Ultra-Broadband Can Heal Telehealth's Wounds

Increasingly taken for granted by urbanites and suburban dwellers, telehealth benefits remain out of reach to regions of the country underserved by ultra-broadband, a situation that costs the nation in lost productivity, sicker populations and higher healthcare costs.

By 2020, the telehealth market is expected to be valued at $30 billion, according to the American Telehealth Association, which is holding its annual conference, ATA2017, in Orlando this week.

This growth comes as more hospitals, healthcare chains and medical specialties adopt remote care, incorporating everything from videoconferencing and sharing vast imaging files to truly integrating telemedicine throughout the entire provider system, ATA CEO Jonathan Linkous told UBB2020.

"Almost all the health systems are thinking about it and have a planning group internally, but some are really investing heavily into it," he said. "The role of the consumer is kind of a dirty hidden secret in telemedicine. The next five to ten years are going to be driven by consumer demand."

A dearth of specialists, especially in rural regions, also promotes telemedicine adoption. Although 15% of the US population lives in the country, only 10% of America's physicians practice in these areas. While there are 40 specialists per every 10,000 rural residents, there are 134 per every 10,000 urban residents, according to "Anticipating Economic Returns of Rural Telehealth," by Rick Schadelbauer manager of Economic Research and Analysis at NTCA–The Rural Broadband Association, in March.

Where the bytes aren't
While many providers today can speedily connect with and share huge files with patients or colleagues, rural and under-served clinicians must compete for a $400-million Federal Communications Commission grant program that's become more well known and in demand and, therefore, harder to access, said Kathy Wibberly, director of the Mid-Atlantic Telehealth Resource Center at the University of Virginia, during a recent webinar, "Grow2Gig: Rural Health Care," sponsored by SHLB (Schools, Health & Libraries Broadband Coalition).

"Although there are some great applications of telehealth throughout our country, rural areas are really suffering because they don't have the bandwidth … to use telehealth applications," she said.

With federal funding, the University of Virginia brought ultra-broadband to the eastern shore of the state, an area that did not have broadband access at that time, said Wibberly. Because the provider focused on strokes -- which require a lot of bandwidth due to their large image files and need for extremely low latency -- it heavily invested in broadband infrastructure, over-provisioning to ensure it met current and future needs, she said.

As a result, both the university's telestroke program and most of Virginia's eastern shore now have broadband access, said Wibberly.

"We're also seeing because that fiber is there, it's allowing the eastern shore to connect to the eastern part of Maryland, although there are still swathes of that area still not connected. Because we put our pilot in to look at telestroke, which is a bandwidth hog, just about everybody involved in the pilot increased their bandwidth pipes," she said. "We are seeing the ability to do EMRs [electronic medical records] to transmitting huge images for PACS [picture archiving and communications system] to videoconferencing. That has been a big win for our rural communities."

Of consumers who had access to telemedicine, 55% used the service -- and 93% of them said it resulted in lower healthcare costs, a 2016 HealthMine poll of 500 insured Americans found. In addition, 46% of consumers were considered "active digital health adopters" because they use at least three categories of digital health tools (such as telehealth and wearables), versus 19% in 2015, according to a RockHealth study. In 2016, 12% of Americans were non-adopters, down from 20% the prior year, the survey found.

Paging service providers
Between ultra-broadband demand, security requirements and the growing terabytes of data patients generate via wearables and through traditional clinical measures, including x-rays, CAT scans and doctor visits, it's apparent why so many healthcare providers are concerned about their ability to safely turn this information into insight.

As more individual medical practices affiliate with hospitals to cut costs and meet Affordable Care Act mandates such as patient engagement and population health, these practitioners can piggyback off hospitals' telemedicine initiatives -- further expanding the base of general and specialty doctors available to patients. This trend also provides telecom and cable service providers with an opportunity to provide broadband and a host of value-added services to clinicians eager to reap more benefits from the data they're accruing.

"The ATA was founded by some of the telcos, back 22 years ago. Of course, they've all changed. Nevertheless, there's a recognition from the beginning that you have to have connectivity. There are opportunities for companies in this space, both to sell bandwidth and to sell related solutions," said Linkous. "We've done a lot of work with AT&T, Verizon and wireless companies, as well as some of the cable companies. Clearly the potential is huge. It's a trillion-dollar market. Besides the money, it's a real problem. As we get to a society that travels, we have the importance of monitoring disease outbreaks and that could extend to a broadband network that extends around the world."

Related posts:  

• NTCA CEO: Broadband Transforms Rural US
• India Gets 1Gbps Broadband
• Bandwidth Surge Demands Virtualization

    — Alison Diana, Editor, UBB2020. Follow us on Twitter @UBB2020 or @alisoncdiana.