Nº 3 2013 > Government and industry role models
Rural broadband to transform health care in the United States
By Deborah Taylor Tate, ITU Special Envoy for Child Online Protection
Sometimes government gets it right; even after a long, long time. That is the case with the new Healthcare Connect Fund in the United States, which is earmarking up to USD 400 million -annually from the universal service fund to expand access for rural healthcare providers to robust, high-speed connectivity.
Telecommunications and rural health care
While the original concept of assistance to rural healthcare providers was part of the Telecom Act of 1996, for years the programme languished, basically unknown and underused. I was proud to have been part of the Federal Communications Commission (FCC) when we saw this as an impetus to continue the deployment of broadband across the rural areas of the United States, as well as to ensure that rural Americans had access to the same medical research, expertise, best practices and specialists that were being offered to urban residents.
Mobile health care
In 2006, the Commission started to seek input from both healthcare and broadband providers regarding how cities, states or even regions might more collaboratively provide healthcare services and gain improved access to broadband. The move began to transform telemedicine into m‑health (mobile health care) by using myriad devices and platforms — making it possible to provide health care no matter where patients or their doctors might be located.
At that time, I was the only Commissioner from a rural area of the United States, and I was thrilled that my colleagues from both parties unanimously agreed to establish a pilot project that would upgrade information technology and create innovative and much-needed healthcare projects to ensure universal availability not only of broadband but also, more importantly, of access to sophisticated medical care and physician specialists. The pilot project funded up to 85 per cent of the deployment and construction costs associated with upgrading broadband to achieve faster connections, from 3 Mbit/s to 10 Mbit/s.
The National Broadband Plan, which the Commission delivered to Congress on 16 March 2010, also touted the incredible opportunities to advance rural health care (see Federal Communications Commission, Connecting America: The National Broadband Plan, available at www.broadband.gov/download-plan/).
Cutting costs and improving services in rural areas
In August 2012, the FCC announced and showcased many of the benefits of the rural healthcare pilot project. Not only had broadband access and speeds been increased, and collaboration with the healthcare sector enhanced, but also enormous savings had been recorded in many of the pilot test areas. For example, a South Carolina consortium saved USD 18 million in Medicaid costs by using telepsychiatry, and a group of healthcare providers in the mid-west saved USD 1.2 million on electronic services for patients in intensive care units.
Following the successful pilot project phase, the FCC recently earmarked up to USD 400 million for the new permanent Healthcare Connect Fund to help expand healthcare providers’ access to high-bandwidth connections. According to the FCC, the new fund will improve access by supporting the implementation of new ideas suggested in the pilot phase, such as:
- encouraging partnerships between smaller rural healthcare providers and urban medical centres to enable remote hospitals and clinics to draw on the medical, technical and administrative resources of larger providers;
- increasing fiscal responsibility by requiring participants to contribute 35 per cent of the costs, while offering lower rates through group buying.
In response to many comments regarding the ageing population, the FCC will also launch a call for new pilot projects — to be selected on a competitive basis — to expand broadband networks to skilled nursing facilities. Up to USD 50 million over three years will be available for these pilot projects.
Broadband access and medical benefit
Access to broadband is absolutely essential to 21st century health care. This is not just about improving the quality of care and reducing costs; the outcome concerns saving and improving lives. The benefits include the ability to connect instantaneously with medical specialists and to have access at all times — day and night — to electronic healthcare records, as well as lowering the cost of educating, training and validating the qualifications of healthcare providers.
The advantages of fast broadband connections are evident. Think about the critical importance of timing in the context of remote surgery, or the need for immediate diagnosis and appropriate care for stroke victims, or telepsychiatry to individuals in remote areas who need the support of family and friends. Consider the ability to predict and prevent premature births, or to gain pertinent medical information and information on drug allergies in the case of an accident far from home. Think about the savings that accrue from avoiding duplicate tests and from ensuring that the most effective and up-to-date medicines are prescribed. And, along with all the ways in which broadband can improve individual health care, think about the benefits of moving towards best practices in diagnosis and treatment through the sharing of disease metadata, while also enhancing the speed at which it is possible to move from science to service, in other words from academic research to practical application, which now generally takes years.
Bringing broadband and health care together will result in exponential improvements in medical services, and shifts toward wellness and prevention, in addition to improved access to the healthcare system and faster delivery of services.
Good public policy
As a government official, it is often difficult to fully appreciate or have the opportunity to experience the culmination of specific policy actions. In this case, however, the Healthcare Connect Fund has demonstrated that good public policy and strong government leadership can indeed, at very low cost, spur innovation and investment, resulting in a return on investment that even Wall Street would envy.
While saving time, effort and money in the healthcare arena is extremely important during this time of budget cuts and continued sluggish economy, the most important outcome is saving lives — no matter where people live.
About Deborah Taylor Tate
Deborah Taylor Tate, a two-time United States Presidential nominee, served as a Commissioner on the Federal Communications Commission. She was a member of the United States delegation to the World Radiocommunication Conference in 2007 in Geneva, and was a policy leader in the fields of international media, telecommunications and broadband. She was appointed Chair of the Federal-State Joint Board on Universal Service overseeing the USD 7 billion telecommunication fund and the Advanced Services (Broadband) Joint Board. Known as the “Children’s Commissioner”, in 2009 she received the ITU World Telecommunication and Information Society Day Award for her international work on the education and protection of children online.
A licensed attorney and certified mediator, Ms Tate currently serves as a Distinguished Adjunct Senior Fellow at the Free State Foundation and Minority Media Telecommunications Council in Washington DC, a Director of the Board of HealthStream, Inc., a charter member of Women Corporate Directors, Tennessee Chapter, an Adjunct Lecturer at Vanderbilt University, and Executive-in-Residence at Lipscomb University where she teaches Communications Law and Policy. Ms Tate is co-founder of Renewal House, a recovery residence for addicted women and their children. Along with Geena Davis, Ms Tate chairs the United States National Healthy Media Commission regarding the impact of media especially on girls and women. She is an ITU Special Envoy for Child Online Protection.