TERRA network improving health care in rural communities

Courtesy ANTHC

For some rural communities, better telecommunications means better healthcare.

GCI launched its TERRA-Southwest network in June, improving telecommunications for much of southwestern Alaska.

The new network created a terrestrial connection from Anchorage to much of western Alaska, primarily in the Yukon-Kuskokwim Delta and Bristol Bay areas. The $88 million project extended a broadband connection to 40 communities, with another 25 expected to be connected in the near future.

The network includes more than 400 miles of fiber-optic cable, and 13 new microwave towers.

The TERRA network is making a difference for local healthcare organizations, as well as for telehealth providers trying to connect with the area remotely.

Yukon-Kuskokwim Health Corporation, or YKHC, is one of those benefactors.

The new network reduces latency, improving a variety of services, said Joe Shawler, who works in YKHC’s technology division.

“It’s just a substantial improvement,” Shawler said.

Previously, data sent from a rural clinic traveled from its location to a ground station, to a satellite orbiting beyond the earth, and then to a ground station on the receiving end before reaching it’s destination.

Data that timed out during that process had to start again. Sending an image could take several tries, upwards of 20 or 30 minutes.

Now, information travels by fiber optic cable or microwave tower. For many YKHC clinics, that means it travels from the clinic to Bethel out of Bethel by fiber optic.

The same image that once took half an hour can be sent in a matter of seconds.

“It allows a lot quicker response from doctors,” Shawler said.

Telehealth services delivered by Alaska Federal Health Care Access Network, or AFHCAN, is another beneficiary of the reduced latency.

AFHCAN is a product of the Alaska Native Tribal Health Consortium, or ANTHC, which is based in Anchorage and serves communities throughout Alaska.

AFHCAN software is used at 248 sites in Alaska, by 44 different organizations. The TERRA improvements primarily affect the sites in the YKHC region, and in the area served by the Bristol Bay Area Health Corporation.

The software enables information to be collected at remote health clinics, stored, and sent to providers in other regional hubs, Anchorage, or even Outside. AFHCAN refers to that process as store-and-forward.

The benefits to AFHCAN come from reduced latency, and increased capacity, said Acting Director of AFHCAN Telehealth Cheryl Moon.

“This all results in improved patient healthcare with faster data exchange and an improved clinical user experience when using our network-based tConsult telehealth application,” she said.

TERRA can facilitate the implementation of real-time video and medical device data streaming, rather than the current store-and-forward system, which could eventually lead to better and faster care for patients.

The improved service could also be a deciding factor for future use of the AFHCAN network.

“…The improved clinical experience that results from low latency will be a positive factor (in) getting physician support for virtual clinical programs like our current tele-cardiology program,” Moon said.

Those programs help connect patients with specialists outside of their area electronically, preventing the need for travel.

Moon said video-conferencing can benefit WHAT ORG as well.

Tele-consults are more feasible with a better connection, she said. The Mayo Clinic in Rochester, New York, provides consultations via videoconferencing for patients at a high-risk for breast cancer. Now, that could be conducted from a regional village clinic that’s part of the improved network.

YKHC also benefits from the ability to conduct health care via videoconference.

YKHC Director of Public Relations Donna Bach said that’s an area of definite improvement for the health corp.

About 40 clinics are able to use videoconferencing capabilities, connecting patients with providers elsewhere in the state, and even outside of Alaska.

Shawler said that latency could create pixilated video-conferencing in the past, but now it’s a more feasible option.

Mental health is an area that is especially enhanced by the ability to have face-to-face interaction, Shawler said.

Bach said the better communications capabilities allows the health corp more flexibility in its operations. Instead of scheduling each data transfer or other use, images can be sent as needed. That can mean faster service for patients.

“We are offsetting the patient wait time, or delay, for results,” Bach said.

Bach and Shawler said video-conferencing is another area where reduced latency has benefitted local health care. Less latency can mean better quality, less pixilated, images, Shawler said.

That means patients can have a face-to-face meeting with a mental health provider.

The mobile mammography program is also enhanced by the faster speeds, Bach said.

The mobile mammography unit travels to subregional clinics in Emmonak, St. Mary’s, Aniak, Toksook Bay and Hooper Bay. Each of the subregional clinics is also part of the new TERRA network.

Now, images can be sent to a radiologist immediately, and an estimated diagnosis might be received in just a day. That’s compared to two weeks or more, when film had to be sent for developing, then for reading, before a patient found out their results.

“We can get faster responses to preliminary assessments,” Bach said.

Dental health also benefits.

Shawler said that a tooth extraction might be performed at a village clinic, but a dentist has to ok the process. If the dentist is in Bethel, the patient info and images can be sent electronically. With the faster service, that can happen nearly instantly, allowing the care to proceed and the patient to see some relief.

On the technology side, better connections make it easier to participate in an increasingly electronic world of data, Moon said.

A terrestrial connection offers better access to cloud-based data solutions, and an ability to store electronic health record data with an out-of-state vendor, Moon said.

Each example might be a small improvement, but collectively they make a big difference for health care in rural Alaska.

“All of these…ultimately improve patient healthcare within Alaska, which moves ANTHC closer to its vision for Alaska Natives to be the healthiest people in the world,” Moon said.

The upgrades aren’t over yet. GCI is continuing to build out the TERRA network. On the horizon is TERRA-Northwest, will extend the terrestrial connection to Kotzebue and elsewhere in Northwestern Alaska.

And improved connections aren’t the only change for the tribal health consortium.

ANTHC recently received a $1.2 million grant to serve as the country’s National Telehealth Technology Assessment Resource Center.

That means it helps organizations throughout the United States determine what telehealth services best fit its needs.

11/11/2016 - 5:52pm