NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.

United States Department of Commerce
National Telecommunications and Information Administration
Telecommunications and Information Infrastructure Assistance Program

Ohio Valley Community Health Information Network

Co-Principal Investigators: Anne S. Goss, M.L.S., Assistant Dean of Libraries and Director, Health Sciences Library, Ohio University; Richard C. Howe, Ph.D., Associate Senior Vice President and Associate Director, University Hospital Computing Services, University of Cincinnati; John R. Kues, Ph.D., Assistant Dean for Continuing Medical Education, College of Medicine, University of Cincinnati; Stephen A. Marine, M.L.S., Associate Director, Medical Center Libraries, University of Cincinnati; Leslie C. Schick, M.S.L.S., Associate Director, Medical Center Libraries, University of Cincinnati; Gaylene Tsipis, M.S., Associate Director, Drug and Poison Information Center, University of Cincinnati

Collaborators: Jack M. Cook, CEO, University Hospital, University of Cincinnati; Donald C. Harrison, M.D., Senior Vice President and Provost for Health Education, University of Cincinnati; John Hutton, M.D., Dean, College of Medicine,University of Cincinnati; Andrea Lindell, D.N. Sc., Dean, College of Nursing and Health, University of Cincinnati; Nancy M.Lorenzi, Ph.D., Associate Senior Vice President, University of Cincinnati; Steve Shoemaker, TriState Online; Leonard T. Sigell,Ph.D., Director, Drug and Poison Information Center, University of Cincinnati; Victor D. Warner,Ph.D., Dean, College of Pharmacy, University of Cincinnati; David G. Whitten, M.B.A., President, University of Cincinnati Medical Associates

1. Introduction

The University of Cincinnati Medical Center (UCMC) is submitting this demonstration grant proposal to provide easy, equitable, and widespread access to health information to citizens of the Ohio Valley, including southern Ohio from Marietta to Cincinnati, northern Kentucky, and southeastern Indiana. Working in partnership with a large number of community groups and organizations, telecommunications access providers, public libraries, health clinics, and hospitals, the University of Cincinnati Medical Center has been a leading member of the Ohio Valley Community Information and Technology Providers (OVCITP), which has created an integrated information delivery model to:

* address the health, educational, and community/public information needs of the Ohio Valley; the first two needs are being addressed by this and two other complementary and cooperative NTIA/TIIAP demonstration grants (see Conceptual Model in Appendix 1);

* provide an integrated technical infrastructure through a NTIA/TIIAP planning grant (see Planning Model in Appendix 2).

The other two OVCITP demonstration grant proposals are:

* Ohio Valley Community Education Information Network

* OVCITP Universal Service and Interoperability (US & I) Demonstration Grant

The OVCITP planning grant proposal is:

* OVCITP Universal Service and Interoperability (US & I) Planning Grant

2. Organizations

Two primary sponsors of this grant proposal are represented by Principal and Co-Principal Investigators:

* University of Cincinnati Medical Center

* Ohio University Health Sciences Library

Both of these organizations are uniquely positioned to be a successful partner in such an initiative. As two large state-assisted universities in Ohio, they support major academic, research, clinical, and outreach efforts at opposite ends of the Ohio Valley region.

For detailed descriptions of the capabilities of these organizations, see the "Applicant's Capabilities" section of this proposal.

3. Objectives

The objectives of this project are:

1. To provide easy, equitable, and widespread access to health related information resources to the general public in the Ohio Valley region, particularly rural Appalachian and urban minoritypopulations.

2. To provide comprehensive training programs for these health information resources by working with community and regional partners.

3. To use the existing telecommunications and hardware infrastructure to extend health, educational, and community/public information resources to as many citizens of the Ohio Valley region as possible.

4. To contribute to the comprehensive plan (OVCITP Universal Service and Interoperability Planning Grant) to extend the information superhighway to all citizens of the Ohio Valley region.

5. To facilitate the development of managed health care by contributing to the health education and awareness of citizens of the Ohio Valley.

4. Systems

Via strategic partnerships with hundreds of Ohio Valley agencies and businesses, this proposal will build on and enhance use of the existing "mixed environment" infrastructure. The approach is inclusive and flexible in that it builds on the Internet, state supported educational networks, regional telephone companies, cable companies, and regional online service providers, both freenets and commercial providers. Although this proposal does not specify immediate connectivity with the University of Cincinnati/Cincinnati Bell Telemedicine Joint Venture or the NTIA/TIIAP planning grant proposal being submitted by the Ohio Supercomputing Center and the seven Ohio schools of medicine, it is certain that this, and other new, connectivity will evolve rapidly. The technical infrastructure detail, including network specifications and client/server hardware, is discussed in Appendix 3. All infrastructure development in this proposal is compatible with and will contribute to the Ohio Valley Universal Service and Interoperability Planning Grant.

5. Services

Health Information Resources

* drug information * alternative therapies

* disease information * insurance / health planning

* physician referral / find the expert * health literature

* wellness / general health

See Appendix 5 for details about the needs assessments.

The Health Information Resources Selection Committee reviewed 75 electronic health information resources, assessing their value based on relevance to a stated need and on quality. The Committee evaluated those not available readily from another site via the Internet using criteria previously developed and successfully used by the UCMC Libraries for the selection of other electronic resources (see Appendix 6 for a description of the evaluation criteria). The Committee selected 15 resources that will directly meet one or more of the expressed needs (see Appendix 7 for descriptions of these electronic resources). In addition, resources that are accessible via Internet will be made available through links to OhioLINK, health sciences Gophers, and file-transfer-protocol sites (see Appendix 8 for descriptions and examples of Internet resources).

Access

Providing the general public, particularly rural Appalachian and urban minority populations, easy, equitable, and widespread access to electronic health information resources has not been attempted before on a large scale. Presently, to find such resources the ordinary citizen usually visits a public library, which usually does not have a wealth of health care information, or an academic health sciences library that allows the general public to use its resources. Three approaches will provide access to a broad population:

1. Personal Workstations

TriState Online (TSO) will offer access to health information resources to all its members. Since the cost of membership is nominal, virtually anyone with a home computer in the Tri-State region will have access. The Southeastern Ohio Regional Freenet (SEORF) and the Dayton Freenet will offer the same access to residents of the southeastern Ohio counties and the Dayton (Ohio) metropolitan area that they serve (see Appendix 9 for descriptions of freenets).

2. Public Workstations

Public libraries, health clinics, hospital waiting rooms, and pharmacies in the region will house public access workstations. Citizens who do not own personal computers will be able to access health information resources via approximately 40 dedicated workstations connected to the resource providers via TSO. The same workstations will also be able to access information resources provided by the other two OVCITP demonstration grants. The project managers of the three demonstration grant projects, including as much as possible other similar and complementary initiatives, will coordinate the placement of public workstations/kiosks to avoid duplication of effort and to integrate access to all resources. For a list of potential workstation sites see Appendix 10.

3. Person-to-Person Service

The information needs assessment surveys and focus groups conducted for this grant proposal revealed strong needs for drug information. In addition to the electronic drug information resources included in this proposal, pharmacists in the Cincinnati Drug and Poison Information Center (see Appendix 11 for a full description) will provide information via an 800 number and electronic mail.

Education and Training

Many health information resources, regardless of format, are complex. Even sophisticated users require training in some cases. A training effort of broad scope is necessary to make these resources usable by the general public. This training program will complement, not duplicate the training proposals of the other OVCITP grants. To meet the training requirements of the diverse users among the general public, a multifaceted approach is necessary. The foundation for such a program is effective trainers. Two librarians dedicated to this project, with the assistance of Cincinnati Community Video (CCV) (see Appendix 12), which will contribute curriculum development expertise, will develop and conduct training workshops on the use of health information resources. Other librarians from the UCMC Libraries and the Ohio University Health Sciences Library also will contribute to training efforts.

1. In-Person/On-site

Public libraries, public schools, community access cable agencies, the University of Cincinnati Medical Center Libraries, and the Ohio University Health Sciences Library will provide training facilities for the grant librarians to provide in-person, on-site training.

2. Video

With the CCV's curriculum development expertise and the production facilities of WCET (see Appendix 13), the grant librarians will develop five training videos. Ohio Valley citizens will be able to borrow the videos from public libraries, or, for a nominal charge, buy personal copies. Grant librarians will also use these videos in on-site training sessions.

3. Broadcast Video

WCET, which reaches over 600,000 homes via Channel 48 and about 180,000 homes and 300 schools via its Cable channels, will broadcast each of the five training videos ten times. Ten broadcasts will be over Channel 48; 40 over the Cable channels. WOUB in Athens will also broadcast the training tapes.

4. Broadcast Interactive

WCET, via Channel 48, and WOUB in Athens, will broadcast four televised interactive training programs to citizens of the Ohio Valley region. The programs will feature a panel of experts fielding telephoned questions from the general public.

The costs of maintaining information resources, access, and training programs project will be funded beyond the period of the award through vendor support and, if necessary, through cost sharing among project participants and the governmental jurisdictions of the region.

6. Geographic Location

UCMC will serve as headquarters for the project. Access to the information resources of the OVCITP proposals will extend from southeastern Indiana and northern Kentucky to all southern Ohio from Cincinnati to Marietta. Maps of the region included in the "Maps" section of this proposal show the various public access sites described in the previous section.

7. Evaluation

The project will be evaluated in a manner similar to the initial needs assessment: a series of interviews, focus group meetings, andonline surveys of users. The University of Cincinnati Medical Center has adopted a continuous quality improvement approach to decision making that includes gathering data from as many people and sources as possible.

Project evaluation results will be disseminated in several ways. Project staff will publish articles describing the project in peer reviewed information service and technology journals, and will make presentations at the meetings of appropriate professional organizations. Information on the project will alsobe made available via the Internet from the UCMC gopher. In addition, the UCMC partnership with WCET will provide other options for soliciting evaluations and disseminating information.

8. Timetable

The first six months of the project will be devoted toplanning, consultation, site preparation, and staff training. For the following twelve months, the demonstration grant will beimplemented. Data gathering and evaluation will commence and run parallel withthe implementation. A detailed project plan is included as the "Project Timetable" section of this proposal.

9. NII Goals

This project expands upon the existing telecommunications infrastructure in the Ohio Valley and will contribute to its long-term development by demonstrating compatibility with the OVCITP Universal Service and Interoperability Planning Grant. More of this region's citizens, especially rural and minority populations, will have easy and equitable access to the nation's information highway including resources throughout the region, nation, and beyond. In close coordination with the other OVCITP demonstration grants, the University of Cincinnati Medical Center with its community partners will deliver health information resources over a complex but coordinated system of existing and new telecommunications links.