fcc pilot program benefits & challenges presented by louis wenzlow rwhc itn chief information...
TRANSCRIPT
FCC Pilot ProgramBenefits & Challenges
Presented by Louis Wenzlow
RWHC ITN Chief Information Officer
Springfield Meeting 10/29/08
ITN Project Goals
…to implement a collaborative electronic health record (EHR) environment (initially consisting of a hospital information system and a physician practice EMR system) that will be shared by multiple hospitals from common datacenters and supported by a pooled staff.
ITN Project Goals
• Redundant Server Model– 2 servers, 2 locations, continuous replication:
high availability; disaster recovery in minutes rather than many hours or days
• Redundant telecommunications
***Project goals already in place when FCC Pilot Program opportunity is announced
ITN Positioned to Move Quickly
• Existing network and expertise from which to develop Pilot Program network
• Firm timeline with established milestones that required telecommunications
• Cohesive group of participants already in the process of being organized in a 501(e) consortium
• Leadership authorized by participants
Step 1: 465 Submission
• Network Design
• RFP Development
• Letters of Agency
• Summary of Changes Document
• 465 Forms and Certifications
• 28 Day Bidding Period
Technical Configuration
• Redundant Telecommunications Model
RFP Development
ITN 465 Results
• Early Hiccup: is a consortium datacenter eligible if it doesn’t provide healthcare?– Resolution: consortium datacenter services are
eligible for funding if they are provided exclusively to eligible entities and are necessary for the provision of healthcare
• Multiple Vendor Strategy– Primary and secondary telecom; network termination
equipment; network management hardware and software
– Benefit: get best prices for a given community and manage your own network
– Challenge: higher complexity and more paper work
Step 2: 466 Submission
• Competitive Bid Review and Follow-up
• Formal Vendor Evaluation Methodology
• Updated Network Diagram
• Contract Negotiations, USAC Review (if eligibility is questionable), and Signing
• 466 Forms and Certifications
ITN 466 Results
• First three contracts signed• First ITN Pilot Program connections went
live on June and July.• Second hiccup: “Sustainability”
– How will the network continue to operate if/when funding goes away?
– For ITN, FCC sustainability dependent on Shared HIS use cases (network is needed; benefits of Shared HIS outweigh telecom costs)
October Activities
• Funding Commitment Letters (FCLs) for Year 1 costs issued on October 1
• 467s issued on October 6th
• First invoices processed on October 14th
Overall Challenges
• Developing cohesive organization and sustainable use cases
• Going early means facing issues that have never been faced before
• Loads of paperwork• Maintaining flexibility within bureaucratic process
(how to add facilities moving forward?)• High level of due diligence required
Overall Benefits
• High level of due diligence required– Competitive bidding leads to best prices– Good evaluation methodology makes for good
choices• 85% rather than urban comparable rates (USF
program) usually makes for lower costs• Important for this program to continue into future
– Incentivizes building networks rather than point to point relationships that perpetuate dependencies
– 15% of best rate (rather than urban comparable) incentivizes choosing lowest possible rate and is a better structure for sustainability
