Network Design & Technology Platforms

1. Network Design & Technology Platforms Virginia Telehealth Initiative Consensus Conference: “Developing a Vision and Strategic Plan for Telehealth in Virginia" Thursday, May 26, 2005

2. Network Design and Technology Platforms Planning Topics 1. Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards 2. How to Determine the Needs for Capacity for Planning Purposes 3. How Do We Keep Up with Changing Technology 4. How can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization

5. Networks Networks come in all types, sizes and shapes BASIC Wired LAN

6. Networks (continued) BASIC Wired and Wireless LAN

9. Networks (continued) Sub LANS within a LAN

10. Networks (continued) Multiples LANs on a WAN via Internet

11. Networks (continued) Large Multi-Protocol WAN

13. Network Design What does your facility use and need today ? - Data/Text - Images - Multi-Media - Video Teleconferencing What will your facility need in 5 years ? - Data/Text - Images - Multi-Media - Video Teleconferencing How does your facility work with other facilities to transfer and receive ? - Data/Text - Images - Multi-Media - Video Teleconferencing What is the availability of Communications Technology within Geographic Locals Now and in Future?

14. Network Design (continued) What does your facility use and need today ? - Data/Text - Images - Multi-Media - Video Teleconferencing What will your facility need in 5 years ? - Data/Text - Images - Multi-Media - Video Teleconferencing How does your facility work with other facilities to transfer and receive ? - Data/Text - Images - Multi-Media - Video Teleconferencing What is the availability of Communications Technology within Geographic Locals Now and in Future ?

15. Network Design (continued)

16. Remote Clinics Router Central Office Virtual Private Network WWW Physicians Homes & Offices Private Network Remote Clinics, Labs, Hospitals Router Central Office Physician Offices

17. University of Arizona Telemedicine Network

18. Today’s Challenges #1. How Do We Design a Telehealth Network for everyone within the Commonwealth of Virginia that is: - Cost Effective - Easy to Use - Manageable - Reliable - Dependable - Scaleable - Maintainable - Meets the Needs of All Users - Focused on a living and flexible Master Plan #2. How Do We Get There From Here ?

19. Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards 1 • Establishment of an Information & Telecommunications Technology • and Interoperability Working Group made up of Users and Industry or • Expand the duties and responsibility of the Virginia Telehealth Network • Infrastructure Working Group to also include Telecom Industry Partners • Consolidate Requirements of ALLUSERS needing Access and Interoperability • with other facilities • Develop a 5 yearIT & Telecom Telehealth MasterPlan Outlining Planned Telehealth • Improvements and Build-outs • Use of Standards to allow for Multi Vendor Environment without sacrificing capability, • Integration and Interoperability (Cisco, Extreme, DICOM, HL-7, VTC, etc.) • Think Logistically for standardized equipment buys to gain most favorable pricing from • vendors

20. Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards 1 • Establishment of an Information & Telecommunications Technology • and Interoperability Working Group made up of Users and Industry or • Expandthe duties and responsibility of the Virginia Telehealth Network • Infrastructure Working Group to also include Telecom Industry Partners • Consolidate Requirements of ALLUSERS needing interoperability • with other facilities • Develop a 5 year IT & Telecom Telehealth Master Plan Outlining • Planned Telehealth Improvements and Build-outs • Use of Standards to allow for Multi Vendor Environment without • sacrificing capability, Integration and Interoperability (Cisco, Extreme, DICOM, HL-7, VTC, • etc.) • Think Logistically for standardized equipment buys to gain most favorable • pricing from vendors Outcome Plan to Begin the Network Development while Assuring Interoperability, Security, Budget Forecasting and Provide Technical Guidance to All Users

21. How to Determine the Needs for Capacity for Planning Purposes 2 • Conduct Analysis – By Users, By Region within the State • Normal Traffic of Network • Peak Traffic Over Network • Near Future Traffic Over Network • Scalability • Secure Free Engineering from Industry & Telecom Providers Significant Work Accomplished in this area already by the Virginia Telehealth Network Infrastructure Working Group as reported in their White Paper of 2/25/04

22. How to Determine the Needs for Capacity for Planning Purposes 2 • Conduct Analysis • Normal Traffic of Network • Peak Traffic Over Network • Near Future Traffic Over Network • Scalability • Secure Free Engineering from Industry & Telecom Providers • Think Operationally to Maximize Bandwidth 24X7 Outcome Bandwidth Requirements for the Primary and Secondary Networks Primary Secondary

23. How Do We Keep Up With Changing Technology 3 • Attend Industry Technology Shows • Invite Industry to brief technology advancements to users and the Information & Telecommunications Technology and Interoperability Working Group • Utilize expertise of the Information & Telecommunications Technology and Interoperability Working Group to answer user questions and support installation of new system previously installed at other user locations • Flexibility of IT & Telecom Master Plan (semi-annual meeting, living document, modify as needed to take advantage of technology advancements) • Maintain Standards Based Products and Applications Acquisitions (Be on Leading Edge….. Not Bleeding Edge)

24. How Do We Keep Up With Changing Technology 3 • Attend Industry Technology Shows • Invite Industry to brief technology advancements to users and the Information & Telecommunications Technology and Interoperability Working Group • Utilize expertise of the Information & Telecommunications Technology and Interoperability Working Group to answer user questions and support installation of new system previously installed at other user locations • Flexibility of IT Master Plan (semi-annual meeting, living document, modify as needed to take advantage of technology advancements) • Maintain Standards Based Products and Applications Acquisitions (Be on Leading Edge….. Not Bleeding Edge) Outcome Continuous Measured Technology Refreshment while Maintaining Interoperability

25. How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization 4 • Utilize the Information & Telecommunications Technology and • Interoperability Working Group to ensure interoperability of all • users at each stage of a facilities growth. • Stick to the IT &Telecom Master Plan • Visit Hardware Sharing between users (storage, business continuity, • disaster recovery) • Statewide Software Licensing • Expertise Sharing via Information & Telecommunications Technology • and Interoperability Working Group

26. How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization 4 • Utilize the Information & Telecommunications Technology and Integration Working Group to ensure interoperability of all users at each stage of a facilities growth. • Stick to the IT & Telecom Master Plan • Visit Hardware Sharing between users (storage, business continuity, disaster recovery) • Statewide Software Licensing • Expertise Sharing via Information & Telecommunications Technology and Interoperability Working Group Outcome Visibility and Assurance of Continuous Interoperability of all Users and Cost Effective Business Continuity

28. Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards Consensus 1 • Establishment of an Information & Telecommunications Technology • and Interoperability Working Group made up of Users and Industry • orExpand the duties and responsibility of the Virginia Telehealth • Network Infrastructure Working Group to also include Telecom • Industry Partners • Consolidate Requirements of ALL USERS • Develop a 5 year IT & Telecom Telehealth Master Plan • Outlining Planned Telehealth Improvements • Use of Standards to allow for Multi Vendor Environment • without sacrificing capability (Cisco, Extreme, DICOM, HL-7, VTC, etc.) • Think Logistically for standardized equipment buys to gain • most favorable pricing from vendors YES NO YES NO YES NO YES NO YES NO

29. How to Determine the Needs for Capacity for Planning Purposes Consensus 2 YES NO • Conduct Analysis – By Users, By Region within the State • Normal Traffic of Network • Peak Traffic Over Network • Near Future Traffic Over Network • Scalability • Secure Free Engineering from Industry & Telecom Providers • Think Operationally to Maximize Bandwidth 24X7 YES NO YES NO YES NO YES NO YES NO YES NO

30. How Do We Keep Up With Changing Technology Consensus 3 • Attend Industry Technology Shows • Invite Industry to brief technology advancements to users and the • Information & Telecommunications Technology and Interoperability • Working Group • Utilize expertise of the Information & Telecommunications Technology • and Interoperability Working Group to answer user questions and support • installation of new system previously installed at other user locations • Flexibility of IT & Telecom Master Plan (semi-annual meeting, living • document, modify as needed to take advantage of technology • advancements) • Maintain Standards Based Products and Applications Acquisitions • (Be on Leading Edge….. Not Bleeding Edge) YES NO YES NO YES NO YES NO YES NO

31. How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization Consensus 4 • Utilize the Information & Telecommunications Technology and • Interoperability Working Group to ensure interoperability of all • users at each stage of a facilities growth. • Stick to the IT &Telecom Master Plan • Visit Hardware Sharing between users (storage, business continuity, • disaster recovery) • Statewide Software Licensing • Expertise Sharing via Information & Telecommunications • Technology and Interoperability Working Group YES NO YES NO YES NO YES NO YES NO

32. Network Design & Technology Platforms Virginia Telehealth Initiative Consensus Conference: “Developing a Vision and Strategic Plan for Telehealth in Virginia" Thursday, May 26, 2005