Today there are a multitude of applications and technology solutions to make the practice of medicine safer, more efficient and more connected. Without proper planning on the front end, however, you might find those options are out of reach for you … or, at best, deliver limited performance.
Just as a structure is only as good as its foundation, your health information technology systems are only as good the infrastructure you put in place.
“Telecommunications provides the infrastructure for healthcare or any other enterprise to connect to your remote locations and the outside world. If that’s not right, nothing is going to be right … and you will be very frustrated,” said Eddie Hooper, director of carrier services for Franklin-based Resource Communications Group (RCG), a telecommunications solutions provider with expertise in voice, data and mobility network customization and internal mission critical networks.
Whether building a new location or changing and upgrading services, Hooper said considering bandwidth is an important first step. Not only should you think about what your current needs are but also flexibility and scalability to meet future demands. As part of the planning function, he suggested looking out two to five years to think about whether or not you will have the necessary bandwidth to scale up as the practice grows or facility adds technology. “It’s not that it can’t be changed,” he said of expanding down the line, “but it’s much more disruptive. It makes it a lot more seamless if you plan for these things on the front end.”
Another consideration is how long it takes to install the type of technology infrastructure that best meets your needs. For Ethernet services, Hooper said to plan 180 days out before occupying the premises or going live with the switchover. With T1, which isn’t as complicated, 60-90 days should be sufficient.
“It may not take that long … but it might, and until you start investigating, you won’t know. A lot of businesses get caught off guard by not doing that,” he said of allowing ample time.
Businesses must also choose between broadband or dedicated Internet service. First, you must decide how much speed you need and then how to access it. Broadband — cable, DSL (digital subscriber line), U-Verse — are much less expensive but are also ‘best effort’ services. Hooper explained that means they offer ‘up to’ a certain bandwidth speed … so service up to 10Mbps means that will be the maximum megabits per second. Many clients mistakenly think that is a guaranteed speed.
“It’s cheap for a reason. You share the port,” he said, adding that in order to keep costs low, these services are habitually oversubscribed. He hastened to add that isn’t necessarily a bad thing. For many, sharing an uplink isn’t a problem. “For some businesses, that’s perfectly fine. You just need to know this on the front end.”
If, however, your practice or facility relies on heavy data transfer or mission critical services — like being able to transfer an image to an offsite physician — Hooper said you should consider dedicated bandwidth where you aren’t slowed by other people’s traffic. A funny kitten video that doesn’t load at home isn’t a big deal. Not being able to get a video connection for a telemedicine visit might be.
Sending data securely and privately is of the utmost importance for all healthcare companies. As with everything else, Hooper said there are choices and decision to be made based on your specific needs.
Multi-Protocol Label Switching (MPLS) is a family of standards in which Internet Protocol (IP) networks make forwarding decisions based on a pre-allocated label to set up paths. It’s a viable option for a facility or practice with multiple locations locally or nationally. “It’s an interstate solution so it can go across state lines,” Hooper said. He added, however, with MPLS, you cannot use multiple carriers so all sites would need to be on the same page.
Metro Ethernet is a cost effective option for quick, secure data transfer in an existing Local Access Transport Area (LATA). Hooper said this option works well if you are streaming data within a single metro area. For instance, this would work if you had practices in Nashville, Murfreesboro and Franklin. However, it wouldn’t extend to an office just over the border in Kentucky or to a site in Chattanooga or Knoxville. If your enterprise is larger, then Long Haul Ethernet might be the right solution as it allows you to continue to use a familiar technology over a regional or national area.
Of course, Hooper added, ensuring security and privacy with so many remote devices now being used requires active management in addition to appropriate technology. Similarly, speed and capability mean little if all that data being transferred isn’t backed up appropriately. “I always say there are two types of people — those who back up … and those who wish they had,” Hooper noted sagely.
With so much emphasis on data transfer needs, Hooper said it’s all too easy to overlook voice services. “People like to talk on the phone so voice services are still critical,” he said.
Working with a hospital impacted by Hurricane Rita several years ago, those calling in heard a fast busy and thought the hospital was closed. The solution was to get a message up letting the community know that although the phones still weren’t operational, the hospital was. Having that type of announcement feature or a call redirection feature can really serve as a lifeline during crucial moments for an industry that serves a critical need.
Unfortunately, Hooper noted, businesses too often try to save money on the infrastructure. “It’s not the place to do this,” he warned. “You are going to get exactly what you pay for … and like anything else, there are no shortcuts.”