Considering telehealth?

As nations today focus on the development of healthcare programs and policies to ensure a healthy and productive workforce, many are faced with a seemingly insurmountable obstacle – how to deliver a consistent level of care to patients, and provide access to medical experts, when citizens are distributed across vast geographies. People living in large cities have multiple choices within short distances for grocery stores, restaurants and other shopping options; people living in remote or rural areas sometimes have to drive hours just for a gallon of milk. The same geographic divide influences access to healthcare.

While a network cannot deliver milk and bread, it can dramatically level the playing field for medical professionals to ensure all of their patients – whether sitting 2 feet away on an exam table in their Manhattan office or thousands of miles away in the wilds of Alaska – receive the same level of examination, diagnosis and treatment. By using fixed and mobile broadband networks, along with a variety of video conferencing, imaging, remote diagnostics (such as smartphone-based mobile health applications) and other tools, medical professionals can make the challenges of geographic distances disappear. These applications, categorized broadly as telehealth applications, are rapidly becoming a viable method for patient treatment, consultations, medical training, education, research and self-health monitoring. In fact, BCC Research indicates that the global market for telehealth is expected to grow from $11.6 billion in 2011 to $27.3 billion in 2016.

Network challenges

Once confined to radiology departments, imaging services are now pervasive across all departments, clinical specialties and even non-affiliated communities of interest. These image files can also be part of a person’s electronic health record (EHR), driving bandwidth needs through the roof as well as consuming more application and storage services and capacity. Network issues are further exacerbated when healthcare organizations make use of new time-sensitive telehealth applications that require real-time HD video and low latency, such as when patients suspected of having had strokes arrive at the emergency room and a remote consultation is required because no specialist is available.

As new bandwidth-intensive applications and services are introduced on the clinical side, network managers are often caught flatfooted, creating planning nightmares. With new facilities being added as part of health information exchanges or through mergers and acquisitions, the burden on a network is growing infinitely. Infrastructure management costs are rapidly increasing, forcing CIOs to look at the risk vs. reward aspects of the cloud, while simultaneously ensuring 24/7 network availability and meeting strict compliance mandates. To help address and overcome these challenges, many facilities are increasingly looking to IT and network solutions vendors.

Updating legacy networks to a powerful converged optical-Ethernet infrastructure

Real-time imaging, EHRs and a host of other telehealth applications empower healthcare providers to deliver the best outcomes for patients. One of the key challenges presented by these emerging applications is that most require tremendous amounts of bandwidth if they are to be shared across a healthcare network. Leased lines, ATM and frame relay just don’t have the capacity and flexibility to handle high-bandwidth medical and storage applications that are becoming mainstream.

Constant application uptime is a key requirement. It’s not uncommon for hospitals to have multiple networks, built for specific traffic delivery in order to carry data, voice, SAN and video traffic. But, in most cases, these disparate, low-speed networks can’t support the increasing bandwidth needs of today’s healthcare information storage and disaster recovery requirements. In addition to bandwidth, multiple, disparate networks are costly to manage and maintain, often with separate management contracts in place for each of the networks, which puts a big strain on IT budgets. To keep costs under control, support exploding bandwidth needs, meet strict data backup and retention mandates, and have the in-place capacity to support next-generation applications and services, healthcare providers are turning to powerful, converged optical infrastructures to achieve the objectives.

Building the backbone for telehealth

Establishing these telehealth systems is not as simple as connecting computers to telephone lines. In order to deliver on the promise of high-capacity broadband service and all it offers, upgrades are required to the network backbone and feeders. To ensure the effective implementation of telehealth, here are three items that must be scoped:

• Fiber optic backbones may need upgrade or installation to meet high-capacity requirements;
• Wireless equipment needs to be installed in other areas where existing cellular service may be lacking; and
• Information switching and transport systems need to be modernized to carry multiple types of service.

All of the previously mentioned requirements are quite achievable and fiscally responsible. State-of-the-art optical transmission systems operate at rates up to 100 Gb/s with the ability to scale simply to multiple Tb/s. Ethernet switching provides a means to aggregate, steer and manage traffic generated by any application, including telehealth elements such as EHRs, PACS imaging, high-definition video and voice. Modern switches use enhancements to provide carrier-grade Ethernet connections that have the security and robustness needed for current and future applications. Together these technologies – optical transmission and carrier Ethernet switching – provide the foundation for a powerful, nationwide telehealth network.

Healthcare providers have no choice but to adopt new life-saving applications, such as telehealth and other advanced medical services, if they are to remain competitive and relevant. This means that they must plan now to provision for their increasing use – and the use of even more bandwidth-intensive applications and increasing storage and backup requirements. Fortunately, optical networking and Ethernet provide the capacity and deployment flexibility to allow healthcare providers to increase their usage as bandwidth demands escalate over time, negating the obstacles that have historically hindered patient care, especially in rural areas of the country. HMT

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