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. 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 Network Design and Technology Platforms Planning Topics

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

6. BASIC Wired and Wireless LAN Networks (continued)

9. Sub LANS within a LAN Networks (continued)

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

11. Large Multi-Protocol WAN Networks (continued)

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

17. University of Arizona Telemedicine Network

18. #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 Today’s Challenges #2. How Do We Get There From Here ?

19. Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards 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 ALL USERS needing Access and 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 1

20. 1 Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards 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 ALL USERS 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 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 2 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. 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 2 Outcome Bandwidth Requirements for the Primary and Secondary Networks How to Determine the Needs for Capacity for Planning Purposes Primary Secondary

23. How Do We Keep Up With Changing Technology 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) 3

24. How Do We Keep Up With Changing Technology 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) 3 Outcome Continuous Measured Technology Refreshment while Maintaining Interoperability

25. How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization 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 4

26. 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 4 Outcome Visibility and Assurance of Continuous Interoperability of all Users and Cost Effective Business Continuity How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization

28. 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 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 YESNO YESNO YESNO YESNO YESNO Processes Needed To Reach Consensus on Configuration, Equipment, Technology, Security Standards Consensus 1

29. 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 YESNO YESNO YESNO YESNO YESNO YESNO How to Determine the Needs for Capacity for Planning Purposes Consensus 2 YESNO

30. 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) YESNO YESNO YESNO YESNO YESNO How Do We Keep Up With Changing Technology Consensus 3

31. 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 YESNO YESNO YESNO YESNO YESNO How Can Smaller Agencies/Organization Maintain Compatibility with Larger Agencies and Organization Consensus 4

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