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FCC Gets a C for Rural Broadband Communication Efforts

As the recent bickering in Washington D.C. over the US debt ceiling brings to light the thorny issue of how government spends money, recent charges that the Federal Communications Commission (FCC) hasn't been spending enough to expand broadband communications in rural areas further demonstrate the controversial role government often plays in many areas of the economy.

Broadband communications has been identified as key to helping folks who live in remote areas adopt telemedicine, but lack of adequate spending on infrastructure by government or subsidies to service providers could limit the deployment of high-tech services that can contribute to the nation's rural health care development, according to industry organizations.

In a letter recently sent to Julius Genachowski, chairman of the FCC, the American Telemedicine Association (ATA) blasted the commission for holding back millions of dollars that it has the authority to spend under its Rural Health Care Program. In the letter, the ATA's CEO, Jonathan Linkous, said:

Despite the commission's stated goal to provide up to $400 million annually in support of telecommunications to improve healthcare delivery, only about $80 million will be spent this year (outside of a one-time pilot program commitment). Thus, the commission annually leaves over $300 million in funds that could be used immediately to help improve Americans' access to health services and help reduce the cost of healthcare. With the crisis America faces in healthcare, the commission's failure to take action is disturbing.

The FCC is already aware that spending money on expanding the nation's broadband service would have a positive impact on telemedicine, and by extension the delivery of health care services. Last year, the commission issued the National Broadband Plan, a report that endorsed the idea that by expanding and strengthening telecommunications networks, the healthcare sector can capture and exchange healthcare information over robust networks faster, thereby providing physicians the data they need to make clinical decisions at the point of care.

Currently, as the healthcare sector accelerates its push to digitize medical records, a corresponding increase in the use of telemedicine systems is occurring, giving a boost to high-tech equipment makers serving the industry. For companies like {complink 1131|Cisco Systems Inc.} and {complink 4361|Polycom Inc.} that provide videoconferencing systems, including audio, video, and other telecommunications and electronic information processing technologies to support health services at distant sites, the expansion of telemedicine, especially in rural areas, can provide an abundance of opportunities.

Given this fact, it was disappointing to read a recent report from the US Government Accountability Office (GAO) that examined weaknesses in the FCC's Rural Health Care Program. The report agreed that telemedicine offers a way to improve healthcare access for patients in rural areas. However, it noted that the FCC's Rural Health Care Program, which provides discounts on rural healthcare providers' telecommunications and information services and funds broadband infrastructure and services projects, has not done enough to meet the needs of rural healthcare providers.

One reason for the shortfall, the GAO explains, is that the “FCC has disbursed only $327 million in total over the 12 years of the primary program's operation — less than any single year's $400 million funding cap.” The FCC's inability to fund rural health networks creates a missed opportunity for high-tech companies to sell their systems to rural hospitals at a time when these facilities need the help.

To confirm the point, one only needs to read the finding of a recently published national study that examined critical access hospitals (CAHs) that serve approximately 20 percent of the US population living in rural communities. Researchers at the Harvard School of Public Health (HSPH) found that these hospitals have fewer clinical capabilities, a lower quality of care, worse patient outcomes, and are less equipped with health information technology to support clinical workflows. To overcome these challenges, one of the report's recommendations was to increase the use of telemedicine and clinical data exchange, which has the potential to improve the quality of care.

There are many reasons why the FCC should spend more to expand broadband connectivity at rural health facilities. Sure, the high-tech industry would benefit immensely from an infusion of funds for this activity, but let us never forget that the more important beneficiaries will be rural patients who suffer from a poorly-connected health IT system. They need the FCC's help.

11 comments on “FCC Gets a C for Rural Broadband Communication Efforts

  1. Daniel
    August 4, 2011

    Nicole, broadband and spectrum are the two essential requirements for any mode of communication. Especially in telemedicine and remote classroom education through VSAT bandwidth is a very real bottle neck. After the implementation of EHR (Electronic Health Record), scanning and sending the medical documents in .JPEG/.BMJ format consumes much of the bandwidth. In telemedicine clarity and pin point accuracy are must for detail investigation and data transfer, so government has to take adequate measures for providing highly soficated equipments with enough broad band communication bandwidth.

  2. mfbertozzi
    August 4, 2011

    I agree with you Jacob, new equipment generation for multimedia processing could help a lot telemedicine tasks. In addition I personal think on one hand funds from FCC are important, but actions to promote education and confidential usage of electronics is important as well. I am convinced devoted educational sessions for students approaching medicine degree can stimulate better e-health spread with benefits for citizens, as consequence.

  3. jbond
    August 4, 2011

    It seems like this is a catch 22 issue. I'm not too familiar with this plan and how the funds are supposed to be distributed. If the funds are to go to the Broadband infrastructure and allow the companies to install services to these rural areas, and then if the individual care providers don't have money to buy the equipment, we haven't solved any issues. If these funds go to both the infrastructure and individual hospitals, then we are making some headway.

    Do you know why all of the budgeted money wasn't spent? Did nobody ask for more amounts, or was the FCC not dispersing more funds?

     

  4. Eldredge
    August 4, 2011

    Good point – to really address the goal, inventment in all of the necessary elements is required.

  5. Edmunds Sinevics
    August 4, 2011

    Broadband in rural areas can improve health care directly, and indirectly – through the local and regional economic development.

  6. AnalyzeThis
    August 4, 2011

    Yes, there are many reasons why the FCC should spend more to expand broadband connectivity at rural health facilities. They do need the FCC's help.

    But there are a lot of other things the government SHOULD be spending money on… but they can't due to bureaucracy, inefficiency, or budget cuts.

    Reducing the amount of government spending and attempting to reduce the deficient is all well and good, but as a consequence to this sacrifices have to be made. And I think FCC funding is certainly going to get reduced or dry up completely.

    In this case, it sounds like the program was not especially effective to begin with. But it is a noble idea, at least.

  7. The Source
    August 8, 2011

    Dear Jacob ,

    Yes, it will take a telecommunications signal of greater bandwidth compared to the standard or usual signal to achieve the kind of results that telemedicine requires.  The FCC has been assigned a budget to provide this service to be used at rural hospitals and should get on with the task of expanding broadband to help rural hospitals adopt telemedicine technology.

    Thanks for your comments.

    Nicole

  8. The Source
    August 8, 2011

    Dear jbond ,

    The FCC has had the opportunity over many years to spend up to $400 million each year to expand rural broadband connectivity and it didn’t.  If you follow the GAO report, it seems that there is a management problem.  I can tell you that the GAO report did note that in one instance a healthcare provider in Alaska used FCC Rural Health Care Program funds to increase the use of telemedicine, which has reduced patient wait times and travel costs.  Therefore, there are examples of some success, but for the most part the FCC could have done more. 

    To your question of how the funds are disbursed, the p rogram provides discounts on rural health care providers' telecommunications and information services and funds broadband infrastructure and services.

    Thanks for your comments.

    Nicole

  9. The Source
    August 8, 2011

    Dear Eldredge ,

    Currently, there are investments that are accelerating the adoption of health information technology, including a federal incentives program that will spend up to $27 billion to encourage hospitals and physicians to use electronic health records. You can read more here: https://www.cms.gov/ehrincentiveprograms/

    Thanks to all of you for reading and responding to this blog post.

    Nicole

  10. Anne
    August 19, 2011

    Broadband technologies is a critical cost-saving and health care enhancing services for rural communities. Telemedicine applications rely on high speed and high quality telecommunications networks to provide rural communities with virtual access to urban health centers and their related medical specialists and services.

  11. JADEN
    August 19, 2011

    Broa dba nd c on nection is  a  must-ha ve in  a ll  a rea s of life as the  need for it in urbarn areas   is  a lsp importa nt in  rura l  a rea s, and l ack of access to it  hinders the growth and development of rural areas.

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