How one state’s unique approach to broadband is saving lives

Broadband isn’t just about faster speeds. It’s reshaping how communities access healthcare, education, and innovation.

In this episode of Connected Nation, host Jessica Denson talks with Tracy Doaks of MCNC and Dr. John Graham of NCTNA at Fiber Connect 2026. They explore how North Carolina’s statewide fiber network is powering everything from AI research to “medical-grade” connectivity that supports telehealth across rural communities.

Related links:
MCNC website

NC Telehealth Network Association website

MCNC on LinkedIn 

NC Telehealth Network Association LinkedIn

Tracy Doaks' LinkedIn

Dr. John Graham's LinkedIn

Transcript

Jessica Denson, Podcast Host (00:07):

This is Connected Nation; an award-winning podcast focused on all things broadband. From closing the digital divide to improving your internet speeds, we talk technology topics that impact all of us, our families, and our neighborhoods.

(00:22):

On this episode of Connect Nation, I talk to leadership from two unique organizations in North Carolina. One is building and improving broadband infrastructure in such a way that it's caught the attention of AI giants such as NVIDIA. And the other organization is making sure that connectivity is not just innovative but lifesaving. I'll explain, I'm Jessica Denson and this is Connected Nation.

(00:55):

 I'm at Fiber Connect 2026 taking place in Orlando, Florida, May 17th through the 20th, and I am now sitting with two wonderful guests who I'm very excited to talk to. They are Tracy Dokes, who's the president and CEO of MCNC and Dr. John Graham, who is with NCTNA.

(01:12):

And I realized, Dr. Graham, that I did not ask you your title. What is your title?

Dr. John Graham, Pres., NCTNA  (01:15):

Well, I recently retired from our operations, but I'm the president of the board, right?

Jessica Denson, Podcast Host (01:19):

President of the board. Yeah. So, uh, pretty important. I should not, I should have had that

Dr. John Graham, Pres., NCTNA  (01:23):

Correct. No

Jessica Denson, Podcast Host (01:24):

Problem. <laugh> Well, uh, let's dive right in because both of these, these two are so important. They're about to do another panel in about 20 minutes or so. So this is going to be a quick interview but a good one. So let's start with you, Tracy. Tracy, talk about what MCNC is and what you guys do.

Tracy Doaks, Pres. & CEO, MCNC (01:40):

Yes. And so MCNC is a research and education network. We run, uh, about 5,000 miles of fiber infrastructure across North Carolina. Some of it is utilized for our research and education network where, uh, the K through 20 education, um, sits on that network that includes, um, public universities, independent universities, um, the K through 12 community and community colleges. But where John and I intersect is that we also run the telehealth network, um, across North Carolina. Uh, I'll let John talk more about that, but that is a really big part of what we do and, um, with the focus on the rural communities. As you also know, you've talked to Beau- mm-hmm. ... uh, from Encore and that partnership over the last year has been based on our middle mile that we have throughout North Carolina and what they do in the last mile for residential in the rural parts of our state, which we really need.

(02:44):

We are one of the, um, higher percentage of rural, um, communities across the country. And so the work that we do with Encore is incredibly important and then folding in that partnership with NCTNA, which I know John's going to talk about a little bit more, has been a real focal point for us over the last year. In addition to that, because we do support education, we've had our research community ask us to build out more infrastructure for AI for them, which is new for us. We did, uh, receive a, a grant through the National Science Foundation to do a GPU as a service pilot with a number of universities and that's gone very, very well to partnership with Lenovo and NVIDIA and all of the usual suspects. <laugh> And so, uh, you know, one of the bigger efforts that's coming up is, uh, an expansion of data center, not an expansion of our own, but in addition to the one that we have.

(03:47):

And so as you can imagine, you know, we want to make sure that we are good stewards of the, the, um, funding that we get as well as, um, the, the prices that are paid through, um, for our services to, um, build out something that is useful and affordable so that researchers can do additional research around AI and quantum. So that, that's also a big piece of what we're doing in the future.

Jessica Denson, Podcast Host (04:14):

New f- for you guys, new for everyone right now. <laugh> Absolutely. Yeah. Um, so be- I'm going to come to you in just a moment, Dr. Graham, but, uh, expand a little bit about, uh, what kind of conversations you, you, you threw out some big names there, Nvidia, the, uh, your research organizations, these, uh, talk, what are, what are the conversations like in those rooms right now?

Tracy Doaks, Pres. & CEO, MCNC (04:36):

Uh, you know, it's varied, obviously. I will talk about a conversation that I had recently with the CEO of a company called Banyan Oak. So Banyan Oak is global and they buy old manufacturing sites, um, in states modernize them for use for AI. And so, um, we've had a conversation with the CEO about their new, um, purchase in, uh, Reedsville, North Carolina, which was an old cigarette manufacturing site. Oh, wow. But it had power already on site. Mm-hmm. And so, you know, the conversation with him is the fact that AMD, NVIDIA, all of those ship makers are at the table and why that's important is the hyperscalers, you know, feel like they have the market on all of the chips. Mm-hmm. And so you can't really provide data center services like that without having access to chips. So NVIDIA, uh, reached out to me and we sat down and a lot of their conversation has been, how do we help?

(05:45):

How can we be a part of this? We know this is important for North Carolina and the researchers, what can we do? Which is a surprising conversation. Mm-hmm. Coming from, you know, for profit, we don't always get that. Lenovo, you know, very similar conversation we've had, we were fortunate enough to have a Lenovo executive on our board-

Dr. John Graham, Pres., NCTNA  (06:04):

Mm-hmm.

Tracy Doaks, Pres. & CEO, MCNC (06:05):

... who was very, very active. So those were really comfortable conversations about, "Hey, here's what I know, here's where I know we can plug in, which are, again, really great conversations to have. " And so, um, I think the real big piece here is how do we build not just the infrastructure for today, but the infrastructure too, for tomorrow when this is moving so fast.

Jessica Denson, Podcast Host (06:27):

It is moving incredibly fast. And I will say, uh, seeing some of the talks that the NVIDIA CEO has given, he seems very excited about what it can mean for humans on the human level. Yes. The human section, the century

Tracy Doaks, Pres. & CEO, MCNC (06:38):

Piece of that.

Jessica Denson, Podcast Host (06:39):

Yeah. Yes. Yeah. So Dr. Graham, let's come to you. Uh, talk about what NCTNA is, uh, how and how you work with M- MCNC, all these acronyms <laugh>-

Dr. John Graham, Pres., NCTNA  (06:49):

Right.

Jessica Denson, Podcast Host (06:50):

... um, uh, and, uh, your role with it as the president.

Dr. John Graham, Pres., NCTNA  (06:54):

Sure. Um, so NCTNA is a nonprofit like MCNC is and it’s a, a broadband provider. We provide what we call medical grade broadband, which is, uh, broadband that's very high quality, uh, because you need very high quality broadband with healthcare. Mm-hmm. Um, we're also, and we're, we have a statewide presence thanks to the president, uh, working with MCNC. Uh, and we have a focus on rural healthcare, just by way of a little background. I used to be, uh, the deputy director of an institute at the School of Public Health at the University of North Carolina and, uh, on the faculty there and we would, we were working with health departments to provide, uh, electronic health records. We were doing IT assessments, um, and some other things around IT and we realized that their broadband was just inadequate. This was 15 years ago or so. They, uh, and so we, in the end we decided, uh, if we're going to do any of these other things, we've got to get good broadband in.

(07:56):

And so a friend and I used to work at Duke and a friend in, uh, mine from Duke and I wound up starting in NCTNA, uh, to provide broadband to the rural health departments. And so we began with about 35 or 40 health departments, and we thought that was it. And because it is, we have a, a very, in terms of the requirements, we have a very substantial focus on reliability and one of the things that stood out in our, uh, sort of looking for providers and ultimately choosing MCNC was, uh, to, to find the kind of infrastructure that would provide that level of reliability. So anyway, we had then, we were able to provide a very high quality service that was dedicated to healthcare and other healthcare providers found out about it and we wound up expanding and now we have a presence in every county in the state.

(08:46):

Uh, we, about two thirds of our sites are rural, but we also, uh, have provided service or for most of them, um, health systems as well. So it's expanded dramatically be- beyond what we expected, and I think it has because it's addressed a, a true need by healthcare.

Jessica Denson, Podcast Host (09:05):

So e- expand upon that a little bit, that need. Why is it so important for hospitals, urban or rural areas to have that connectivity? Um, what does it mean to your average patient, your doctor, that type of thing? Why is, like, why does it matter?

Dr. John Graham, Pres., NCTNA  (09:21):

That's a great question. Um, so when I was working at the School of Public Health, one of my principal areas of interest was healthcare access. And in rural North Carolina, healthcare access is still poor and with Medicaid changes and that sort of things, is deteriorating. So the importance of telehealth is, has, has, has, has simply increased over time. Um, so part of our, our intention was to; to do this to expand healthcare access or really that's the fundamental intention and then to use telehealth as a, as the vehicle to do that.

Jessica Denson, Podcast Host (09:57):

And, uh, I'm going to ask you to go a little deeper. Okay. So what are some of the things that connectivity is used for? Is it just remote monitoring or what?

Dr. John Graham, Pres., NCTNA  (10:07):

There, there are lots of things. Uh, of course they're the health information exchange, electronic health records and lots of telehealth applications they would use. I'll give you an example. Uh, there are, uh, east of, in eastern North Carolina, east of I- 95, they are an area that's characterized as the stroke belt buckle. So the south is known as the stroke belt. Mm-hmm. The buckle is where it's particularly bad and, you know, we have lots of good food and bad food for your food, comfort food, that people eat all their lives. And so stroke is a real issue. We have 12, uh, hospitals that are critical access hospitals that, uh, we provide service to through MCNC and, uh, they have people presenting all the time with strokes. And as you know, stroke is, it's absolutely critical that you get, uh, some sort of, um, resolution as quickly as possible.

(11:01):

Mm-hmm. Well, there is a group at Wake Forest Baptist in Winston-Salem, which is in Western North Carolina, uh, where they have a, a specialty group of, uh, stroke experts. So we have a direct connection that allows them to be in direct contact with the internists and the hospitalists in Eastern North Carolina and they can get, uh, diagnosis and in, in some cases even treatment. All of that requires highly reliable broadband and that's one of the reasons they chose our service to provide them with the connectivity.

Jessica Denson, Podcast Host (11:33):

And so you've essentially given this, this whole other group access to these specialists that they wouldn't have

Dr. John Graham, Pres., NCTNA  (11:39):

Otherwise. And that's true across the board. And what that means is there is from a patient perspective, uh, they have determined that about 2,500 patients since we, in the last couple of years have, uh, been able to stay home, receive the care they need without having to come to, to Wake Forest Baptist. Mm-hmm. So it's very important in terms of their quality of care, but also staying in their own communities, staying with their families, all of that.

Jessica Denson, Podcast Host (12:07):

And Tracy brought up, um, the AI, the need for AI access and building that infrastructure out. Uh, for hospitals, what are you hearing from them on the AI front? Are they looking at how this can improve or, or what are they, what are they talking about?

Dr. John Graham, Pres., NCTNA  (12:21):

So AI is, uh, you may know this already, but A- the, the healthcare industry is the, is adopting AI more rapidly than any other industry. And so there are lots and lots of ways they use. As an example, I have a friend who's a radiologist. She uses AI to review images and to discard images that don't have any infer- interesting information. She says it more than doubles her productivity and most, like at UNC as one of our, uh, subscribers and members, uh, they use it to, to, uh, do, uh, note taking during physician visit, visits. And it is, I've talked with a number of physicians there and it has dramatically increased their productivity, and it's changed the way they interact with the patient. They actually have regular conversations now rather than being in front of a terminal where they're typing into an EHR. Um, they're just talking with the patients, everything's captured, summarized, and then the physician will, will look it over and make sure it's okay and then sign off.

(13:19):

So it's a big ... So there are things that are very day-to-day operations, other things that are specialist oriented, um, all of which are being adopted. And again, the, in the ... So I was at a, at UNC and at Duke, which are both major research, uh, academic hospitals and, uh, they are using it for dramatic, uh, breakthroughs really in all sorts of, uh, research, particularly in our area in oncology.

Jessica Denson, Podcast Host (13:47):

So Tracy, in addition to AI, I would think that, um, when you're dealing with the infrastructure, you have to think also about things like cybersecurity, resiliency, redundancy. How are you tackling all that and what are you hearing from people like Dr. J- Graham's organization or other organization partnerships like what they have with Encore? What are you hearing from them on those fronts?

Tracy Doaks, Pres. & CEO, MCNC (14:08):

So I love listening to John because I learned something new every single time. <laugh> I was just sitting here wide-eyed <laugh> listening to John because he's always teaching me something new and not just something new, but something new for us to take into account every time we scale and every time we think about, um, uh, enhancing this medical grade network that we've been calling it because it's, it's, it's really, really important. Cybersecurity, I can't talk about that enough and it's not just, um, the network itself, but also the, the, um, organizations and the people who sit on it. And so we were talking earlier in another panel, um, I was on about, yes, the, um, providers, um, will sit on the telehealth network, but it's the patients. How do we ensure that they've got the right level of cybersecurity to have the devices that they need to access, um, to these providers as well as, you know, any other types of things that they need to do, um, on the internet.

(15:16):

And so I'm a huge proponent of additional funding that goes to that end. And so for Encore and the work that we do with Encore, I would love to see, and this is just Tracy's wish. <laugh> I would love to see over time where, you know, we're the middle mile provider Encore is residential, but there's also another, uh, piece here around cybersecurity and the training that is going to be required, um, as it relates to that. And when you talk about, you know, AI and even quantum, um, the bad actors are going to be able to impact people faster than they were before because they're using the tools to their advantage too. And so it's really important for MCNC to stay abreast of all of those things. We are fortunate that we have a partnership with CrowdStrike. We have a partnership with Palo Alto. So we're not building these services on our own.

(16:17):

We are working with them to get the licenses but also provide the high touch managed services to, um, those folks that sit on their network and need it and we know they need it and having to go to them and say, you know, this is what we're seeing across the country and across the world as a vulnerability that we all need to be aware of, whether it's through training, whether it's through tools and technology, or whether it's through infrastructure. So the, um, network that we provide is highly secure and will continue and continue to be, but I think the major concern here is the people that access it and make sure they have the proper level of cybersecurity as well because AI and quantum is just making those- Everything. It is. Yeah. Those breaches faster, you know, and I was telling somebody earlier, I have, um, remote access to my parents' computer for that reason.

(17:17):

It's like, yeah, I, they, they don't really- That's a good idea actually. <laugh> Yeah. They don't really understand that, you know, putting your credit card in is not the right thing to do, but they also don't understand that telehealth is a better way to get access to care so you don't have to go out, um, you know, and, and travel for an hour to get to the doctor that you need. And so that's a, a sidebar. But, um, in terms of cybersecurity, that's going to be critically important for today and tomorrow and MCNC is, uh, working very hard with our research teams to build out a roadmap that, um, that ensures that cybersecurity is a part of that equation.

Jessica Denson, Podcast Host (17:58):

So I know you guys have a panel, so I have one more question and then I'll ask each of you to give us something that you really think people should take away from our conversation. And then I would love to do a follow-up with you guys to dive deeper-

Dr. John Graham, Pres., NCTNA  (18:10):

Yes. ...

Jessica Denson, Podcast Host (18:10):

Into what MCNC is doing and what NCTNA is doing. Um, you know, I was struck ... Encore told me earlier, you know, MCNC that it was amazing that we already had this infrastructure and that a lot of states have said, you know, or around you have said that we're very jealous of this. <laugh> That is true. So it's obvious, you know, yes, there are borders on our maps, but they're not borders out in the real world, you know. Uh, do you work with other states to continue what you guys are doing out around you because in your region and not just North Carolina?

Tracy Doaks, Pres. & CEO, MCNC (18:47):

So, um, there's an organization called Quilt, which is made up of all the research and education networks across the country. Um, I happen to chair the board for, um, for the quilt and I think besides us and Michigan, we are the only two that have such a widespread, um, fiber network and for the people we serve and the connections that we have on our network. I think we're one of the only states that really has a telehealth network that is part of a research and education network. Um, we have talked, especially, especially the last year about one, how does MCNC help others do the same thing that we're doing? Now, I think it's a little bit difficult because, uh, some of them are 501 some of them are connected to universities so they're different models across the country. Being a, a private, um, 501 allows us some, uh, flexibility that some of those others don't.

(19:51):

Mm-hmm. And especially if they are, um, part of the state broadband office or something like that, they've got, you know, a lot of government, um, uh, bureaucracy that they're having to deal with. And I can say that because I work for state government for 20 years. <laugh> Um, but in answer to your question, we are only doing it through talking and not execution- mm-hmm. ... at the moment. And we do need to talk more about that because North Carolina isn't the only state-

Dr. John Graham, Pres., NCTNA  (20:19):

Yeah.

Tracy Doaks, Pres. & CEO, MCNC (20:19):

... that, that falls into this. However, you do have other states that have, um, broadband that is, um, sponsored by the municipalities. Well, for North Carolina, that is illegal. Yeah. But in other places it isn't. It's possible. So you get a lot of community and faith-based organizations that help, uh, talk to, uh, those communities and help them understand the importance of telehealth and, and education and workforce development and, uh, you know, my final word on this is, you know, that's what builds thriving communities and that's why this work is so important that we do and yes, I would love to see it expanded, you know, even regionally- Yeah. ... and, uh, working towards that.

Jessica Denson, Podcast Host (21:06):

Seems like a great model. And Dr. Graham, I know you guys are up against the clock, your, your handler is standing there pacing behind you <laugh> so I have to let you go. But final word, what would you hope people take away from this conversation?

Dr. John Graham, Pres., NCTNA  (21:19):

Um, I think the importance of telehealth as a vehicle for healthcare access We saw a tremendous spike in the use of telehealth during the pandemic. 80% of patient visits were telehealth at that point. Mm-hmm. Now it's gone down to about 15 or 16%. I think people have, uh, you know, just have become accustomed to going back to the old ways. Telehealth really is a great resource, not only for primary care visits, but it's used widely for, uh, um, behavioral health very widely and it's very effective. In fact, there's studies that suggest it's even more effective for various reasons, particularly for those that have, uh, anxiety about social situations, things like that. Anyway, the point is it's very valuable and, and to do it right, people need a little training, and they need the right connectivity. And, uh, the last thing I'll say with regard to that is we're actually working on a grant with Encore to provide access to patients so they can more effectively and securely, uh, adopt telehealth,

Jessica Denson, Podcast Host (22:20):

That's fantastic. Well, I would love to do a follow-up with you both and have more time. Um, I understand why they want you, so I'm going to let you go, but Tracy Dokes with MCNC and Dr. John Graham with NCTNA. Thank you both for your time. Sure.

Dr. John Graham, Pres., NCTNA  (22:33):

Thank you so much. Thank you.

Jessica Denson, Podcast Host (22:34):

Yeah. Great.

Dr. John Graham, Pres., NCTNA  (22:35):

I'll

Jessica Denson, Podcast Host (22:35):

Continue my coverage from Fiber Connect 2026 in upcoming episodes of the Connected Nation podcast. Until then, I'm Jessica Denson and this is Connect to Nation. If you want to know more about us, head to connectednation.org and you can find our latest episodes on your favorite podcast platform.