Chattanooga, Tenn., has earned a reputation as a leader in municipal broadband and is actively evaluating telehealth as a benefit it hopes to make available to subscribers of its gigabit service. Telehealth is transforming the way health care is delivered in many parts of country.
The Electric Power Board of Chattanooga (EPB), the public utility that operates Chattanooga’s network, reports that it will soon reach 100,000 subscribers to its broadband service, and wants to offer those customers more. “We’re very interested and committed to participating in this telehealth market, and are evaluating our options,” said Katie Espeseth, vice president of product development at EPB. “Having partners that provide innovative products and services is how we plan to maintain our competitive edge in this market.”
In Good Health is a family medical practice that was part of a pilot test for Docity telehealth products and services conducted by EPB.
“Our patients who are under 40 were the most enthusiastic, especially if they have young children,” said Dr. Laurie Davis, principal of the practice. “Parents quickly understand that hours spent in the waiting room full of other sick kids can be painful, and a video consult is just like being in the room with the doctor.”
Davis and her staff use EPB broadband in the office and their homes. “Our practice built its reputation on the long-term relationships we have with our patients, and telehealth enables us to bring additional value to those relationships,” she said.
Founded in 2006, In Good Health provides affordable primary care to individuals and families in the Chattanooga area. They offer a full complement of general medical services and medical home visits for elderly patients who have difficulty getting to the office. The staff feels telehealth will help their home health-care practice grow.
Chattanooga is bullish on telemedicine, and the public gigabit effort has already improved medical practices in the city. Radiologist Dr. Jim Busch is one of the city’s premier medical business stories. He brought radiologists in the city together under one organization, Diagnostic Radiology Consultants, where they connect to the city network, to each other, and to the city’s hospitals.
Busch wrote software to enable his group to deliver new services, including making it easier for radiologists to read and annotate images from wherever they are. Chattanooga’s network and Busch’s software together allow the team to serve more hospitals and patients, grow and expand the business, and create another hook that draws individuals and businesses to the city.
The city’s gigabit network saves radiologists and medical facilities 40 hours per radiologist, which represents a sizable dollar savings. It’s not uncommon for more than 10 radiologists to be sending multiple files simultaneously that each are 80 to 100 megabits in size.
“You either have applications that move small amounts of data for every transaction, but may generate thousands of transaction every minute," Busch said, "or you have applications that only do a few transactions a day, but each transaction is a monster and you don’t need many users to max out the network.”
“The opioid epidemic is particularly felt in East Tennessee, and where there is street-use of opioids, there is also an increase in hepatitis C and HIV,” said Matt McAdoo, COO of Choice Health Network. “Access to quality, competent health care has been a challenge.” Choice Health Network’s Docity telehealth suite is housed in a Nashville clinic and interacts with six other local telehealth hubs.
Choice Health Network’s first-year goal is to do 25 percent of treatment through telehealth, with a higher goal for mental health patients. Currently they are using these telemedicine hubs for delivering treatment, but it’s also their goal to deliver telemedicine directly to patients’ homes.
Although Nashville doesn’t have its own public broadband network, Docity offers municipalities and co-op networks a revenue share arrangement, marketing support, software defined networking capabilities and real-time analytics.
The Sevier County School System in Tennessee was challenged to stop the spread of communicable illnesses during the winter that resulted in school closings. "In some winters, the flu could affect as many as 20 percent of 14,000 students, causing entire schools to shut down in an effort to slow the spread of the flu," explained Don Best, coordinator of school health for the system.
In 2009, Sevier County Schools turned to telemedicine. They use video-conferencing hookups and USB-compatible devices for quick exams and recording vital signs. The telehealth platform comes from AMD Global Telemedicine, and the county also made sure there would be a nurse for every school.
In the eight years the telehealth system has been in place, there have been more than 11,000 telemedicine encounters, and the county has gone five years without a school closure due to influenza. Eighty-four percent of the students treated via telehealth remain in school. The school also wants to make sure that students receive health care even if they don’t have health insurance. The district is doubling its return on its investment by treating parents via telemedicine in the hours when students aren’t being treated.
Jennifer Amis, CEO of Encounter Telehealth, a Nebraska-based telemedicine vendor, is frustrated every time they partner with a facility that can’t meet Encounter’s basic bandwidth requirement. “One prospect’s connection was so poor the audio was always out of sync. It was a group of 15 facilities and we weren't able to connect with any of them. I’m sure all of those patients need specialized care they can’t get.”
Solid telehealth apps built on strong community broadband networks are key to the vendor’s success. “Our platform works well over cellular,” said Amis. “However, if an area has bad broadband, they probably have bad cellphone reception as well.”
Telehealth vendors such as Encounter are finding that they are in a symbiotic relationship with community broadband owners: Vendors cannot have telehealth without highspeed Internet, and communities cannot have a gigabit network without continually pushing the innovative edge. United, everyone wins.