed a statewide collaborative called the West Virginia TeleHealth Alliance and was awarded $8.4 million from those funds which provide an 85 percent discount to the cost of developing and deploying these services. The West Virginia Telehealth Alliance (WVTA) is a non-profit organization dedicated to advancing telehealth use and telemedicine capabilities throughout West Virginia. Participants in the alliance include hospitals, doctors, rural health care centers, medical schools (West Virginia University School of Medicine, Marshall University School of Medicine and West Virginia School of Osteopathic Medicine), mental health centers, local health departments, as well as consumers and business entities. The alliance’s main goal centers on the development of a statewide telehealth network infrastructure to enhance health care delivery with priority emphasis placed on rural, medically underserved regions.
Potential Impact
The Huntington Area Metro Fiber Build project promises to transform telehealth access in numerous ways. Consider this scenario in Huntington, home to two major hospitals, St. Mary’s Medical Center and Cabell Huntington Hospital, which alternate responsibility for trauma care on even and odd days. Suppose an individual involved in a motor vehicle accident is transported to the emergency room of one of the hospitals. A CT scan of the head, chest, abdomen and pelvis, blood work and X-rays are performed. After observation for 24 hours, the patient is released. A few days later, on the other hospital’s trauma day, this individual experiences a blinding headache and is taken to that hospital’s ER for treatment. Medical personnel are informed about the patient’s recent car accident and again order X-rays, blood work and a CT scan. For continuity of care, ideally these health care providers would have instant access to the patient’s earlier test results and medical images. Once the telehealth network is firmly in place, health care providers following appropriate protocols will have a powerful network that can provide access to critical medical images and data instantly and seamlessly. Precious time could be saved as these health care providers diagnose and treat such a patient, and possible cost savings could result by eliminating duplication of unnecessary tests. As the network expands, referring rural hospitals and clinics will also be part of these larger networks that can access the information in the same manner as the larger facilities.
Future phases of the West Virginia Telehealth Alliance promise to refashion health care access throughout the state, especially in rural, underserved areas. For instance, an elderly individual living in a remote area hours away from Huntington could take advantage of teleconferencing located in a rural health care center close to his or her home. By using the local health care center’s telehealth network, such a patient could consult with a specialist at a major medical center or follow up after a medical procedure without making a lengthy, expensive and exhausting roundtrip. The Huntington Area Metro Fiber Build project and the West Virginia Telehealth Alliance not only promise to improve health care data access and use within the Mountain State, but also allow West Virginia physicians and other health care providers as well as researchers to collaborate with leading medical entities throughout the nation and worldwide. Telehealth capabilities can benefit area residents in unforeseen ways. Consider another scenario in which a Huntington woman travels to a major metropolitan city for a conference and begins to exhibit possible signs of a heart attack. The Emergency Room physician there needs a list of her current medications and to be able to access any previous cardiac images and current medical history. At the same time, her local cardiologist needs to be able to be part of the consultation team and view the same information and images that are being created in the remote city. In the future, Huntington’s entrée in telehealth could make access to such medical images possible, thereby improving health care strategies for area residents.
Ultimately, assisting researchers in finding cures for many of our most common diseases is one of the major objectives of telehealth. Imagine the impact on the quality of life as well as the cost – savings of finding a cure for cancer. Thanks to the Huntington Area Metro Fiber Build project, researchers, physicians and other health care providers in Huntington will have access to the same kind of resources and applications as those aligned with leading universities and research centers anywhere. Researchers based in our area will be able to compete with their Ivy League counterparts for grants, and this kind of infrastructure offers Huntington an edge in attracting leading health care providers and researchers to live and work in the region.
Dr. Jan I. Fox is Senior Vice President for Information Technology/CIO at Marshall University.
