As the nation’s health care services are increasingly delivered and accessed online, a divide is becoming more apparent between those who have access to broadband and those who do not. Making matters more complicated is the fact that more and more health care services are being offered online as well as mandates for electronic medical records. This trend toward the digitization of everything healthcare related could leave many unserved and underserved users on the wrong side of the digital divide.
To prevent this divide from widening, we as a nation must take affirmative steps to promote investment and innovation in broadband infrastructure as well as encouraging greater digital literacy. Without investment in critical broadband infrastructure, traditionally vulnerable and underserved segments of society will not have adequate access to broadband and the healthcare services that it will deliver. This means that underserved persons with diabetes and heart disease will not benefit from digital monitoring and online telehealth applications designed to monitor and detect abnormalities, before they become harmful or fatal problems. It is important to note that chronic disease disproportionately affects communities of color, seniors and low-income persons who stand to benefit most from chronic disease management services delivered online.
Investment — in health and digital literacy, and broadband infrastructure — is the first step toward providing access to all Americans. Innovation naturally follows next, as innovators and small business owners eager to invent new services find their way into the healthcare IT business and begin offering newer and better solutions that improve the quality of life of those with broadband access. But universal health care without universal broadband access could unintentionally create a new generation of medically underserved Americans – a new social class of high speed internet “have nots” — who will be unwillingly segregated from the broadband health care services that their fellow citizens enjoy.
The same obstacles that technology is designed to eliminate — weather, transportation, wait times — for the health care recipient who has to travel 10 miles to a library to use the Internet to access telehealth, the obstacles to change in name only; it’s as difficult to access broadband as it is to make a traditional doctors visit. Let’s avoid this tragedy by ensuring broadband access for all Americans by preserving the environment that has borne the thriving Internet we know today.
Marcia Thomas-Brown is an IIA Broadband Ambassador, Chief Operating Officer of the National Health IT Collaborative for the Underserved, and Program Manager for Health Information Technology at the Summit Institute for Research and Education.
Read Write Web highlights a new study that finds wireless use in the healthcare industry is growing rapidly:
A report this week from ABI Research tells us that the “uptake of Wi-Fi within healthcare has grown at more than 60% over the past 12 months in both wireless local area network and Wi-Fi RTLS (Real-Time Locations Systems) deployments” and the trend only looks to continue.
“Wi-Fi adoption has helped overcome initial concerns about complexity and reliability of wireless within healthcare,” said ABI Research principal analyst Jonathan Collins in the company’s release. “The growing number of wireless technologies and wireless applications being developed, piloted and deployed within healthcare further underline the level of interest in using wireless to improve the flexibility and efficiency of healthcare services around the world.”
Via Government Health IT, the FCC is putting a lot of thought into health care applications as it develops a national broadband plan:
The American Recovery and Reinvestment Act called for the FCC to develop a plan for establishing broadband connections to the Internet as a way to spur business development, job creation and improvements in healthcare.
As part of the plan, the FCC will analyze health IT applications enabled by broadband, including electronic health record systems, video conferencing and remote monitoring, Kaushal said at a Feb. 3 conference sponsored by the mHealth Initiative, which advocates the use of cell phones and other mobile devices to improve healthcare.
According to Susannah Fox of the Pew Internet Project, 42% of all adults say they or someone they know has been helped by following medical advice or health information found on the internet.
John Horrigan, “Broadband Adoption Barriers,” Blogband [FCC Blog]. August 25, 2009.
IIA Broadband Ambassador Carl Taylor recently penned an editorial on the promise of telemedicine for the Birmingham News. Here’s an excerpt:
Telemedicine is quickly burgeoning into one of the most significant and cost-effective services in the health care industry. In addition to monitoring patients with diseases such as diabetes and heart disease, telemedicine can be used for a host of other applications, including emergency-room triage, neurology, pediatrics, mental health and geriatrics.
The applications of telemedicine are indeed endless, and the ability of specialists to provide services to those in remote areas via broadband creates a truly wonderful opportunity to revolutionize the quality of health care services to the most isolated communities. Moreover, telemedicine fits neatly into the vision of a fully electronically integrated system of health care as envisioned by the president and the Department Health and Human Services and Office of the National Coordinator for Health Information Technology.
The future of health care in Alabama and across the United States is promising, and that promise lies in the continued development of modern broadband Internet infrastructure that will support life-enhancing telemedicine applications.
The Rural Health Care Pilot Program provides funding for the construction of state or regional broadband networks and for the advancement telecommunications and information services provided over those networks for health care providers. 67 projects, serving 6,000 health care facilities, in 42 states are eligible for the program.
Copps, Michael J. “Bringing Broadband to Rural America.” Federal Communications Commission. Washington, D.C. May 22, 2009.
Count the White House’s proposed health care plan as one of the now 300 million Facebook users worldwide. Reports Read Write Web:
In an effort to personalize healthcare reform benefits, WhiteHouse.gov launched a “Reality Check” Facebook quiz application to rally for President Barack Obama’s widely disputed Health Insurance Reform Plan. While the application was only shared with Facebook users 6 hours ago, 350 people have already commented on everything from education, to war, to congressional travel records to general partisanship.
The New York Times examines efforts — and struggles — in turning health records digital:
Encouraged by the billions of dollars in government funding, technology companies are making a big push to help bring computerized health records into small-office physician practices.
This is crucial if the goal of bringing doctors’ offices into the computer age is to be achieved, with its promise of improving care and curbing costs. Three-fourths of all the nation’s physicians practice medicine in offices with 10 or fewer doctors.
But the challenge ahead is daunting, for reasons that have more to do with economics than technology.
According to the Times, practices that are successful in making the digital transition fall into two groups: large physician groups with the resources the make the shift, and small practices willing to take the challenge on. Up until now, however, very little help has been available for most smaller practices. That’s sure to change now that the Obama administration has pledged $19 billion in incentives to help make the digital shift.
While the FCC works to bring high-speed Internet access every corner of America, the U.S. health care industry is about to receive a major overhaul. From the Washington Post:
The Obama administration unveiled $1.2 billion in federal grants for electronic health records systems on Thursday, the first wave of funding under a health-care reform plan to create vast records-sharing networks aimed at cutting costs and improving care in the coming decade.
It’s estimated that making medical records digital could save over $77 billion each year.
A woman in New York has become the first person in the world to receive an Internet-connected pacemaker. Via the Register:
The device contains a radio transmitter which connects to receiving equipment in New Yorker Carol Kasyjanski’s home, using a very low-power signal around 400MHz, to report on the condition of her heart. Any problems are instantly reported to the doctor, and regular checkups can be done by remotely interrogating the home home-based equipment - the pacemaker itself doesn’t have an IP address, fun as that would be.
Interesting sidenote: the spectrum 402-405MHz has been dedicated for use by medical devices, so expect more innovations such as this one in the immediate future.
Using a remote monitoring system with high-resolution video and real time data on patient vitals, one doctor is able to treat multiple patients in the ICU at once. Using this type of medicine at Johns Hopkins “cut ICU deaths by 50% and saved 90 lives annually.
Fuhr, Joseph P. Jr. Broadband Services: Economic and Environmental Benefits. American Consumer Institute. October 2007.
Beginning August 1 in Hawaii, TriWest Healthcare Alliance, which provides health care for a third of military service members and their families, will use American Well to put soldiers and their family members face to face with psychologists and psychiatrists over the Web.
The service is part of a program mandated by the Department of Defense to address soldiers’ mental health. Accessing mental health services quickly, conveniently and privately is important for service members, said David J. McIntyre, Jr., chief executive of TriWest.
More information on the Internet and health care can be found in the IIA Broadband Fact Book.
Telehealth can save money and improve quality of life and quality of care. In Pennsylvania, diabetic patients using a remote home monitoring system averaged hospitalization costs of $87,000, versus $232,000 for members of a control group who received only traditional in-person nurse visits.
Rintels, Jonathan. “An Action Plan for America: Using Technology and Innovation to Address our Nation’s Critical Challenges.” The Benton Foundation. 2008
As the Obama administration’s call for electronic patient records is gearing up, the New York Times examines efforts already underway in the Lone Star State:
Cook Children’s Health Care System, based in Fort Worth, is taking a comprehensive step toward the digital future championed by the Obama administration. The pediatric provider, with 350 employed physicians, plans to install Web-based electronic health records and data integration technology at its 60 offices and clinics throughout Texas. It is also offering personal health records, controlled by the families of its young patients, that can follow them throughout their lifetimes.
The Web-based health records will be supplied by AthenaHealth, while the data integration software and personal health records will come from Microsoft.
The full article is definitely worth checking out. And more information on broadband and health care can be found in our Broadband Fact Book.
Carl Taylor, Director of the Center for Strategic Health Innovation (and IIA Broadband Ambassador), discusses changes in health care and telemedicine.
Health care technology today allows patients to track their own vital statistics via mobile devices and work with doctors over broadband to develop personal care strategies.
Here’s something cool: A new mobile application called Airstrip allows doctors to monitor care of their patients on their phone. CNBC reports:
“With Airstrip, we provide physicians with real time, remote access to critical patient data, any time, anywhere, on their mobile device, with just a cell phone connection,” Dr. Cameron Powell, the company’s president tells us. “It allows the physicians to utilize that internet connection, which is the cell phone signal, to obtain these data…so from the patient safety standpoint, it is critical to be able to deliver these kinds of data to a doctor anywhere they have a cell phone connection.”
Right now the tech is used for fetal monitoring, but the FDA is already reviewing its application for cardiac care.
Via Wall Street Journal, a look at the rise in online doctor-patient consultations:
This year, 39% of doctors said they’d communicated with patients online, up from just 16% five years earlier, according to health-information firm Manhattan Research, a unit of Decision Resources Inc. So far, the most common digital doctor services are the simplest ones, like paying bills, sending lab results and scheduling appointments.
The number of patients offering online consultations is still small, but it’s expected to grow steadily, especially as more and more insurance companies start covering online consultations.
In the wake of President Obama’s call for the America’s medical records to be digitized, a new group calling itself HealthDataRights has been formed that wants to ensure the privacy of patients is protected when records start to live online. From the New York Times “Bits” blog:
The new Web-based push comes a week after the Obama administration published a “preamble” document outlining the goals for electronic health records and the broad criteria for their “meaningful use” to qualify for incentive payments to doctors and hospitals. The administration document declared that its “ultimate vision” is one in which “all patients are fully engaged in their health care,” while physicians and clinics have real-time access to all the medical information they need to ensure the quality and safety of care.
Here’s the group’s “Declaration of Health Data Rights” from their website:
In an era when technology allows personal health information to be more easily stored, updated, accessed and exchanged, the following rights should be self-evident and inalienable. We the people:
Have the right to our own health data
Have the right to know the source of each health data element
Have the right to take possession of a complete copy of our individual health data, without delay, at minimal or no cost; if data exist in computable form, they must be made available in that form
Have the right to share our health data with others as we see fit
These principles express basic human rights as well as essential elements of health care that is participatory, appropriate and in the interests of each patient. No law or policy should abridge these rights.
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