Network Plan , Cleveland, OH 44195 FCC Healthcare Connect Fund

1. Background, Goals and Objectives of the proposed network

Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit, multi-specialty academic medical center that integrates clinical and hospital care with research and education. It was founded in 1921 by four well known physicians in the Cleveland area who had a goal to provide outstanding patient care based upon the principles of cooperation, compassion and innovation. From this, Cleveland Clinic has become one of the largest and most respected hospitals in the country.

Cleveland Clinic has over 200 facilities, mostly located in Northeast Ohio, as well as other key facilities around the country and world. Today, with more than 1,400 beds on Cleveland Clinic main campus and 4,400 beds system-wide, Cleveland Clinic is one of the largest and most respected hospitals in the country.

Its main campus consists of 41 buildings on 160 acres near University Circle, in Fairfax, Cleveland. Cleveland Clinic operates 18 family health and ambulatory surgery centers in surrounding communities, a multispecialty hospital and family health center in Weston, Florida, an outpatient clinic in Toronto, Ontario. A location in Abu Dhabi, United Arab Emirates— Cleveland Clinic Abu Dhabi—was opened in 2015.

In August 2015, the Akron General Health System in Akron, Ohio joined the Cleveland Clinic system. Akron General includes Akron General Hospital, Visiting Nurse Service and Affiliates, Hospice of VNS, Lodi Community Hospital, Edwin Shaw Rehabilitation Institute, and three health and wellness centers. In May 2017 Cleveland Clinic reached an agreement to acquire 150- bed Union Hospital in Dover, Ohio.

Cleveland Clinic has some very impressive patient care statistics: • 7.14 Million Total Visits • 220, 059 Acute Admissions and Observations • 207,510 Surgical Cases • 3584 Physicians and Scientists • 11,862 Nurses • 51,487 Employees • 18 Full-Service Family Health Centers • 10 Regional Hospitals

From modest beginnings in 1921 with 60 employees, Cleveland Clinic is now the largest employer in the region. It was able to overcome a devastating fire in 1929 which killed over 120 people including one of the four founders. With the help of community leaders, Cleveland Clinic was able to reestablish itself in temporary quarters and patient care services resumed five days later with total recovery and renovation in just a few years.

In the 1950’s and 60’s Cleveland Clinic became famous for breakthroughs related to cardiac artery care including bypass surgery procedures and techniques. In the 80’s and 90’s Cleveland Clinic pioneered breakthroughs in transplantation and the use of artificial organs. The Cleveland Clinic Lerner Research Institute conducts biomedical research in a building that opened in 1999. The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University opened in 2004. It’s a 5-year medical school track in the Case Western Reserve University School of Medicine with 32 students per class, each receiving a full tuition and fees scholarship. While most MD-granting medical schools in the U.S. are 4-year programs, the fifth year of CCLCM is dedicated to a year of research.

The Cleveland Clinic publishes the peer-reviewed Cleveland Clinic Journal of Medicine monthly, focusing on internal medicine, endocrinology, and diabetes.

It is nationally recognized as one of the top medical centers in the US and the world, particularly in technological and management systems and in the treatment of cardiovascular disease.

The Cleveland Clinic wishes to participate in the FCC Healthcare Connect Program whose goal is to connect all the remote sites to the hospital's information systems to provide a central source for patient information. Connecting the clinics to the hospital's network allows the clinics to access all of its resources including primary EMR applications, current and NextGen information services.

Our long-range vision of the Program is to enable a set of standard telehealth connection services that will interconnect throughout the region and facilitate any healthcare location in the state to share one or more telehealth services with any other healthcare location within the region and ultimately to interconnect with other health care providers on a national basis.

This RFP addresses the telecommunications and network maintenance to interconnect the main hospital and data center and the remote hospitals and multiple clinics and doctor’s offices in the area as described in the Background and Goals Section.

2. Sites that are participating in this consortium are:

HCP Site Name HCP Address NO. 11626 North Hawaii Community Hospital 67-1125 Mamalahoa Hwy, Kamuela, Hawaii 96743 14208 Cleveland Clinic - Union Hospital 659 Boulevard St, Dover, Ohio 44622 15109 Fisher - Titus Medical Center 272 Benedict Avenue, Norwalk, Ohio 44857 15109 Fisher Titus Medical Center 272 Benedict Avenue, Norwalk, Ohio 44857 18405 Lodi Community Hospital 225 Elyria Street, Lodi, Ohio 44254-1096 25587 Lodi Community Hospital Medical Group 402 Highlands Drive, Lodi, Ohio 44254 32706 FTMC - Wakeman Area Family Care Center 24 Hyde Street, Wakeman, Ohio 44889 32707 FTMC Medical Care 115 N Main St, North Fairfield, Ohio 44855 32708 Fisher-Titus Medical Care - Internal 2114 State Route 113 East, Milan, Ohio 44846 Medicine 32709 Fisher-Titus-Monroeville Family Care 136 Ridge Street N, Monroeville, Ohio 44847 Center 32710 Fisher-Titus-General Surgery Clinic 34 Executive Dr, Norwalk, Ohio 44857 32710 Cleveland Clinic - Norwalk Spine 34 Executive Dr, Norwalk, Ohio 44857 32711 FTMC- North Central Eye Associates 217 E Walton, Willard, Ohio 44890 44372 Fisher-Titus Medical Care - Family Medicine 54 Executive Drive, Norwalk, Ohio 44857 44584 FTMC - Internal Medicine 24 Executive Dr., Norwalk, Ohio 44857 46618 FTMC-Convenient Care Norwalk 368 Milan Avenue, Norwalk, Ohio 44857 52427 FTMC - Endocrinology 278 Benedict Avenue , Norwalk, Ohio 44847 56958 Cleveland Clinic - Akron General Hospital 1 Akron General Avenue, Akron, Ohio 44307 57002 Cleveland Clinic - 6780 Mayfield Rd, Mayfield Heights, Ohio 44124 57003 Cleveland Clinic - Lutheran Hospital 1730 W 25th Street, Cleveland, Ohio 44113 57004 Cleveland Clinic - 12300 McCracken Rd, Garfield Heights, Ohio 44125 57005 Cleveland Clinic - Medina Hospital 1000 E Washington Street, Medina, Ohio 44256 57006 Cleveland Clinic - South Pointe Hospital 20000 Harvard Rd, Warrensville Heights, Ohio 44122 57007 Cleveland Clinic - Chardon PT/OT 325 Center Street, Chardon, Ohio 44024 57008 Cleveland Clinic - Elko Alzheimer's Clinic 247 Bluffs Ave, Elko, Nevada 89801 57009 Cleveland Clinic - Ashland Sugarbush Eye & 21 Sugarbush Ct, Ashland, Ohio 44805 Laser 57010 Cleveland Clinic - Lakeland Eye Center 309 W Lorain St, Oberlin, Ohio 44074 57011 Cleveland Clinic - Cleveland Clinic Mohican 637 N Union St, Loudonville, Ohio 44842 Eye Center 57012 Cleveland Clinic - North Coast Cancer 509 W McPherson Hwy, Clyde, Ohio 43410 Center 57014 Cleveland Clinic - Wellington Primary Care 805 Patriot Drive, Wellington, Ohio 44090 57016 Cleveland Clinic - Avon Hospital 33300 Cleveland Clinic Blvd, Avon, Ohio 44011 57017 Cleveland Clinic Children's Hospital 2801 Martin Luther King Jr Dr, Cleveland, Ohio 44104 57018 Cleveland Clinic Florida 2950 Cleveland Clinic Blvd, Weston, Florida 33331 57019 Cleveland Clinic Main Campus 9500 Euclid Ave, Cleveland, Ohio 44106 57020 Cleveland Clinic Rehabilitation Hospital 33355 Health Campus Blvd, Avon, Ohio 44011 57021 Cleveland Clinic - Euclid Hospital 18901 Lakeshore Blvd, Euclid, Ohio 44119 57022 Cleveland Clinic - Fairview Hospital 18101 Lorain Ave, Cleveland, Ohio 44111 58998 FTMC Fisher-Titus Family Medicine 13 Tilton Street, Greenwich, Ohio 44837 Greenwich 59018 FTMC Fisher-Titus Family Medicine Willard 315 Crestwood Drive, Willard, Ohio 44890 59019 FTMC Fisher-Titus Family Medicine New 187 West Main Street, New London, Ohio London 44851 59077 Akron General IT Building 180 W Cedar St, Akron, Ohio 44307 59078 Akron Data Center 191 E Miller Ave, Akron, Ohio 44301 59079 CCF Administrative campus 3050 Science Dr., Beachwood, Ohio 44122 59080 Cleveland Clinic Data Center 8950 Euclid Ave, Cleveland, Ohio 44106 59081 Cleveland Clinic Brecksville Data Center 8002 Katherine Blvd, Brecksville, Ohio 44141 59197 FTMC New Beginnings Pediatrics Norwalk 282 Benedict Avenue, Norwalk, Ohio 44857 59199 FTMC Fisher-Titus Women's Health 38 Executive Drive, Norwalk, Ohio 44857 59263 FTMC New Beginnings Pediatrics Bellevue 1400 W. Main Street, Bellevue, Ohio 44811 59264 FTMC Executive Urology Specialists 290 Progress Drive, Bellevue, Ohio 44811 Bellevue 59265 FTMC Executive Urology Specialists 278 Benedict Avenue Suite 650, Norwalk, Ohio Norwalk 44847 59609 Cleveland Clinic Business Operations 6801 Brecksville Rd, Independence, Ohio Center 44131 59930 CCF Admin campus 2 25875 Science Place Dr., Cleveland, Ohio 64280 CCF Union Hospital Newcomerstown clinic 60881 County Road 9, Newcomerstown, Ohio 43832 64281 CCF Union Hospital Alpine Family 126 South Broadway, Sugarcreek, Ohio 44681 65077 CCF Indian River Medical Center 1000 36th Street, Vero Beach, Florida 32960 65617 CCF Martin Medical Center 200 Southeast Hospital Avenue, Stuart, Florida 34994 65647 CCF Martin Hospital South 2100 Southeast Salerno Road, Stuart, Florida 34997 65648 CCF Martin Tradition Medical Center 10000 SW Innovation Way, Port Saint Lucie, Florida 34987 69894 FTMC Norwalk Admin 3 Stower Lane, Norwalk, Ohio 44857

3. Strategy for aggregating the specific needs of health care providers (HCPs), including providers that serve rural areas, within a state or region Most of the remote clinics are small, so providing a separate EMR application for each site would not be cost effective and would make the sharing of this information with other health care providers difficult. By sharing the hospital's resources, each clinic and remote site will have access to a much broader array of information services. 4. Strategy for leveraging existing technology to adopt the most efficient and cost-effective means of connecting those providers The hospitals and clinics already have network equipment to interconnect PCs and printers. By using high speed connections and standard network equipment, the Cleveland Clinic will be able to connect the PCs and printers in the remote offices to the hospital's existing network. This will allow access to servers and applications in the hospital as well as cloud based applications available on the internet. The hospital already has an extensive network of leased facilities, which interconnects the Hospitals and remote clinics. 5. Discussion of how the broadband services will be used to improve or provide health care delivery The main data center in the Cleveland Clinic network is located on the main campus. All are interconnected with high speed communications. The hospital and clinics have direct access to the internet for cloud based services and dedicated access for such services as radiology and patient records. Remote locations are connected using mostly a combination of ISDN PRIs and high speed Ethernet and Optical internet connections. This network will support applications such-as: • Interactive video conferencing and telemedicine. • Streaming video for distance learning and continuing education. • Enabling medical record queries from multiple sources. • Transmission and receipt of imaging files. • Web-based collaboration tools for meetings and peer-to-peer consultation and interaction and for hospital administration. • Access to internet based resources for staff and patient education. The hospitals and all clinics and locations will benefit from these high speed connections. Facilities will be upgraded and expanded, as needed, for growth and new services beyond what’s mentioned above. 6. Discussion of previous experience in developing and managing health IT (including telemedicine) programs Scott Faini, Director of Unified Communications will oversee this project.

A project management plan outlining the project's leadership and management structure (a work plan, schedule, and budget) • Mr. Faini also will be the project Manager.

• Schedule: - Bid process to last 28 days with earliest contract selection date on the 29th day - Implementation of service is expected to take place within 60 days of the Allowable Contract Selection Date

• Budget: -Telecommunication Services - Annual Cost ~ $1,500,000.00 + -65% of these costs will be covered under the Healthcare Connect Fund, while the remaining balance will be paid out of the hospital's income.