- Earlier this week, President Trump signed two executive orders to expand access to broadband internet in rural America. Many patients in rural areas depend on broadband services to support their telehealth network usability , especially if they are chronically ill and live far away from their healthcare provider.
While the initial reason for the executive order was to support the needs of farmers and other rural businesses, the improvements are intended to improve broadband access for all rural users, including patients using broadband for telehealth programs.
“Last April, I commissioned a task force to meet with farmers and local communities and find the greatest barriers to rural prosperity,” said President Trump. “The task force heard from farmers that broadband internet access is an issue of vital concern to their communities and businesses.”
Other task forces have been commissioned to specifically assess broadband access in rural areas for medical purposes.
In late 2017, The FCC Connect2Health Task Force (C2HFCC) collaborated with the National Cancer Institute (NCI) on how to increase broadband access and adoption in rural areas. The two organizations signed a memorandum of understanding to focus on the networking needs of cancer patients in remote areas.
The agreement was spurred by the higher cancer death rate in rural areas compared to cancer deaths in urban areas.
“Initial analysis of broadband data and cancer data shows that these rural ‘cancer hotspots’ also face major gaps in broadband access and adoption, often putting promising connected care solutions far out of reach,” the FCC explained in its official release.
The first recent executive order instructs the Department of the Interior to dedicate resources to install rural broadband. The order states that the executive branch will use “all viable tools to accelerate the deployment and adoption of affordable, reliable, modern high-speed broadband connectivity in rural America, including rural homes, farms, small businesses, manufacturing and production sites, tribal communities, transportation systems, and healthcare and education facilities.”
The first order added that the Secretary of the Interior will develop a plan to support rural broadband and report to the Director of the Office of Science and Technology Policy to identify the assets being used to support rural broadband within the next 180 days.
The second order will simplify the broadband installation process by requiring agencies to use standardized forms and contracts to improve efficiency.
In May 2017, The American Medical Informatics Association (AMIA) urged the FCC to categorize broadband access among the social determinants of health as they continue to develop policies and programs in the future.
AMIA stated that healthcare is being “transformed by the availability and accessibility of broadband-enabled services and technologies and the development of life-saving wireless medical devices.”
The importance of broadband connections to patient health makes broadband a social determinant of health, according to AMIA.
“FCC has a critical role in ensuring that Americans benefit from the electronic health infrastructure that was initiated with the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act, and supported by the 21st Century Cures Act,” said AMIA.
Expanding broadband in rural areas is vital for the continued success and advancement of telehealth programs. However, reports that the FCC may redefine what qualifies as broadband could cause patients to struggle with broadband connections for telemedicine.
According to Ars Technica, the FCC is considering changing the standard it uses to determine if broadband is being delivered to all Americans in a reliable and timely fashion.
The plan has yet to be finalized, but the FCC may declare that users only need access to either home internet or cellular internet with at least 10 Mbps download speeds. The current FCC policy states that all users should have access to mobile data and fast home internet services.
This is potentially problematic for telehealth patients because they may not get the home internet speeds they need to use their telemedicine tools. Users may be forced to use their cellular data plan, which generally has more strict data caps than home internet. There also may be tasks patients cannot perform on a mobile device.
Ars Technica pointed out that home internet and cellular plans are complementary, not substitutes for one-another.
"The FCC's decision would classify more rural and low-income Americans across the country as 'served' by lowering the country's broadband standards while doing nothing to improve service, expand broadband access to all, or close the digital divide," reported Ars Technica.
If the FCC changes what qualifies as ‘served’ for broadband, the executive orders to improve network infrastructure for better connectivity in rural areas won’t be as impactful. Fewer improvements will need to be made and users will not get the benefit of truly improved internet connections.
Secure and reliable internet connections are vital to healthcare, and clinicians and patients need access to reliable internet to fully utilize digital tools.