Making Rural Health & Well-Being a Reality Through Telehealth is Possible with Fiber

Case Study

Internet connectivity has changed how we work and play, and over the last decade it has been steadily impacting how we access healthcare. One such advanced practice that shows promise for rural communities is telehealth – considered to have a bright future in rural healthcare. According to the Mayo Clinic, telehealth is “the use of digital information and communication technologies, such as computers and mobile devices, to access healthcare services remotely and manage your healthcare.” Every sector of healthcare is utilizing telehealth in one way or another, but not every healthcare provider has the connectivity needed to deploy telehealth services.

Aspire Indiana is a fully integrated health system that addresses behavioral health, primary care, substance use disorders, and the social determinants of health, including housing and employment. It also provides HIV services, deaf services, veterans programs, and advocacy for abused and neglected children. Aspire aims to make health and well-being a reality for the community and to take care of people who may be neglected in traditional healthcare spaces.

With 20 facilities in five Indiana counties and 500 employees serving 20,000 patients per year, it’s imperative that Aspire’s healthcare staff be able to communicate with one another and with their patients. This is particularly vital for mental health services – workforce shortages of psychologists and psychiatrists mean fewer professionals are available in the Aspire system at a given time.

Wanted: Faster, More Reliable Service

For years, Aspire Indiana had been running on a Multiprotocol Label Switching (MPLS) network. They were constantly trying to move faster and do more for a lower cost but were unable to do so with their current system. In short, the MPLS network was not reliable, it was expensive, and it was hard to fully understand. Frustrated with recurring issues and having to maintain over 100 servers and countless software, Aspire Indiana began a new strategy.

The company signed up for rural health association funding through the Indiana Rural Health Association (IRHA) – an organization dedicated to improving the health of Hoosiers in rural communities – to receive help in funding fiber builds to their many locations. IFN was on IRHA’s list of providers and took a simple approach to design Aspire’s point-to-point network.

“Others were overthinking it,” said Aspire Indiana CTO David Speicher. “The process with IFN went smoothly. They outlined what we could expect in terms of dates of completion, what was happening when, what to expect throughout, and what they needed from us. The implementation went really well.”

IFN laid fiber for Aspire and built 10 circuits for eight facilities in two stages. After funding was completed, the process took 90 days to build the fiber for five circuits. A few years later, IFN did the construction and built another five circuits, again in 90 days.

“Our high quality, reliable internet has helped change our culture,” said Speicher. “We do nearly 1,000 video calls a month for both meetings and telehealth. That would not have been possible before IFN.”

Since working with IFN, Aspire has saved over $100,000. They pay for the circuits, but with funding and by working with IRHA, they have better fiber for cheaper than the cost of the old MPLS.

“The true ROI is how fiber enabled us to really leverage the cloud in ways that are unique to Aspire,” explained Speicher. Aspire has moved to utilizing native Google cloud services, allowing all tools to be delivered over the internet. This means the quality of the connection is even more vital. “Aspire has these ‘Big Hairy Audacious Goals’ to be 100% in the cloud in three years. IFN has been a big part of that. We’re moving all our tools to modern architecture cloud services. We’re down from just over 100 servers that we had to watch over, power, cool, endlessly patch and plan on replacing to just 25. We celebrate every time we turn one off.”

Another “Big Hairy Audacious Goal”? Aspire aims to extend lives in the community it serves by 10 years in 10 years. People who suffer from mental illness or substance abuse die 15-20 years before the rest of population. Aspire provides both mind and body care together to address all aspects of their lives that may be impacting their health, from mental health, to physical health, to social determinants. Telehealth is essential for this care. It can get the right people in front of a patient at the right time – it just may be on a tablet or laptop instead of in person.

Fiber allows modern cloud architecture to work quickly and smoothly. “I would absolutely recommend other healthcare groups take the steps to serve rural communities and work with IRHA. This program has allowed us to move faster than any other tech infrastructure project. Every single healthcare facility should be looking at telehealth and applying for that funding.”