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FCC Faces New Pressure to Expand Broadband for Rural Telehealth

Several groups have lobbied the FCC to allow telecommunications providers to use so-called white spaces technology to expand broadband to remote and rural areas. That would, in turn, create more opportunities for telehealth and telemedicine expansion.

Source: ThinkStock

By Eric Wicklund

- Rural broadband advocates are looking to put pressure on the Federal Communications Commission to expand broadband services through TV white space technology, which could be used to expand telehealth and telemedicine services to remote parts of the country.

In a letter to the FCC, a group of 44 communications companies and organizations urged Commissioner Adit Pai and his committee to explore ways to support the technology. White space technology is defined as unused UHV television band spectrum below the 700 MHz frequency range that enables wireless signals to travel over hills and through buildings and trees.

“Our deployments are giving us real-world experience in how a set of pragmatic changes to FCC rules would allow us to reach even more Americans, without causing harmful interference to incumbent licensees,” the group wrote.

The group is part of Connect America Now, an organization launched last January to work with the FCC and other stakeholders “to ensure that there is sufficient unlicensed low band spectrum in every market in the country to enable broadband connectivity.” CAN includes Microsoft, the National Rural Education Association, the Schools, Health and Library Broadband Coalition, the Wisconsin Economic Development Association, Alaska Communications, Axiom, the Mid-Atlantic Broadcasting Communities Corporation, the American Pain Relief Institute and HTS Ag.

The group has also launched “local coalitions” in Kansas, Mississippi, Montana, North Dakota, Oregon, South Dakota and Wisconsin.

“All Americans – regardless of where they live – deserve access to high-speed Internet,” CAN Execute Director Richard T. Cullen said in a January 2018 press release. “Without a broadband connection, millions of students struggle to keep up with their assignments, Americans in rural areas are unable to fully utilize telemedicine, farmers are denied the promise of precision agriculture and businesses are unable to tap into the world of online commerce. Congress and the FCC must stand with rural America by allowing Internet service providers to deliver broadband via white spaces spectrum.”

Congress is also interested in the strategy. In August 2017, 43 members of Congress wrote a letter urging the FCC to open up TV white space spectrum for telehealth and other uses.

“We believe that the television white spaces (TVWS) have strong potential to revolutionize broadband internet accessibility in rural areas,” U.S. Rep. Kevin Cramer (R-N.D.) said in a press release accompanying the letter. “TVWS allows a broadband internet connection to cover nine miles, while navigating the physical terrain that at times can make wireless broadband connectivity difficult. Because of this range, these Internet connections are extremely cost-effective requiring minimal infrastructure investments, and are far more dependable than the limited connections that many rural areas currently have.”

Spearheading the effort is Microsoft, which included TV white spaces spectrum in its five-year plan, unveiled in 2017, to boost broadband access in rural America. The project looks to connect more than 23 million Americans in rural parts of the country that currently don’t have Internet access, and empower businesses and health systems to improve their capabilities in underserved communities.

Microsoft officials reportedly wrote a separate letter to the FCC in October asking the agency to move forward with support white spaces technology.

In this latest letter, the group of 44 businesses and groups are urging the FCC to support:

  • Higher power for fixed devices in rural areas where companies using white spaces technology can operate without causing harmful interference to broadcasters;
  • Antenna placement at larger heights above average terrain governed by a new protection mechanism;
  • Narrowband IoT operations to support important applications such as precision agriculture and environmental sensing; and
  • Geofenced operation on moving vehicles.

Telehealth advocates argue that the “digital divide” prevents many rural Americans from accessing specialty services, as well as connecting with their healthcare providers in between regular visits to coordinate and manage care and improve their health and wellness. One recent study also linked low broadband access to reductions in patient portal use and health equity.

“Telemedicine could collectively save lives and millions of dollars annually for underserved patients and rural hospitals that pay up to three times more for broadband than their urban counterparts,” CAN states on its website. “Broadband allows patients, regardless of where they live, to access specialists and benefit from advanced monitoring services that would normally require hours of travel for patients or their providers.”


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