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Weekend edition September 09, 2022 | Tom Ballard

Nondescript building near downtown Knoxville houses cutting-edge technologies

By Tom Ballard, Chief Alliance Officer, PYA

In a fairly nondescript building on a hill just east of Knoxville’s Old City, Covenant Health houses cutting-edge technology capabilities to serve its own needs on the healthcare front as well as those of companies in the information technology (IT) sector.

The structure, once known as the Fort Hill Building and housing Knox County government offices, is home today to Covenant affiliate TenHats, an information technology managed services firm and major data center for the region, and Covenant Health’s Tele-ICU and Virtual Care Operations Center. Both represent investments by Covenant in technologies to support the system’s healthcare needs as well as its own IT requirements and those of companies in the region.

We had the opportunity recently to tour both facilities and get briefings on each from Brian Strong, Chief Executive Officer of TenHats, and Mandy Halford, Senior Vice President and Chief Medical Informatics Officer at Covenant Health, respectively.


There’s usually some sort of meaning in the name chosen for a business, and that is certainly the case with TenHats. As Strong told us, “The name is emblematic of what we do. It’s wearing whatever hat or hats you need us to support.”

He’s referring to the IT areas that the team can support. They include: (1) managed IT resources; (2) helpdesk services; (3) cybersecurity; (4) private and public cloud hosting; (5) back-up and disaster recovery; (6) Microsoft licensing; (7) Internet service consulting; (8) colocation; and (9) Infrastructure-as-a-Service; and network infrastructure.

“Our clients can outsource to us whatever is not in their core competency,” Strong said. “We’re set-up for large, complex networks.” That comes as a result of supporting Covenant and its numerous hospitals around the region as well as a number of other clients.

At the same time, he’s quick to add that TenHats can also serve companies of any size . . . from 10 to 10,000 employees.

Noting that Knoxville has not had a real data center since the Digital Crossing closed several years ago, Strong says that TenHats can provide a range of colocation services, whether it’s 10 gigabytes or 10 racks of servers. The data center has a substantial foundation, one that can sustain an F3 tornado, and significant, redundant security. Seven carriers also serve the facility, and it is further fed by two different Knoxville Utilities Board substations.

One of the distinctive capabilities that underscores the work of TenHats is the history of its core team. Many are alumni of Claris Networks LLC, a Knoxville-based company that was acquired in 2015 by TekLinks, Inc. That previous work experience is a valuable asset to TenHats.

“We learned how to scale a business and work together,” Strong says, adding that a group of Claris alumni gathered about five years ago and said they wanted the opportunity to work together again. That’s now a reality.

His goal is to build TenHats into a 60- to 80-employee organization with 300 customers as the IT firm partners and grows with those customers.

 Covenant Health Tele-ICU and Virtual Care Operations Center:

About a year ago, Covenant, the area’s most comprehensive healthcare delivery system, and Hicuity Health, the nation’s leading provider of high-acuity telemedicine services, announced the launch of an innovative virtual health initiative that offers a full complement of telehealth services for patients in intensive care units at Covenant’s member hospitals.

In so doing, Halford, an Internal Medicine Physician who grew up in Clinton, said that Covenant became the first health system in East Tennessee to provide tele-ICU services, as they are called, as an extra layer of care for critically ill patients. The service, which was launched at Fort Sanders Regional Medical Center in Knoxville, is now available at all nine Covenant locations.

“The biggest drivers for virtual care are quality of care, convenience, and affordability,” Halford explains. Tele-ICU allows critically ill patients to remain in a hospital in their home communities where family and other support system players are more readily available. At the same time, it also provides additional support for physicians and other members of the bedside clinical team who are taking care of these patients.

In other words, it’s the proverbial “win-win” for everyone.

The Knoxville Virtual Care Operations Center, located on a floor of the building that also houses TenHats, is staffed around the clock with critical care nurses and physicians from both organizations. These professionals work virtually alongside hospital staff to proactively evaluate high acuity patients and anticipate medical needs before they become urgent.

You might be asking, “How does all of this actually work?” Here’s the answer.

  • Each tele-ICU room at one of the Covenant hospitals is equipped with a camera, microphone and monitor that enables two-way communication between the critical care team at the hospital and a remote virtual team located at the secure tele-ICU operations center.
  • The hospital care team can consult with the tele-ICU team by phone or via the camera/monitor in the patient’s room. The camera allows a tele-ICU physician at the remote operations center to see the patient and bedside caregivers at the hospital. The patient and care team at the hospital can see and talk with the tele-ICU physician via a microphone and computer monitor.
  • The camera is activated by the critical care team only when needed, and video/audio communications are never recorded. When the camera is off, it faces the wall and does not capture video or audio.
  • In addition to visual monitoring, the tele-ICU team at the clinical operations center can assess the patient’s condition through remote review of vital signs, lab results and other clinical data.
  • All aspects of tele-ICU operations are secure and comply with federal patient privacy and security regulations.

Covenant also embraced telehealth technology at least in part as a result of COVID-19 when it launched its Virtual Urgent Care” initiative. It is a fast and convenient way for patients to see a clinician by video call when they are unavailable to make an in-person visit for urgent (non-emergency) medical needs. Insurance is not required for the video call with an emergency medicine-trained provider. The charge is a flat rate of $65, payable by credit card, debit card, or Health Savings Account card.

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