The California Telehealth Network: Evaluating
Its Role in Statewide Health Information Exchange

The planned California Telehealth Network (CTN) is a private, high-speed network to support telehealth applications in underserved areas of California. Planning is also underway in California for a statewide computing infrastructure to support electronic prescribing, lab-result reporting, medical records sharing and other exchanges of health information.

Given these concurrent initiatives related to telehealth and health information exchange, the California Healthcare Foundation engaged Sujansky & Associates to evaluate whether the CTN should be expanded to comprise the general infrastructure for statewide HIE, or whether its scope should be confined to enabling telehealth services for underserved areas.

To perform this evaluation, we prepared a report addressing the following questions:

• What are the specific networking requirements for telehealth applications with respect to bandwidth, latency, packet loss, and downtime?
  
  
• What are the distinctive features of the CTN relative to existing commercial networking options and how do these features enable it to meet the stringent requirements of telehealth applications?
  
  
• What are the specific networking requirements for non-telehealth HIE applications with respect to bandwidth, latency, packet loss, and downtime, and how do these requirements differ from those of telehealth applications?
  
  
• What are the existing commercial networking options available to health care facilities in urban and rural areas of California? Where do these options fulfill the networking requirements of telehealth and HIE applications, and where are the distinctive capabilities of the CTN required?
  

Relevant documents:

Applicability of CTN as the Network Infrastructure for HIE in California (Final Report - PDF)

Highlights

The CTN will be most valuable and cost-effective as a means for enabling telehealth and health information exchange in rural areas, because commercial broadband service remains prohibitively expensive there.

Due to the demanding networking requirements of telehealth applications, the CTN may also benefit urban facilities engaging in videoconferencing (but not "store-and-forward" telehealth).

The CTN is unlikely to be needed for non-telehealth applications in urban areas. There, the commercial broadband services already available will be adequate and more cost effective. In addition, commercial broadband services that are faster and less costly than the CTN (such as fiber-to-the-home and enhanced cable) are increasingly available in urban areas of the state.