FCC Pilot Program Benefits Challenges Presented by Louis

FCC Pilot Program Benefits & 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 • 467 s issued on October 6 th • First invoices processed on October 14 th

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

Questions • For more information please contact Louis Wenzlow – lwenzlow@rwhc. com – (608) 644 -3237