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Broadband will boost telemedicine applications, FCC chairman says

Telemedicine proponents have an ally: the chairman of the FCC. Here's what Ajit Pai has planned to get broadband into poor and rural communities in the U.S.

BOSTON -- Federal Communications Commission Chairman Ajit Pai delivered a simple message to attendees at the 2018 Connected Health Conference: Broadband can help make people healthier.

Pai, whose parents are both physicians, said his travels to 41 states, as well as Puerto Rico, have shown him that broadband has an important mission to bring physicians -- via telemedicine applications -- to underserved populations. "It seems undeniable to me that telemedicine has not reached its full potential," he said. "It's some of the FCC's work to make sure it reaches its potential."

Telemedicine applications have untapped potential in rural and even urban settings, according to a recent study from The New England Journal of Medicine that found 93% of patients felt a video consultation met their needs. But the survey also showed the consultations are still in their infancy -- most of the physicians involved in telemedicine today have fewer than 5% of total patients in the U.S., which means the consults add up to less than 1% of total office visits.

Obstacles remain to increase telemedicine use

At a time when health IT professionals are considering a wide swath of new technologies from virtual reality to AI, telemedicine is an obvious direction to head in, said Joseph Kvedar, M.D., vice president of connected health for Boston-based Partners HealthCare. Expanding broadband to make telemedicine applications easier is a good first step, he said, but from a physician's point of view, some hurdles remain. As it is set up now, telemedicine "doesn't enhance efficiency," he said. "It's still a one-to-one effort tying two people up."

Ajit Pai discussed telemedicine applications at the 2018 Connected Health ConferenceAjit Pai

For Pai, though, the ability to deliver remote medical care is a huge step in breaching the digital divide. "There are vital signs rural America is in trouble," he said. "We want to make sure every American has high-speed internet access, but we're not there yet." All told, 24 million Americans don't have broadband at home, Pai explained, including fully 30% of rural households.

The FCC is trying to tackle this gap on a number of fronts, Pai said. The Connect America Fund will use private investments to help 713,000 homes and small businesses in underserved areas acquire broadband services. And the Rural Health Care Program will give $518 million this year to eligible medical providers to help them improve their connectivity and acquire tools for telemedicine applications.

And there are several other programs under consideration. A $100 million Connected Care Pilot Program would put sensors for remote monitoring of patients in the homes of lower income individuals or veterans, Pai said. That program is now open for public comment. Two other initiatives to target specific healthcare challenges -- cancer and opioid addiction -- are also under discussion.

"The Centers for Disease Control says rural Americans are more likely to die of cancer than their urban counterparts," he said. "To address this, we've formed a strategic partnership with the National Cancer Institute so we can study how to increase broadband and decrease the burden of symptom management in these rural underserved communities." The FCC is also working with a number of groups to promote telemedicine and monitored wearables via broadband in the fight against opioid abuse, Pai said.

Telecom vendors want in

While the FCC is pushing this agenda from the government side, private telecommunications carriers, including AT&T, also have a role to play, said Maria Lensing, vice president for the company's global healthcare solutions. AT&T expanded its healthcare efforts last year and sought out providers, device makers, pharmaceutical companies and other players to bring a broader perspective to the company, she explained during an interview at the Connected Health Conference.

"We come into healthcare not to make a device but to partner with a device maker and to use our connectivity technology to make it work," she said. Financially, it may not make sense to build a hospital in a sparsely populated rural area; bringing telemedicine to remote locations is an alternative way "to help people get a doctor on tap using video conferencing."

Pai said he's optimistic that expanded broadband efforts will result in telemedicine applications that succeed in getting doctors in front of patients. "One big advantage to improved healthcare delivery in America is that we have bipartisan support for action," he said. "We have the tech expertise and we can do this."

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