It’s a Catch 22: patients in remote or rural settings are among those that stand to benefit most from telehealth programs, and yet the areas in which they live are often the least likely to have the basic technology that telemedicine requires…fast, reliable broadband services.
Two groups ask for changes to Healthcare Connect Fund
The American Hospital Association (AHA) and the American Medical Informatics Association (AMIA) have formally called upon the Federal Communications Commission (FCC) to ameliorate this disparity. The two groups are asking the FCC to expand access to telehealth services to rural geographic regions of the country via changes to the Rural Health Care (RHC) program’s Healthcare Connect Fund (HCF).
Ashley Thompson is Senior Vice President of Public Policy Analysis and Development at the AHA. She wrote: “The need for access to health care is no less critical for rural Americans than for those living in urban areas. Yet, due to a variety of factors, from economic challenges to the sheer distance one must travel to reach a rural health care provider, obtaining access to care in rural America is a significant challenge. About 60 million Americans live in rural parts of the United States, and many of them have inadequate or reduced access to health care services.”
Thompson goes on to acknowledge the “good news” of telehealth services (which include “videoconferencing, remote monitoring, electronic consults and wireless communications”) being more widely adopted by doctors and facilities. However, there is still a gap in care, and one of those comes in the form of slow internet speeds that do not allow providers to remotely connect with patients in a reliable or meaningful manner.
“…much work to be done…”
“Thus, despite increasing adoption of telehealth and rising participation in the RHC Program, there remains much work to be done to digitally integrate the more geographically isolated populations of our nation,” Thompson wrote. She applauded the RHC’s work in attempting to provide broadband access to telemedicine practitioners in remote areas, but she said that the program is in need of increased funds for it to truly evince positive change on a large scale.
“The AHA urges the Commission to implement several changes to the HCF that will lead to greater program participation, further expansion of broadband connectivity, and ultimately, improved health outcomes for rural Americans,” Thompson wrote in her statement to the FCC.
In addition to a boost in HCF funds allocated for telehealth overall, Thompson’s statement included recommendations that the FCC implement changes to the administration of the HCF so that the program can be streamlined; revisit the definition of “rural” with the goal of expanding program coverage; and making remote patient monitoring an eligible expense.
AMIA addresses common obstacles to reliable healthcare
The AMIA (a professional organization with over 5,000 members “dedicated to the science of data collection, analysis and application” with the goal of delivering “evidence-based policy recommendations that focus on the opportunities and challenges of implementing health informatics tools”) presented its own statement to the FCC, one that complements the AHA’s call for bolstering the telehealth platform for potentially underserved individuals.
Douglas B. Fridsma, MD, PhD, FACP, FACMI, is the President and CEO of the AMIA. He wrote: “Vulnerable groups face specific challenges related to inadequate access to affordable and consistent high-speed Internet.”
Fridsma’s statement spoke to demographic barriers that impede ideal patient care. “Race, ethnic, and age disparities in patient portal use and readiness and preferences for using digital communication for health-related purposes have shown to be significant, and this, in turn, reduces their ability to participate in many new and exciting mHealth solutions.”
And his statement went on to sketch his vision for a more inclusive system for delivering healthcare: “These groups would benefit from an environment that would foster a low-cost broadband option with access that would be open and as ubiquitous as possible.”
AMIA suggests FCC use NSTIC’s work to enhance security
Some of the AMIA’s recommendations for the FCC included: partnering with federal, state, and local agencies to use broadband-enabled health technology in combatting the nation’s opioid epidemic; connect patients with chronic conditions with relevant broadband-enabled healthcare programs; take advantage of progress made by the National Institutes of Standards & Technology’s National Strategy for Trusted Identities in Cyberspace (NSTIC) in order to improve public broadband security in matters of telehealth.
In his statement, Fridsma went beyond the urging for reliable broadband in all areas to a bold prediction: “AMIA believes that access to broadband is, or soon will be recognized as, a social determinant of health.”
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