BROADBAND TO BOOST ACCESS, QUALITY IN RURAL AREAS

Volume 29, Issue 507 January 22, 2008

Matthew Gever

Some much-needed federal money is starting to pour into states that want to expand electronic health access to severely underserved areas.

Beginning this January, organizations in 42 states and three territories will receive grants totaling $417 million from the Federal Communications Commission (FCC). The 69 grants will enable clinics, hospitals, universities, research centers, behavioral health sites and correctional facility clinics to connect to “broadband” Internet access.

Often shortened just to broadband, this type of network is high-speed (at least double the speed of dial-up access over a modem) and enables users to transfer large amounts of data—such as x-ray images, videos and medical records—over a network line.

The broadband links are expected to be especially useful in rural areas, where specialists such as mental health specialists are often in short supply. In its application to the FCC, the Wyoming Telehealth Network (which won a grant of $800,000) stated that only 18 psychiatrists practice in the entire state. “Rural areas rely heavily on telemedicine,” Colorado Senator Bob Hagedorn said during a recent NCSL Webinar on the topic.

The grants—which encompass both statewide and regional projects—range in size from under $100,000 to over $20 million and generally go to support building new networks and upgrading existing lines.

The largest grant went to the New England Telehealth Consortium, which received $24 million to link together its 555 rural and urban clinics, doctors’ offices, hospitals, public health centers and universities in Maine, Vermont and New Hampshire. “It means patients can go into their local clinic or rural hospital and have a medical stroke expert in Boston diagnose what's wrong as if they are there,” said Jim Rogers, president of ProInfoNet, which wrote the grant proposal.

The next largest grant of $22 million went to the California Telehealth Network, a partnership between the Governor’s office, the University of California system, and various government agencies and rural health coalitions. The Network will focus on linking rural residents to mental health professionals and specialists in hypertension and cardiovascular disease, which disproportionately affect rural residents.

Improving Emergency Management

In addition to improving access for rural residents, the FCC hopes the pilot project will improve emergency management capabilities for these regions. “For a lot of us, there is concern about pandemic readiness,” said Senator Hagedorn. Currently, many emergency networks are disconnected from existing telemedicine networks. This problem is made worse with even fewer avenues of communication to and from rural areas.

“We also know that if a health catastrophe visited many of our rural areas today, our rural health-care system would not generally be equipped to deal with it,” said FCC Commissioner Michael Copps. The FCC is encouraging providers participating the in program to connect their telehealth networks to federal health agencies to share critical, time-sensitive information about breaking public health emergencies.

Despite the benefits of telehealth, many obstacles remain. “What regular folks were concerned with were privacy and security,” said Colorado Senator Bob Hagedorn in a recent NCSL Webinar on the topic. Both staff and patients may be anxious about being “on television,” with some hesitant to discuss personal medical issues over a camera. This can be especially problematic for mental health facilities that serve patients with schizophrenia or similar disorders. Some staff also may be resistant adopting new technology for fear that this could lead to phasing out of jobs and staff reductions, according to a report from the Health Resources and Services Administration.

The money for the grants comes from the Universal Service Fund, a tax levied on wireless and long-distance telephone subscribers intended to ensure that residents of low-income and rural areas pay no more for such services than their urban counterparts.

“This is where the future is,” said Senator Hagedorn. “[Congress] provided the money for the interstate highways and they should provide money for the electronic highways.”

For more on the broadband initiative, please go to www.fcc.gov/cgb/rural/rhcp.html#orders