The proliferation of the internet of Things (IoT) creates unprecedented new uses for internet-enabled devices and heightens the demand for high-speed connectivity among residential and commercial users. One example of such uses is telemedicine and the associated applications to monitor patients, personnel, and medical devices, all of which are expanding the health care sector at an accelerated pace.
The economic returns of telemedicine
Telemedicine and its related applications are highlighted in a recent paper from NTCA -- The Rural Broadband Association, entitled "Anticipating Economic Returns of Rural Telehealth".
NTCA's paper clarifies the difference between telemedicine and telehealth. The American Telemedicine Association (ATA) defines telemedicine as "the remote delivery of health care services and clinical information using telecommunications technology. This includes a wide variety of clinical services using internet, wireless, satellite and telephone media." In comparison, "telehealth" includes telemedicine and nonclinical services, such as provider training and administrative meetings.
According to the paper, telehealth decreases costs for travel, lost wages, and hospital fees, and increases local revenues for lab work and pharmacies, particularly in rural areas. National average estimates of cost savings in NTCA's paper include:
• Travel expense savings: $5,718 per medical facility, annually;
• Lost wages savings: $3,431 per medical facility, annually;
• Hospital cost savings: $20,841 per medical facility, annually;
• Increased local revenues for lab work: from $9,204 to $39,882 per type of procedure, per medical facility, annually; and
• Increased local pharmacy revenues: from $2,319 to $6,239 per medical facility annually, depending on the specific drug prescribed.
The need for high-speed broadband access in telemedicine deployment
NTCA's paper emphasizes that "[t]he continuing advancement of telemedicine and the accrual of its potential benefits to patients, health care providers, health care facilities and the communities that house them will not be possible without high-quality, reliable broadband infrastructure."
Yet, according to the Federal Communications Commission (FCC), in 2016, 34 million Americans did not have access to broadband that meets the FCC's current definition of 25 megabits per second (Mbps) download/ 3 Mbps upload; a speed that, according to the authors, "would make telemedicine viable." Notably, 23 million of these individuals are in rural America.
In March 2017, FCC Chairman Ajit Pai, who is the son of two doctors from Kansas, visited the Cleveland Clinic and particularly noted being "impressed by the innovative work they are doing in telehealth ... Expanding the reach of medical expertise with connectivity illustrates the potential of broadband to improve people's lives, particularly in rural and underserved areas." Chairman Pai also acknowledged the FCC's important role "in bridging the broadband-enabled health gap" component of the digital divide -- the economic, educational and social inequalities between those who have access to high-speed internet and devices and those who do not.
Federal and state approaches to broadband expansion
Commissioner Mignon Clyburn leads the FCC's Connect2Health Task Force. According to the Connect2Health page, "Connect2HealthFCC is exploring the intersection of broadband, advanced technology and health and further charting the broadband future of health care -- serving as an umbrella for all FCC health-oriented activities to help enable a healthier America."
In June 2017, the Task Force released a data update to the Broadband Health Mapping Platform, as well as several new lists. The Priority 2017 and Rural Priority 2017 lists identify key "critical need" counties regarding broadband and health with the goal of driving better decision-making and creating a road map for private investment and coordinated public support. The Positive Trend Counties list includes counties that were previously identified as having critical broadband health needs but have since demonstrated progress in broadband access and/ or health status.
Rural areas are widely understood to be more challenging and costly to serve with broadband access due to topography challenges and low population densities. As such, several states have considered or enacted legislation to incentivize broadband build-out in un- or underserved areas. For example, since 2014, Minnesota's "Border-to-Border Broadband" competitive matching grant program has helped to connect more than 29,000 homes and businesses and approximately 250 community anchor institutions, including hospitals, to high-speed broadband. The grants can provide up to 50 percent of project development costs, and the maximum grant is $5 million. Several other states have explored and/ or passed legislation to incentivize broadband build-out.
The future of telemedicine
As with countless industries, IoT will impact health care in ways that are not yet fully imaginable. However, these impacts will not be possible without access to robust, high-speed broadband. As stated in NTCA's paper, "[r]ural telemedicine's ultimate role in addressing the significant health problems inherent to rural areas will depend in large part on the availability of an underlying future-proof, fiber-based broadband infrastructure. Further investment in, and expansion of, broadband infrastructure is a critical need for our nation."
This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. The reader should consult with legal counsel to determine how laws or decisions discussed herein apply to the reader's specific circumstances.