By: John Shepler

In today’s healthcare landscape, broadband connectivity is crucial, driven by the increasing use of electronic health records, medical imaging, and telemedicine. When establishing an effective EHR environment, it’s essential to consider both private lines and public internet bandwidth services.

While both serve a purpose, private lines offer secure internal communication channels ideal for organizations managing sensitive electronic data. Essentially, these lines act as an extension of your network, ensuring restricted access to authorized users only.

Various options are available for point-to-point private lines, each with its own bandwidth capacity and implementation technology. T1 lines, for instance, are recognized for their widespread availability, reliability, and affordability. However, despite being sufficient in the past, their 1.5 Mbps bandwidth falls short of today’s standards for handling large file transfers, particularly those containing both text and images.

Health IT. gov suggests a minimum bandwidth of 4 Mbps for a single physician practice, enabling essential functions such as email, web browsing, EHR access, video consultations, image downloads, and remote monitoring. For practices with 2-4 physicians, 10 Mbps is recommended to accommodate simultaneous use. This bandwidth is also suitable for nursing homes and rural health clinics.

Clinics or larger practices with 5-15 physicians require 25 Mbps, while hospitals need 100 Mbps. Large medical centers or academic institutions require even higher bandwidth, reaching up to 1000 Mbps.

Published in 2010, the FCC’s “Health Care Broadband in America” report provides insights into bandwidth requirements for various medical data types. For instance, a 10 MB X-ray takes 60 seconds to download at 1 Mbps but only 5 seconds at 16 Mbps. Similarly, downloading a 45 MB MRI requires 72 Mbps for a 5-second transfer, while a 3 GB CT scan needs 4800 Mbps for the same speed.

These figures highlight the direct correlation between bandwidth and file transfer speeds. Considering the increasing complexity of medical technology and subsequent larger file sizes, it’s recommended to exceed these minimum requirements.

Beyond bandwidth, other technical factors influence performance. Symmetry, service dedication, latency, jitter, and packet loss all impact the quality of service. Dedicated private lines generally excel in these areas.

While T1 lines can be combined to achieve higher bandwidth (up to 12 Mbps) and are suitable for rural areas, metropolitan locations benefit from options like DS3 (45 Mbps), OC3 (155 Mbps), OC12 (622 Mbps), and OC48 (2.4 Gbps), all delivered via SONET fiber optic carriers.

Alternatives include Ethernet over Copper (3-50 Mbps depending on location) and Ethernet over Fiber (10 Mbps to 10 Gbps). Due to their superior performance, dedicated lines are commonly used for internet connections.

For internet access, shared bandwidth services like DSL, Cable, satellite, and 3G/4G wireless are also available. While generally more affordable, these services often lack service level agreements and typically prioritize download speeds over upload speeds.

Although internet security for shared services falls short compared to private lines, it can be enhanced using encryption methods like VPN and SSL.

Many practices find that a combination of private lines and internet service best suits their needs. While the internet facilitates patient communication, mobile app usage, and visitor WiFi, private lines are more suitable for high-speed data exchange between medical facilities and physician offices.

In today’s EHR-driven environment, practices struggling with bandwidth limitations may find that they can afford more robust solutions than they realize, thanks to the variety of bandwidth options and providers available.