Telehealth

[Commentary] The high rate of rural hospital closures is one factor driving the increasing interest in telemedicine, which uses high speed internet services to connect patients with healthcare providers. What some may not understand is that the push for telehealth may very well be the secret to advancing broadband itself in underserved communities, both rural and urban. By aligning healthcare institutions with schools and libraries that have telemedicine applications and services into a healthcare hub, a community can produce a powerful infrastructure.

The Schools, Health & Libraries Broadband (SHLB) Coalition along with 35 health care providers and telehealth networks from across the country sent a letter to Congressional leaders today asking them to support an increase in funding for the Federal Communications Commission’s Rural Health Care (RHC) program. “This is a life and death issue for Rural America,” said John Windhausen, Executive Director of the SHLB Coalition.

[Commentary] There is a national conversation taking place on how to get broadband providers to go the last mile, and strike a balance with electric utilities to utilize their existing or planned infrastructure. And, private investment remains an essential component to any broadband buildout. The Energy and Commerce Committee, of which I am a member, is currently considering legislation to streamline federal permitting processes, create common contracts for siting wireless facilities on federal properties, and create an inventory of federal assets. One of the key roles of Congress is to facilitate policy and programs that help unserved or underserved communities. The infrastructure bill that will likely be debated later this year must include provisions for rural broadband deployment.

Many bureaucrats in Washington simply don’t understand the challenges we here in Eastern and Southeastern Ohio face. We will not be left behind anymore. There’s a lot of intellectual capital here in rural Appalachia…and, America needs to start tapping into it.

[Commentary] Broadband infrastructure can help plug some of the leaks in rural healthcare services. The result can be better healthcare access and an improved local economy. Arrowhead Electric Cooperative built a fiber network in Cook County (MN) a few years ago. “Our main healthcare facilities send patients home with medic alert-type devices and even tablets to monitor recovery and ensure communication thanks to fiber to home,” says Yusef Orest, head of membership services for the co-op. “Before the network, individuals had internet access but it wasn’t fast. Now, hospitals are increasing services at patients’ home and on-site. For example, they can perform ultrasounds and radiology scans and send results instantly to bigger hospitals for analysis.”

Rural communities can learn from small towns – some in metropolitan areas and some in less populated regions – that have made it their missions to use broadband to transform the nature of healthcare and telemedicine.

[Craig Settles is a broadband industry analyst and consultant to local governments.]

President Donald Trump touted a new program to increase veterans' electronic access to medical care as part of a broader tele-health push at the Department of Veterans Affairs. The initiative connects veterans with health providers via mobile phones or computers, and is intended to improve medical care especially for those needing mental health and suicide prevention services, President Trump said. “It will make a tremendous difference for the veterans in rural locations in particular,” President Trump said at the White House with VA Secretary David Shulkin. The application allows veterans to schedule appointments via their smart phones. Shulkin also previewed a regulation allowing VA providers to provide tele-health services to veterans anywhere in the country.

Do Medicare and Medicaid pay when beneficiaries use two-way video visits to get care from their doctors? It depends. Medicare pays for some two-way video visits—referred to as "telehealth"—if the patients connect from rural health facilities. Medicare is testing new ways to provide health care that allow telehealth coverage regardless of location. Under Medicaid, states may cover different types of telehealth services from different types of care providers. In the 6 states we reviewed, officials from states that were generally more rural said they used telehealth more frequently than officials from more urban states.

The Federal Communications Commission’s Connect2Health Task Force announced updates to its Mapping Broadband Health in America platform. The 2017 platform now reflects the latest complete annual fixed broadband dataset from the Commission and updated health data from the Robert Wood Johnson Foundation’s County Health Rankings. As telehealth, telemedicine, and other cutting-edge mHealth initiatives gain momentum across the country, this web-based mapping platform enables more efficient, data-driven decision making at the intersection of broadband and health.

I am pleased that the Commission is demonstrating its continued commitment to the Connect2HealthFCC Task Force and the Mapping Broadband Health in America platform with the release of today’s update. For far too many rural and underserved consumers, the broadband health picture remains bleak By investing in this vital broadband health mapping platform and unveiling a new list of critical need counties, the Commission is providing the data needed to ensure connectivity reaches those communities most in need. I am confident that when relevant stakeholders work together across sectors, we will successfully break boundaries at the intersection of broadband and health policy.

[Commentary] Reverting back to a voluntary approach to network neutrality potentially threatens the well-being of many people, particularly those at risk for health disparities due to low income or rural residency. Not only does this voluntary approach shift winners and losers to favor large telecommunication giants, we are specifically concerned with several areas of health care being negatively impacted, including innovative solutions for telemedicine, health enhancement, and cost effective scalable sharing of health care data.

In summary, the new FCC may be proceeding in directions that may make it harder to use telehealth, cloud-based EHRs, and remote sensing technologies that improve access to care and potentially lower costs for all. A thoughtless move toward free enterprise on the Internet could have a negative impact on the health of the most medically underserved Americans. We urge the FCC to investigate the unintended consequences of policy changes to insure that they do not amplify issues of health disparities in lower income and rural populations.

TeleQuality Communications filed comments urges changes to the Federal Communications Commission rural healthcare-broadband programs, arguing that the Universal Service Fund (USF) rural healthcare, telecom and e-rate schools and libraries programs would be more effective if they did not operate as isolated silos. TeleQuality, an organization that provides network connectivity for healthcare providers funded, in part, through the USF rural healthcare program. The filing includes some compelling data points, along with some creative ideas for potential reforms to FCC rural healthcare-broadband programs – although some readers may find some of the ideas unrealistic. The most compelling data points in the TeleQuality filing:

• The number of physicians serving rural areas is insufficient. The filing cites a Health Resources and Services Administration (HRSA) report that found that a majority of rural counties have 1 practitioner serving 3,500 patients when 1 practitioner per 2,000 patients is recommended for adequate care – a finding that confirms similar data that Telecompetitor has reported previously. There is also a shortage of skilled IT personnel in rural areas, TeleQuality argues – another data point that is consistent with previous research on that topic.
• The number of FCC rural healthcare funding requests from healthcare providers has not increased as dramatically as the amount of funding requested – a phenomenon the filing attributes to the significant bandwidth increases needed to run electronic health records systems. At the same time, the FCC program remains underutilized because some healthcare providers do not have the resources to handle program filing and administration.