To improve network speed and capacity in hospitals and clinics across the state, the Iowa Communications Network designed and implemented site upgrades for the Iowa Rural Health Telecommunications Program (IRHTP), a consortium that connects around 85 healthcare facilities to a dedicated broadband fiber network.

As part of the project, ICN, a state agency, installed new switches and migrated broadband services from an existing platform to the new multiprotocol label switching network. It installed basic equipment on 21 sites and an aggregation on 23 sites, supplying 91 hospitals.

“The entire infrastructure is based on a 10 gig infrastructure,” said ICN Technical Director Scott Pappan. “All of this infrastructure is actually a redundant design, so one fails over the other,” he said. “I can lose a primary device, I can lose an aggregation device, but now because of the design infrastructure I’m failing [over] to another device. Our goal is that the network never goes down.

If a network ring fails, a network monitoring tool detects it, notifies the network operations center, and reroutes traffic in less than 50 milliseconds, Pappan said.

“What this has done has really given us a more reliable network,” said Corey Martin, vice president of education services for the Iowa Hospital Association, which manages the IRHTP.

IRHTP provides a closed network that allows healthcare workers to transport data to and from hospitals, clinics and outside partners. The program began in 2007 and laid the first fiber in 2008. Planning for the refresh began in 2017, and work began in mid-2020 and ended this year.

“They did a lot of the work in parallel sections, so one section could move while the other was cut and stopped,” Martin said of ICN. “It really helped our hospitals to see no downtime. “

An important use of the IRHTP is telehealth – a pre-pandemic capability that exploded when COVID-19 hit.

“All of our facilities took stock of their bandwidths and how much they were allocating for telehealth visits,” said Martin. “Almost every one of them has had some sort of increase in bandwidth.”

For example, rural hospitals and clinics don’t have a lot of specialist care, so if someone tears a ligament in their knee and the hospital doesn’t have an orthopedist, they can take a virtual tour with a specialist. in Des Moines or Iowa City and share X-rays. One area of ​​telehealth that has grown dramatically is behavioral and mental health, he said.

“Having this network and these connections, you don’t rely on this stuff going over an open Internet connection,” Martin said, adding that many connections involve both Ethernet to move data from site to site and the Internet, which can be used for public access. “This network is really something unique and quite special.”

Other services that ICN can provide include cloud connections to Amazon Web Services, Google Cloud, and Microsoft Azure, as well as firewalls and Distributed Denial of Service (DDOS) mitigation. ICN bills IRHTP facilities individually based on the bandwidth they hold, but the consolidated bill goes to Martin, the executive director of the consortium, who then bills the members and pays ICN.

“What’s fantastic about this is that a lot of our sites are eligible for a federal rebate… so a lot of them are getting what I consider almost a reduced cost at their expense because it is about ‘a 65/35 split,’ Martin said. “They pay it all up front, then I submit claims and… they can get up to 65% of their fees.”

In fiscal 2021, Universal Service Administrative Co. provided funds for rebates to 158 hospitals and healthcare providers, saving them nearly $ 2 million on data services through the Healthcare program. Connect Fund. USAC is an independent, not-for-profit organization designated by the Federal Communications Commission, and HCF is a USAC program that offers a 65% discount on eligible broadband connectivity expenses for eligible rural healthcare providers.

For Martin, the construction of the network is never finished.

“Healthcare is constantly changing and evolving, so how can we evolve with it? ” he said. “As new clinics and locations open up, it’s time to put new fiber on them and get those last mile connections to these new locations. As institutions grow and change and their business models change – if a hospital decides to add comprehensive cancer care, it’s going to add a lot more bandwidth, different needs with their medical records – how are we going to adjust? We constantly look at it from a health care perspective and from this model.

ICN has several efforts underway, Pappan said. Because the network experiences an average of nearly 11,000 DDOS attacks per year, it updates its platforms and relocates and updates its firewall infrastructure. It will provide security for agencies based on their individual needs, not as a single group.

It also expects to complete a 100 gigabit core within the next two months, moving the aggregation to a statewide 10 gigabit format and scaling it to 100.

But ICN’s real success is the result of its partners, Pappan said. “I think the whole public / private partnership is the reality of the future,” he said. “This is a great example of how the public / private partnership comes together and works for everyone. “

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