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Broadband Can Alleviate the Health-Care Crisis (Contributed)

The lack of physicians in rural areas could be offset by using telehealth delivered by community-based digital networks. That, in turn, can make non-urban areas more livable and sustainable for seniors.

There’s a health-care crisis in the country and it’s hitting rural areas particularly hard. The U.S. could face a shortage of 95,000 physicians by 2025, according to a recent report from the Association of American Medical Colleges.

“Everywhere across the country there is a crisis happening in health care,” said Samantha Schartman, CEO of Connected Insights, a nonprofit social science research firm. “Published research a few years ago indicates that by 2030, we will hit the apex of the baby boomer retirement crisis.” 

Schartman points out that in Cleveland, where her organization is based, there are a lot of major hospital systems. “But when you go an hour outside of the city, you start finding less and less access to hospitals and doctors,” she said. “When you hit the rural areas, it gets really bad.”

But health care’s physician distribution problem, with too many doctors in urban areas and not enough in rural locations, could be alleviated by community broadband. With over 700 municipal networks, 108-plus electric co-op’s, and 2,000 wireless ISPs, as well as hundreds of telehealth project teams and vendors, community broadband is poised to help the U.S. weather the impending health-care storms. But that’s assuming these two industries find each other to form symbiotic relationships.

Gene Scott, general manager of Wilson, N.C.’s Greenlight public network, explained the situation this way: “The role of broadband in health care and telehealth cannot be ignored. The medical community needs to be part of the research into broadband and the broadband planning itself.” 

Telehealth and Community Broadband: Symbiotic Partners

Initially, telemedicine was a simple concept of remotely monitoring a patient’s health data wherever they might be located. Many of these patients were elderly, living at home and suffering from a long-term medical condition or chronic disease. Today, the more appropriately named “telehealth” is the use of intranet and Internet networks to diagnose, administer, initiate, assist, monitor, intervene, and/or report on the continuum of medical care.

According to a July 2019 survey by J.D. Power, a marketing information services firm, “9.6 percent of consumers have used telehealth in lieu of a doctor’s office, urgent care or emergency room visit in the last 12 months. Usage is highest among patients in the Western region (11.1 percent) and lowest in the Northeast (5.7 percent). Usage is highest among sub-urban (11.7 percent) and urban residents. (11.0 percent). However, only 8.7 percent of rural patients have adopted the service.”

Telehealth touches many medical disciplines, including mental health, tele-stroke, dermatology, women’s health, remote patient monitoring and physical rehabilitation. Just about every person, from newborns to seniors, may be impacted by telehealth at some time in their lives. Access to broadband determines how convenient, affordable and far-reaching are the telemedicine benefits communities receive.

Obviously, you cannot have telehealth without having quality broadband. But broadband network owners must offer more than just connectivity and price wars with incumbents to continue to be financially sustainable. By offering quality affordable health care via telehealth in places where it wouldn’t be available otherwise, community broadband boosts its marketing and sales advantage.

Westminster, Md., built a gigabit network for all the 6,500 premises in town. The core broadband infrastructure passes every premise and fiber links connect about 15 percent of home and business subscribers. A major proponent of the network is Dr. Robert Wack, a former Westminster City Council president and still-practicing pediatric physician. 

“As current subscribers get comfortable with being connected to the Internet to run Netflix, their businesses, kids’ homework assignments, they are looking for the next big thing,” said Wack. “So, we’re trying to get out in front of this.” He now oversees a small telehealth pilot project.

“We have two houses that are managed by a local nonprofit that provides residential services for adults with disabilities,” said Dr. Wack. “These comprise our ‘healthy smart home’ pilot. There are three clients in each home and they all have multiple medical issues. There's a lot of opportunities there to work on their health using telehealth 24/7. The staff live in separate apartments within the houses.”

Boosting the Health of Local Economies

Besides deploying telehealth and broadband to foster healthy constituents, community-run digital infrastructure also contributes to healthy local economies. 

In a survey conducted earlier this year of members of the International Economic Development Council, 42 percent said telehealth “is a major economic development issue for us.” Another 42 percent said telehealth is “mainly an indirect economic impact.” The survey included a section of what-if scenarios, and participants gauged the potential economic impact certain telehealth outcomes might have:

  • Reduce unnecessary visits to the ER. “The average cost of an ER visit is $1,200 and comes with an average wait time of four hours or longer,” according to a 2015 Blue Cross and Blue Shield of North Carolina newsletter. “A recent study indicated that treating many of these ER non-emergencies at urgent care or retail clinics could save $4.4 billion.” 
  • Keeping seniors living at home longer. Telehealth could enable seniors to add years to their ability to stay in their homes or possibly move to a nearby senior facility. This will keep a community’s senior ecosystem active and seniors can still maintain a social and economic role within the community. “Our telehealth program has saved $2.7 million by reducing chronic care for patients, many of them seniors, keeping them from returning to the hospital or needing to go to the ER,” said Lisa Hogan, RN, head of the Chronic Care Management Program for Frederick Memorial Hospital in Maryland.
  • More mental health-care services stay local. “There are 65 million Americans that have a diagnosable mental health illness but we have less than half of the psychiatric providers needed to meet that demand,” said Encounter Telehealth CEO Jennifer Amis. According to a Scientific American blog, depression in America costs society $210 billion annually. For every dollar spent treating depression, $4.70 is spent treating related mental illnesses and $1.90 is spent for lost work productivity and suicide.
In 2007, the city of Wilson started building its Greenlight municipal broadband network. The network’s No. 2 goal, right after impacting the economic health of the community, was to enhance the quality of life for citizens. Municipalities must always keep an eye on the financial bottom line with these network projects. Telehealth running on broadband can touch a community’s soul.

“The fact that broadband availability can directly affect the health of a community shows that its significance to [the community] transcends economic development, and likely will play an important role in social well-being,” said Pete Pizzutillo, vice president of ETI Software. “It’s vital that underserved areas get the funding and the access they need or quality of life will slowly erode.”

Craig Settles assists cities and co-ops with business planning for broadband and telehealth. He has surveyed economic development professionals nationwide about the impact of telehealth and community broadband, and offers guidance for federal grant proposals for broadband, telehealth, or other digital projects.