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FCC Proposal to Expand Rural Broadband Too Limiting

Cheryl Clark, for HealthLeaders Media, August 18, 2010

If the U.S. is ever to improve rural America's access to quality healthcare, the one thing it must provide—just about everyone agrees—is broadband Internet access.  Connections are needed from clinics to hospitals and to physician offices, to specialists who read images in faraway places, and even to patients' homes so their conditions can be remotely monitored and managed.

So when the Federal Communications Commission last month released its "Notice of Proposed Rulemaking" seeking comments on its plan to spend up to $400 million a year to improve rural health connectivity, I jumped in to read the 30-page tome.  The money would come from the Universal Service Fund, the charge appearing on phone bills, which is administered by the FCC.

"This greater broadband connectivity has the potential to revolutionize healthcare delivery by providing access to state-of-the-art Health IT solutions to over 12,000 hospitals and clinics across the nation," the proposal begins.

"Greater use of broadband will allow patients in medically underserved communities to receive healthcare locally and have access to state of the art diagnostic tools typically available only in the largest and most sophisticated medical centers.  Use of health-related applications delivered over broadband will not only save lives, but also cut costs by shortening average hospital stays, reducing the need for tests, and increasing administrative efficiencies."

For example, the proposal says, "remote patient monitoring for heart failure can save up to $6.4 billion annually through reduced hospital admissions. The monetary benefits of remote monitoring of other medical conditions could be exponentially larger."

But for a variety of reasons the entire program and proposed rulemaking has become extremely controversial. Many rural health experts I spoke with insist that the FCC's current plan falls far short of being able to deliver its promises.  There are problems with whether it will help providers qualify for meaningful use requirements, but that's not even their main issue.

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