Broadband Provides Big Bang for Federal Bucks

John Commins, for HealthLeaders Media, October 29, 2008

Despite the dour economic times, U.S. Rep. Lee Terry, R-NE, said there is little enthusiasm in Washington, DC, to cut spending on cost-effective programs like eICU, which uses broadband to connect America's rural hospitals with off-site medical experts.

"I'm not worried about that at all," Terry said last week from Omaha, where he presented a federal grant for $384,000 to Alegent Health's eFocus Monitoring Center. If the money's not there, he said, Uncle Sam will use the credit card.

"The emergency spending on the economy is going straight to the debt and we aren't offsetting that," Terry told HealthLeaders Media. "If we were forced to offset it we would have to look within the budget. No one in Congress is saying now we should go in and cut the budget.

"Healthcare reform is a priority in Congress and you are going to see a renewed discussion on it with whoever comes into the White House next year," said Terry. "These are the low hanging fruit that we are all going to embrace in the medical reform area."

Terry's assurances should be taken with a grain of salt. He doesn't speak for Congress. He is a minority member of the House Subcommittee on Telecommunications and the Internet. And he was commenting in a room full of influential constituents, all of whom care deeply about improving healthcare access in rural America.

But, he also makes a good point. Money spent to improve rural healthcare is money well-spent. Since 2001, the federal government has funded $7.1 billion on all broadband programs, about $89 million a year. Hospitals are only one of many rural constituencies that benefits from the programs, along with schools, police and sheriffs departments, and local governments.

"If we can empower our rural communities through access of technology, especially through broadband, it really unites urban, suburban, and rural areas into one," Terry said. "We lack in rural areas the physicians and experts for our critical care centers out there and this is a way to bridge that gap."

The USDA Rural Development Grant will be used to connect Alegent's Community Memorial Hospital in Missouri Valley, IA, to eFocus, making it the sixth Alegent hospital in the program. By next summer the remaining three Alegent hospitals will have eICU capability.

Alegent officials are giddy with excitement. "How cool is this to have rural hospitals looking at the next generation of healthcare delivery," Mark Kestner, MD, Alegent's chief quality officer, said at press conference announcing the grant.

"This will allow the air traffic controller (the off-site physician) to look at the screen and analyze data while the pilot, in this case the bedside clinician, manages the immediate care. It's not a solution to the physician shortage but it does help us going into the future as far as coordinating care."

Kestner said Alegent is already looking to expand eFocus "beyond the walls of the ICU." By next summer, the health system hopes to provide broadband access to pharmacists, who can provide 24/7 analyses of drug-drug interactions, appropriate dosing, and potential toxicities. Beyond that, Kestner says, Alegent is looking at eFocus potential for other disciplines like infection control surveillance and case management research.

Government gets legitimately rapped for wasting taxpayers' dollars. Not this time. When cost-effective, well-targeted grants are awarded to conscientious and innovative entities like Alegent, good things happen and everybody wins.

It is hard to imagine any other program that gets this much bang for the buck. It's heartening to learn that at least one member of Congress knows that, too.

John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at
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