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Rural Health Care Pilot ProgramLessons Learned & Best Practices

Pennsylvania Mountains Healthcare Resource Development (PMHRD) is a not-for-profit organization under Pennsylvania law, and functions as a regional health information organization.  (An application for tax-exempt status under section 501 (c)(3) of the Internal Revenue Code is pending).      The purpose of PMHRD is to promote the health of the community and reduce the burden on government by facilitating the exchange of electronic health information among hospitals, physicians, and others in the health care system.  PMHRD seeks to do this by:

(1) overseeing the creation and maintenance of a fiber network that will be used for the secure exchange of electronic health information among hospitals, physicians and others in the health care system in Pennsylvania;

(2) overseeing the creation and operation of programs involving the delivery of health services, and the associated exchange of electronic health information, via telemedicine using that fiber network; and

(3) engaging in various other activities that support these purposes.  Also, Through PMHRD, the PMHA member hospitals and other Pennsylvania hospitals can collaboratively take on projects and seek grant funding as a means of financing their initiatives related to the exchange of electronic health information. 

1) ACMH Hospital2) Bradford Regional

Medical Center3) Brookville Hospital4) Charles Cole

Memorial Hospital5) Clarion Hospital6) Clearfield Hospital7) Elk Regional Health

Center8) Fulton County

Medical Center9) Indiana Regional

Medical Center10) J. C. Blair Hospital11) Jersey Shore

Hospital12) Laurel Health

System13) Memorial Hospital14) Mount Nittany

Medical Center15) Nason Hospital16) Punxsutawney

Area Hospital17) Titusville Area

Hospital18) Tyrone Hospital19) Windber Medical

Center

Aggregate Size:

… Net revenue of $1.04 billion… Staffed bed size of 1,896… Employees 8,697

… Patient Visits;Inpatient 65,947Outpatient 1,986,277

Pennsylvania Mountains Healthcare Alliance

MISSION:

To enhance the ability of the member hospitals to provide patient centered community based care and to maintain their status as independent community hospitals.

Organization Overview

Purpose: To prevent from being overtaken by larger health systems and preserve independence.

Resulted in ability to: Leverage power Reduce costs Share “best

practices”

Role of

PMHA

Pooled Resources &

Contract Management

Revenue Cycle

Technology/ Fiber Ring

insurance

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Sting and their partners: CenturyLink Comcast First Telecom Services Level 3 nTelos Sprint Time Warner Verizon Windstream Zayo Zito Media Many more

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Primary Network Design Elements

High Levels of Redundancy Ethernet Based Optical Fiber Backbone High Speed Open Network Internet & Private WAN Capabilities Full Participation Sustained Through Cost Savings

PMHRD Shared Services Network

Key Strategy: Aggregate Demand

10+ Mbps Broadband

Access/VPNs

GeneralInternet Access

3rd Party Connectivi

ty External

Client Connectivi

ty

IP Based Network

Video

Voice

Data

The Most Cost Effective Future Solutions will

Seamlessly Integrate all 3 Technologies into 1 Network

Key Strategy: Embrace Convergence

Key Strategy: Sustainability

Sustainability not based on one specific deliverable1. Internet Delivery2. Service Delivery of Telemedicine &

Shared IT Infrastructure3. Though not specifically intended for

Electronic Health Record support, is certainly a vehicle for enhanced information delivery

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RHCPP Background:

Participants Eligible Participants Ineligible Participants

Expenditures Eligible Expenditures Ineligible Expenditures

PA Approved Projects

New Program Details

FCC Rural Health Care Pilot Program (RHCPP)

Funding Details

FCC / USAC: $1.2M over 3 years to provide up to 85% discount on purchased network services (100 Mbps service for on average $600/month)

Highmark: $1M to provide network hardware, certain fiber build out costs and implementation costs.

Merged with JVN RHCPP project in 2009 resulting in an additional $3.3M in funds for networking services

Timeline: Announcement

:Nov 2006

Application:May 2007

Award: Nov 2007

Nov. 2007 – FCC announces RHCPP funding winnersPMHA receives approval for $1.2M 1 of 69 projects in the nation

FCC Announcement of RHCPP Funding Opportunity Nov. 2006

PMHA Applies to program May 2007

Timeline:

Training:Feb 2008

Bid / RFP Submission:Aug 2007

Vendor Selection:

Oct 2007

4 Proposals submitted; Committee of 6 Hospital representatives recommend Sting Communications as the PMHRD Network Provider

Because this is a one of a kind program and process… there was a 2 day “training event” covering eligible services and funding participants.

Submitted by PMHRD, the project was one of the 1st - 5 in the country to get out for bid

Timeline: Hospital

Commitments & Establish Contract:Dec 2008

Final Design Review and Build Complete:Dec 2009

Applications:During 3 years of Project

Full participation of the 1st group of 14 hospitals

Highmark Project Support of $1M Received in January 2009

Additional 5 Locations Connectivity Funded through acquisition of JVN funds $3.2M in July 2009

Install fiber to facilities, routers and firewalls

Additional Facilities Build complete by Dec 2010 (target)

October 2009 Strategic Planning Analysis Results in Priorities Focusing on:

Shared IT InitiativesDisaster RecoveryTele Medicine Initiatives - Tele-Radiology - Tele-Neurology (Stroke)

- Tele-ICUFollowed in priority by: - Tele-Dermatology - Tele- Wound Care - Tele-Pharmacy - Tele- Cardiac

Opportunities Provided by a PMHA Network

Centralized Contract for Internet / Data Services Shared Remote Pharmacists, Radiologists, Mental

Health Practitioners

Shared IT Applications such as: PACS Centralized Data Backup Resource Many Other Possibilities…

Telecommunication Aggregation / Purchasing

Q & A - Contact Info

Greg SnyderVP TechnologyPennsylvania Mountains Healthcare Alliance (PMHA)150 McCracken Run RoadDuBois, PA 15801814-372-2355gsnyder@pmhalliance.orghttp://www.pmhalliance.org