COMMUNITY NETWORK

Community network infrastructures are supposed to provide ubiquitous access, full area coverage, accessibility from a variety of user devices, quality of service, among others. Due to these characteristics, community network infrastructures as opposed to usual public telecommunication services provide the right platform for implementing telemedicine services in a given city or region. In fact, telemedicine is often one of the main applications that drive the development of community networks. Wireless technologies are particularly suitable for building community networks for several reasons, including ease of installation and expandability, affordable costs and the availability of a range of state-of-the-art technologies, starting from the ubiquitous Wi-Fi through Wi-MAX and 3G mobile. In this paper, planning guidelines of wireless community networks and the authors experience in practical wireless city/region projects are presented. The requirements of telemedicine applications are dealt with first. Currently available and emerging broadband wireless and mobile technologies for community networks (Wi-Fi mesh, fixed and mobile Wi-MAX and 3G mobile) are then considered and compared based on technical parameters, availability, timescale of implementation, regulatory issues and costs. The aim of this discussion is to provide a basis for technology selection. Planning of community networks should also include the selection of an appropriate business model that makes the community network infrastructure sustainable. Finally, several case studies are summarized, including European community network projects and test-beds planned by the author and his team. Winona has been designated as a community in the Beacon program that will implement an expanded use of broadband technologies for internal hospital operations and for community wide Telemedicine. This program is also referred to as the Winona Deep Dive. Winona Health is in a unique position to implement these additional broadband strategies. Winona Health has been a beta site for Cerner Software development for 10 years and has been recognized as one of the top 10 Health IT enabled regional hospital systems for the past 8 years. Cerner will be a participant in developing these new medical applications and connections to the core HIT systems at Winona Health. Many other organizations in Winona have also committed to implement this expanded use of broadband enabled Telemedicine.

The new broadband network will be called the Winona Community Telemedicine Network (WCTN). This network will be hosted by Hiawatha Broadband, a local broadband network operator that already serves the participating organizations. It will provide a secure, HIPAA compliant, high capacity system that connects all participants in the program. This network will provide a minimum of 40 Telemedicine stations located at public schools, public subsidized housing, older adult assisted living and nursing home facilities, the county jail, group homes for the disabled, St. Marys University of Minnesota, Cotter Private Schools, and Winona County agencies that serve these populations. Each location will be given a shared access multi-media Telemedicine station that includes live encrypted video conferencing. These stations will support remote medical data collection, patient assessment, confidential access to personal health records, and communications to all healthcare services on the network. Winona Health will be implementing the needed technology for all of its internal operations to utilize the new telemedicine network. The WCTN will allow Winona Health and other providers to evaluate the addition of telemedicine to the care plans for the diabetes and juvenile asthma patients that will be part of the Beacon Program. Home and Community Options (HCO) will also be receiving technology upgrades for its Winona operations serving the disabled. HCO is already a recognized leader and innovator for using remote monitoring and other broadband enabled services for its residents. The Beacon program will extend their service profile to include the use of Telemedicine for their served population of persons with disabilities. Providing broadband access to citizens, communities, public institutions and developing businesses has become a strategic objective for governments and international organizations worldwide. In particular, serious problems related to the digital divide have been widely recognized by public administrations. Therefore, a large number of initiatives, under the collecting name community networks have been launched in North America as well as in Europe. By creating telecom infrastructure in underserved regions, local governments can prevent remote communities from digital divide, and are able to create a healthy climate for economic development, help startups grow, bring new businesses into the region.