This post was written by Neal Neuberger, President of Health Tech Strategies. — IIA

Telemedicine continues to present new applications and possibilities for health care — everything from examinations via videoconference to electronic medical records, remote health monitoring, and quick and efficient diagnostic image sharing between health care professionals. Many people have already experienced the incredible ways in which new health technologies have changed the field, and more exciting technologies are on the horizon. 

Telemedicine delivers quality health care to more people in more places, particularly to those who could not receive quality health care in the past, and it continues to present new solutions for health care access. But these applications and technologies depend on access to high-speed broadband Internet.  In many areas across the country, that isn’t a problem. However, in rural locations, gaining access to reliable and affordable broadband service is often a serious challenge. Without that access, rural health care clinics cannot offer their patients the same cost-effective, cutting-edge quality of care that is available elsewhere.

To address this harmful discrepancy, the FCC-designed Rural Health Care program of the Universal Service Fund was created by Congress. I was integrally involved in the original legislative deliberations that resulted in the “Snowe-Rockefeller” USAC provisions of the Telecommunications Act in 1996. The program was designed to ensure that rural and urban health care providers and clinics pay similar rates for telecommunications services. The intent was (and is) noble, and the expansion of rural health care services is essential. However, the statutory language and resultant implementation has fallen short of its objective. The process of applying for and receiving telecommunications support from this program is hampered by red tape, hindering rural health care providers from gaining access to the tools they need, illustrating the pressing need for FCC reforms

In order to receive support, rural health care providers must complete and file complicated FCC forms each year. These forms are numerous and are accompanied by confusing and intricate filing requirements; the entire process is considered burdensome.  In an ex parte filing to the Wireline Competition Bureau from March 28, 2012, officials from the National Organization of State Offices of Rural Health and the Michigan Center for Rural Health described some of the difficulties of the process and made suggestions to the FCC. 

According to the filing, many health care providers must hire outside contractors to complete the required program paperwork every year because they lack the resources to handle the onerous paperwork themselves. In the filing, officials recommended that the FCC switch to a three-year period of eligibility, which would eliminate some of the paperwork burden. Additionally, the rural health care experts critiqued the unwieldy program for its odd and confusing design and for its “unusual” competitive bidding process, which has, for example, delayed implementation of the greater Minnesota telehealth broadband initiative pilot.

When a program that was established to address a problem fails to do so (and actually creates a larger workload), it drives home the need for thoughtful and effective FCC reforms