A coalition of telehealth and health IT organizations is petitioning the Federal Communications Commission to improve wireless and broadband access to rural healthcare providers, calling it critical to the development of virtual visit and remote patient monitoring efforts.
While an estimated 1 percent of the nation’s small providers lack broadband connectivity, the issue is especially acute in rural parts of the country, where an estimated 7 percent of providers lack access – and where that access can costs three times more than in urban areas.
“People get real excited about mHealth, but they forget that big parts of the country don’t have reliable broadband. We often don’t think about our infrastructure in this case,” Harry Greenspun, the director of Deloitte’s Center for Health Solutions, said in an interview last year with mHealthIntelligenc.com. “You travel around this country or you look at the coverage maps of telecom companies and you see places that are not colored in and you know they do not have broadband.”
In a 47-page document filed Dec. 7, 2015 with the FCC, the California Telehealth Network, New England Telehealth Consortium, Health Information Exchange of Montana, Utah Telehealth Network, Colorado Telehealth Network, Southwest Telehealth Access Grid and Schools, Health & Libraries Broadband Coalition are seeking changes to the Rural Health Care (RHC) program.
The organizations argue that the RHC program and its Healthcare Connect Fund, created in 2012, “are being overwhelmed by a host of demographic, economic and social trends that disproportionately affect rural communities.” They’re urging the FCC to, among other things, increase incentives to help rural healthcare providers access affordable broadband necessary to support telehealth, support more remote patient monitoring efforts and help launch coalitions that enable safety-net healthcare providers to “participate in the unfolding broadband revolution.”
”After many years of slow evolution, (healthcare) is undergoing increasingly rapid change,” the petitioners said. “Petitioners urge the Commission to take this opportunity and build on past reform efforts. In this rapidly evolving environment, it is vital for the Commission to ensure universal service for rural healthcare continues to efficiently and cost effectively promote access to affordable modern broadband.”
Also supporting this effort are the Healthcare Information and Management Systems Society (HIMSS) and the Personal Connected Health Alliance.
“The need amongst many rural healthcare providers for access to high quality broadband access is profound,” wrote Thomas Leary, HIMSS’ vice president of government relations, and PACHA Vice President Robert Havasy in a two-page letter of support. “This need for wireless and wireline broadband access represents a critical component to furthering a nationwide network optimized for tomorrow’s high-quality healthcare delivery systems. Benefits of expanded broadband access include the ability to conduct secure high quality eVisits such as telemedicine and expanded remote patient monitoring within the home.”
Congress gave the FCC power to address disparities between urban and rural healthcare in the Telecommunications Act of 1996, enabling the agency to set broadband rates that promote the use of telemedicine. That led to the 1997 launch of the RHC Telecommunications Program, which enables rural healthcare providers to access telecommunications services at discounted rates, followed by the 2006 Pilot Program to support “innovative telehealth and telemedicine services,” and then the Healthcare Connect Fund in 2012.
“Despite these and other critical governmental programs, rural Americans continue to experience significant health disparities,” the coalition says. “Rural residents have higher incidence of disease and disability, increased mortality rates, lower life expectancies and higher rates of pain and suffering than those in urban areas. Rural risk factors for health disparities include geographic isolation, lower socio-economic status, higher rates of health risk behaviors and limited job opportunities. Studies have shown that rural residents are older, poorer, have fewer physicians to care for them, and have greater transportation difficulties reaching physicians and HCPs.”
Furthermore, the coalition, wrote, rural healthcare providers face higher costs in that “last-mile connectivity” between provider and patient, which they can’t afford. As a result, they lack the resources needed to upgrade what they do have to accommodate new telemedicine and telehealth platforms.
The coalition also questioned whether the Pilot Program and Healthcare Connect Fund are doing the job. It says the HCF “has had limited success stimulating new broadband deployments,” possibly because rural providers can’t afford the 35 percent match to qualify for federal funding. The same goes for the Pilot Program, which requires a 15 percent match. As a result, some providers are launching projects that they can’t complete.
Amid the list of proposals to improve broadband access, the coalition also said it supports a 2015 request from CHRISTUS Health to the FCC to allow rural providers to obtain discounts for using broadband in remote monitoring programs. “Petitioners believe the CHRISTUS proposal has merit and urge the Commission to formally explore whether it will help rural HCPs if the broadband costs for remote patient monitoring were eligible, and what the likely demand for such funding will be,” the coalition wrote.