Connectivity and the NRHP Wide Area Network
Created in 2001, the NRHP Wide Area Network (WAN) serves members in many ways. NRHP provides IT support for the network and coordinates that support with the University of Nevada School of Medicine, which owns the backbone over which the WAN operates. The T1 and fiber WAN links NRHP members and enables high speed communication of data and video. The WAN is used as a secure conduit for patient information such as teleradiology images and other telehealth services, and it allows NRHP members to share software applications. Through connectivity management software, NRHP is able to provide monthly reports to member CEOs concerning internet utilization in their facilities. Access to the WAN is available to NRHP members as a benefit of membership. New members may be required to fund the equipment necessary to establish the link.

NRHP supports members’ email service by managing email addressing, providing shared spam management software, and providing various enhancements such as shared calendars and webmail.

Shared Data Archive
Using grant funding, NRHP developed and now maintains an electronic data archive for member use. The archive provides HIPAA compliant off-site data storage for radiology and file-based data. The existence of this data repository also positions members for the storage of electronic medical records as they are developed.

Legacy Integration Software
In conjunction with the development of the data archive, NRHP invested in an interface engine intended to enable members to more fully utilize their existing software systems by allowing the systems to communicate with each other through HL7 interfaces. For example, if a hospital has a long-term care software system that does not communicate with the hospital’s main health information system, the interface engine can enable that communication, reducing duplication of effort and enhancing productivity.

Members’ IT Staff Support
NRHP’s Regional Chief Information Officer serves as a consultant for members’ IT staff. Assistance with facility-specific issues is provided, along with help negotiating prices for IT purchases. The Regional CIO also assists members with IT planning, decision support, and hospital IT staff training.

Universal Service Fund Management
NRHP manages the process through which member hospitals receive Universal Service Fund discounts on the cost of T1 lines.

Teleradiology and the Diagnostic Imaging Solution for Rural Nevada (DISRN)
NRHP members are linked to distant radiologists through the NRHP Teleradiology Network, allowing even the most remote hospitals to have access to 24/7 radiology coverage. This network has been in existence since the early 1990s. Several years ago, NRHP undertook an upgrade of this capability by launching the DISRN project.

The purpose of DISRN is to enhance and expand telehealth capability in Nevada’s rural and frontier hospitals. DISRN enables integration of patient information with diagnostic digital images, electronic transmission of those images over a secure, redundant wide area network (WAN) to a central image archive, and a centralized information system for image retrieval and management for hospital radiology departments. The program is coordinated with other NRHP information management initiatives that will ultimately enable hospitals and physicians to share clinical and administrative information in a secure electronic environment.

First funded with a HRSA/CMP grant in 2004-05, seven hospitals received equipment and software. NRHP received a second CMP grant for 2008-09. Funds were used to add PACS/RIS capability in another NRHP member hospital, improve the RIS capability at the seven existing sites, improve electronic network capability, integrate existing teleradiology capability with distant radiologists’ Radiology Information Systems, and provide centralized technical support for the program.