The vendor is required to provide that fiber-based wide-area-network (WAN) ethernet services for university, on behalf of the state education and telehealth network (UETN), and its public and higher education, healthcare and state government constituents, hereafter referred to as the university.
1. Network goals and objectives
- Provide access to healthcare providers, especially those in remote rural areas, to healthcare services and resources:
• In state, 90% of the population are concentrated in urban areas, while 74% of the state’s land mass is designated as frontier and remote by the USDA economic research service.
• Critical access hospitals and federally qualified health centers are among the healthcare facilities serving as safety net providers operating in remote and isolated rural communities.
• Each healthcare facility’s connection links patients and health professionals to multiple resources and specialists, wherever they are.
• Healthcare facilities in surrounding states often have relationships with state healthcare providers and/or seek access to healthcare resources in state.
• University health sciences center is the only academic medical center in the intermountain west and has a catchment area that includes parts of Colorado, Wyoming, Montana, Idaho and Nevada.
• Therefore, the RFP includes some out of state healthcare providers.
- Facilitate the capability of healthcare providers to utilize technology in a meaningful way to:
• Meet the clinical and operational missions of member healthcare organizations
• Expand the use of telehealth and telemedicine
• Adopt and use health information technology
• Foster collaboration to improve patient care
• Improve training and educational opportunities for staff and patients - Invite new healthcare facilities to join UETN
• Several healthcare providers have expressed interest in joining UETN.
• Healthcare facilities not currently in the network have been invited to participate in the application and competitive bidding process with us.
• They will be under no obligation to commit to participating in UETN until a competitive bidding process allows us to finalize costs to each healthcare facility.
- Improve redundancy to keep network availability at 99.9% or greater:
• Utilize the healthcare connect fund to implement a fully redundant offsite secondary network core and seek alternate options for connectivity to reduce the possibility of single points of failure.
• A greater percentage of health information systems being hosted in the clouds; healthcare facilities are challenged to operate when network access goes down.
• While UETN often meets our goal of 99.9% network availability or “uptime,” outages in isolated parts of the state can cause us to drop below this target.
• State predominant urban area and the university of state, home to UETN’S network core, are situated along an earthquake fault line.
• It is imperative that the network becomes more robust to protect against these vulnerabilities.
2. Strategy for aggregating the specific needs of healthcare providers
• UETN reaches healthcare providers (HCPS) in their communities throughout the state and our network includes sites in neighboring states.
• The UETN network has maintained 60-80 sites to date on our network which enables us to sustain effective relationships and services with individual healthcare organizations and their sites.
• UETN staff conduct periodic visits to sites to make sure that we are in touch with their needs. in addition, the state telehealth advisory council, which reports to the UETN governing board, represents constituent groups of hcps, and a technical subcommittee vet new technical initiative.
• Connecting new sites, or seeking new connections for existing sites, UETN works with each individual hcp to determine an appropriate range of bandwidth
• This is based upon recommended guidelines and also tailored to their specific needs. next, a comprehensive competitive bidding process that includes a range of bandwidth options for each participating site is conducted
• Final decisions are made in collaboration with each site once costs are finalized, with sites signing a participation agreement prior to implementation
• Different geographic areas of the state have different challenges and, to date, there is not a single service provider that covers the entire state cost-effectively.
• We currently work with all the major rural telecommunications service providers and several that cover urban areas.
• Once services are selected, UETN, working with the university of state, centralizes contracting, procurement, installation, implementation, and billing.
• The network is managed by UETN and includes a single point of contact for service and support, 24/7 monitoring and management of the network, access to a variety of security management services and tools, internet access, remote access for end users, set-up of virtual private networks ("VPNS"), vulnerability management and other services.
3. Strategy for leveraging existing technology for efficiency and cost-effectiveness
• Services are delivered via fiber optics. the network includes a backbone to a network core and interconnect sites with services from multiple telecommunication service providers for redundancy and to extend the network cost-effectively.
• As mentioned in the introduction, UTN is a division of UETN and it is merged operationally with the state education network (UEN).
• In partnership with telecommunication service providers, UETN built and manages a robust 100 gig backbone that connects all public education and libraries in state.
• Engineers from both teams developed a design that would allow healthcare traffic to transit via UETN’S backbone efficiently and securely.
• The design will allow healthcare providers to benefit from UETN’S faster network speeds while maintaining UTN’S HIPAA secure infrastructure.
• Network and security management and support will be provided by combined UETN resources.
4. Using broadband services to provide and improve healthcare delivery
• These include access to tools such as remote-hosted electronic medical records, PACS systems, pharmacy and lab systems, public health reporting, claims processing, medication management software, access to clinical information exchange systems, cloud-based telemedicine platforms, and security cameras.
• telemedicine services include real-time two-way interactive videoconferencing used for tele stroke and telepsychiatry (crisis and scheduled appointments), and store-and-forward services such as diabetic retinopathy screening and tele dermatology.
• The use of teleradiology is nearly ubiquitous in rural state where few facilities have an on-site radiologist and no hospitals have 24-7 on-site radiology coverage.
• The use of tablets and other mobile devices for remote patient monitoring and patient engagement are also becoming part of care delivery.
• Providers also use broadband services for care coordination, mentoring and education of health professionals
• Project echo creates “knowledge networks” which are especially beneficial to remote rural providers caring for patients with complex conditions.
5. Previous experience in developing and managing health it programs (including telemedicine)
• As described in the introduction, agency is made up of both the state telehealth network (UTN) and the state education network (UEN).
• The university administrative services provided to agency include human resources, finance, accounting, purchasing, legal.
• University rules and processes guide procurement, competitive bidding, and contracting to ensure that applicable state and federal laws and requirements are met
• The state telehealth network was established in 1996 with a connection from the university of state to a Clinic in Wendover, Nevada for telemedicine purposes.
a. Network and security services:
• 24/7/365 network monitoring and support
• “Uptime” goal of three 9’s – up 99.9% of the time
• Internet access
• Remote VPN access for end-users
• Antimalware protection
• Security management services and tools, including vulnerability management and scanning
• Technical site assessment, network design, and consulting services
b. Telehealth development and support
• Successful telemedicine programs are a result of careful planning, accurate information and thoughtful execution.
• Agency expert technical and administrative team has worked with a range of partners within the university of state and beyond to provide customized consultative services to guide telehealth program development efforts
• A small sampling of telehealth and telemedicine programs agency was instrumental in developing at the university of state include tele stroke, tele burn, tele behavioral health, remote monitoring for diabetes care, project echo, and the college of nursing group therapy sessions for mothers with postpartum depression.
c. Media services
• Agency manages extensive use of videoconferencing and other tools to deliver hundreds of online courses for public and higher education state-wide.
• Healthcare providers are benefitting from the merger with agency to share best practices and tools as media services options continue to evolve to better meet healthcare providers’ needs and use cases.
6. Project management plan
- Project leadership and management structure
• Includes the agency governing board, which provides oversight of the budget and major initiatives, and the telehealth advisory council, which reports to the board and represents healthcare membership
• The telehealth finance subcommittee and the technical subcommittee serve as expert content reviewers for fee schedules and technical processes/design, who offer input to agency staff and make recommendations to the telehealth advisory council
• Network projects to upgrade or expand the network utilizing USAC programs, including hcf, are co-managed by the agency consortium project coordinator and the agency associate director of it.
• Other staff support the administrative and accounting activities of the USAC application process
• The university provides comprehensive administrative services including finance, accounting, grants management, HR and payroll
• The university manages the purchasing process and its office of general counsel (OGC) provides legal guidance and contract support.
- Contract Period/Term: 2 years
- Questions/Inquires Deadline: March 10, 2025