A filing made last week urges changes to the FCC rural healthcare-broadband programs, arguing that the Universal Service Fund (USF) rural healthcare, telecom and e-rate schools and libraries programs would be more effective if they did not operate as isolated silos. The filing came from TeleQuality Communications, an organization that provides network connectivity for healthcare providers funded, in part, through the USF rural healthcare program.

The filing includes some compelling data points, along with some creative ideas for potential reforms to FCC rural healthcare-broadband programs – although some readers may find some of the ideas unrealistic.

FCC Rural Healthcare-Broadband Programs
The most compelling data points in the TeleQuality filing:

  • The number of physicians serving rural areas is insufficient. The filing cites a Health Resources and Services Administration (HRSA) report that found that a majority of rural counties have 1 practitioner serving 3,500 patients when 1 practitioner per 2,000 patients is recommended for adequate care – a finding that confirms similar data that Telecompetitor has reported previously. There is also a shortage of skilled IT personnel in rural areas, TeleQuality argues – another data point that is consistent with previous research on that topic.
  • The number of FCC rural healthcare funding requests from healthcare providers has not increased as dramatically as the amount of funding requested – a phenomenon the filing attributes to the significant bandwidth increases needed to run electronic health records systems. At the same time, the FCC program remains underutilized because some healthcare providers do not have the resources to handle program filing and administration.

As a result of reforms made to the FCC rural healthcare program a few years ago, healthcare providers now can have up to 65% of their telecom costs covered, including wide area connectivity costs. But TeleQuality argues that additional reforms should be made.

The filing argues, for example, that “the mere fact that a [healthcare provider] is receiving some support for service does not necessarily imply that [the provider] is able to afford adequate service.” Healthcare providers often are forced to select slower speeds and less reliable service because of budgetary constraints, according to the filing.

TeleQuality makes several suggestions for how the FCC can help improve rural healthcare, including:

  • Undertake a trial program aimed at better understanding how to encourage the best use of available funds.
  • Incorporate incentives for sharing infrastructure funding between e-rate, the Connect America Fund and the rural healthcare program.
  • Work with insurance providers to increase reimbursements for telemedicine that could ease the rural doctor shortage and improve treatment
  • Work with the Department of Health and Human Services to solve the training needs of the healthcare IT workforce
  • The minimum bandwidth for small clinics should be between 10 Mbps and 50 Mbps symmetrically. This increases to 100 Mbps to 10 Gbps for larger hospitals and major health facilities.
  • Noting that existing critical access hospitals often cannot be retrofitted to support wireless communications, the authors argue that a best practices profile should be put in place to ensure that new health care facilities can support modern healthcare technology.
  • If Congress makes additional funding available for rural broadband, it should be administered through the FCC – an idea that seems to be gaining support.
  • The FCC should encourage competition for the delivery of broadband services in rural areas.

I suspect some readers will disagree with TeleQuality on the latter point and with TeleQuality’s statement that “there should be no more propping up of an industry that can’t seem to adjust to new market conditions because of a lifelong culture of regulated protectionism.”

Opponents would argue that there are some areas of the country where the costs of providing broadband service are too high to support a competitively priced offering without government support – let alone multiple broadband offerings.

Some of the other ideas presented in the filing would appear to have merit, however. Readers are encouraged to offer their views in the comments section below this post.

Image courtesy of flickr user jfcherry.

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