8. ACT NO. 185 (C) Study the wide-area network needs

 

This section addresses item (C) of ACT NO 185.

8.1. Overview

For the purpose of this analysis, this task focuses on what this report defines as Vermont Citizens Access Telecommunications System (VCATS). The legislation is again not clear on what is to be studied: GOVnet, private Internet service providers and "other alternatives" are not directly comparable. Therefore, it is unclear whether the evaluation is for alternatives to network administration, StateGovNet or Vermont Citizens Access Telecommunications System (VCATS). Therefore the approach that was taken was with regard to collaboration of technology on a conceptual level, involving the specific parties listed in the legislation.

An important point to consider with regard to this task is that an extensive analysis of the feasibility of consolidation and collaboration among the identified parties is now underway. Vermont Technical College (as administrator) has received $91,445 in funding from a Telecommunications Information Infrastructure Applications Program (TIIAP) grant from the US Department of Commerce. The goal of the planning grant is to determine in what ways the primary players of Fletcher Allen Health Care, University of Vermont, Vermont State Colleges and Vermont Interactive Television, and the state of Vermont as an interested party, can work collaboratively to maximize the use of their resources and the delivery of services and programs to the citizens of Vermont. Vermont Technical College’s grant application says: "The final product will be an action plan indicating how the partners will proceed to implement cooperative purchasing, building, budgeting, programming and facility usage plans to ensure widespread access and enhanced use of the state’s telecommunications infrastructure." The study is targeted for completion by the end of 1997.

8.2. Government

Coordination of government technology resources is already established by Bulletin No. 1.5, July 1, 1994, Information Resource Management Advisory Committee (IRMAC). That Bulletin specified that "The IRMAC will develop and support the capacity to coordinate technological issues across organizational lines." The membership of IRMAC was initially defined to consist of:

The bulletin establishes a formal means for members of the executive, judicial and legislative branches to collaborate on technical and operational matters.

8.3. VTMEDNET and GOVnet

VTMEDNET is a telecommunications service supported at a grass-roots level by Fletcher Allen Health Care, UVM College of Medicine, Vermont Hospital Association, Vermont Medical Society and NYNEX. It is available to all physicians in Vermont, with local dial-up service and a menu-driven interface. It provides access to the following services:

Collaborative efforts between VTMEDNET and GOVnet were explored a few years ago, according to people interviewed in focus groups. No additional activities resulted from the efforts, in part due to concerns about patient confidentiality. Although the two networks share no formal collaborative efforts, they do act on information dissemination opportunities as they arise. Such areas include health care policy, public health and consumer health information.

Fletcher Allen Health Care (FAHC) has obtained a Certificate of Need (CON) to proceed with its Information Technology Plan of August 1995. The original plan included an expansion of VTMEDNET [ The expanded network will be called Vtmednet Plus.] , with greater information sharing among health care providers throughout the state. As a first step involving potential collaboration, the Agency of Human Services is developing plans that would enable greater information sharing between FAHC and the Vermont Department of Health. FAHC is proceeding with expansion plans for VTMEDNET, which includes expanding its physical network. In a coordinated effort, the Agency of Human Services is developing preliminary plans for laying fiber optic cable in Burlington, where FAHC and the Vermont Department of Health are located. The fiber optic cable would physically connect the network that supports VTMEDNET with the network that supports GOVnet. Plans for information sharing will be developed at a later date.

VTMEDNET and the Health Department have been working closely for the past two years to provide the rapid dissemination of public health information to health care providers across the state via the Internet. It is frequently easier to collaborate on information sharing than on technology sharing. [ Dr. Julie McGowan, personal note, 12/29/96.]

8.4. Funding Issues

In examining opportunities for collaboration, it is instructive to review the sources of funds for each entity. Those entities with similar sources of funds have a better opportunity for collaboration. This assumption is based on the premise that if two organizations have similar funding streams, and differing technology objectives, the funding source has the leverage to resolve the differences. Conversely, if two organizations have different funding streams, and different technology objectives, there is less leverage to resolve the differences. Given this assumption, collaborative opportunities are evident from the following table.


Organizational Entity

Source of Funding

University of Vermont

66% tuition, 15% state, other

Vermont State Colleges

n/a

Vermont Interactive Television

61% state, 29% sales, 10% federal (FY 1996)
73% state, 27% sales (FY 1997)

Executive Branch
Judicial Branch
Legislative Branch

State revenues

Vermont Public Libraries

Federal, state and local revenues

VTMEDNET

Primarily FAHC, although grants are desirable; donations of time and resources are provided by Dana Medical Library, UVM College of Medicine, Vermont Medical Society and others

Health Care Institutions*

Patients and employers: Insurance, managed care, self-pay

Schools

Local and state revenues

* [Health care institutions could include any combination of health care providers, including individual physicians’ offices, clinics, chiropractors, group practices, visiting nurses, etc. A thorough assessment of their combined needs is outside the scope of this project.]

8.5. Program and technical issues

In addition to funding sources, potential collaborative opportunities should be evaluated along two other dimensions: program objectives and technical considerations. In considering the technical dimension, substantially more issues must be reviewed, including governance, security, confidentiality as well as the purely technical concerns (protocols, bandwidth, network management, etc.).

Collaboration due to similar objectives has occurred through VTMEDNET. On an informal basis there has been some sharing of resources through common objectives. As described at the beginning of this section, the TIIAP grant will focus on generating a plan for resource sharing.

8.6. Summary of Findings

There are plenty of opportunities throughout Vermont for discussions of cooperation and collaboration to occur. Technical issues do not appear to constrain collaboration. The more difficult hurdles appear to be sources of funding, differing organizational objectives, ability to commit resources to collaborate, and ability to administer shared resources across organizations

Sharing of information may be easier to achieve than sharing of technology. Due to the sources of funding, opportunities for technology collaboration may be greatest through IRMAC, which has the responsibility on a state-wide basis to evaluate technology opportunities across state government.

A comprehensive state-wide review of collaborative opportunities is beyond the scope of this project. However, a 10 month project which studies this question in detail is underway, and is expected to be completed by the end of 1997.