Connected Health Driving Demand for Rural Connectivity, SHLB Showgoers Say

SHLB Chair and California Telehealth Network President Eric Brown told us he also would like the FCC to directly contact Department of Health and Human Services agencies such as the Centers for Medicare & Medicaid Services for feedback on what metrics and outcomes they want on Connected Care. Brown said staffing issues, especially for smaller rural healthcare providers, could be a barrier to implementing programs that include remote patient monitoring. That's if clinicians are too busy to consider who will set up wireless monitors in a patient's home and replace them when needed.

To cut administrative burdens, the FCC should offer a "healthcare layer" to the Lifeline program of about $50 monthly so hospitals could better track heart attack or stroke patients after discharge, Brown suggested during a panel. Some attorneys expressed skepticism the FCC would consider this. "All these things are great ideas, but then you run into government reality," said Danielle Frappier of Davis Wright.

Attendees representing state telehealth programs want the chance to participate in the pilot, but some patients live in isolated areas outside the reach of residential broadband. Deb LaMarche, associate director for the Utah Telehealth Network, told Carr more broadband infrastructure is needed to connect to patients who would benefit from the pilot. Carr noted a notice of inquiry asked whether the FCC should use the program to build infrastructure, but there wasn't much support. Carr conceded the agency will be more likely to partner in the pilot with healthcare providers already "on second or third base" in their connected care.

In South Carolina, FCC broadband maps were so inaccurate that Palmetto Care Connections hired an engineer to create its own map to find where patients weren't connected, said CEO Kathy Schwarting on another Thursday panel. Broadband mapping also came up elsewhere at SHLB Thursday (see 1910170024).

SHLB continues to advocate for a significant increase in USF spending on healthcare. "We think the program hasn't been right-sized in terms of investment," Brown told Carr.

No decision has been made on what happens to Connected Care beyond the pilot, Carr said. If the program moves beyond that, he said, he would like to see how "we get the cost of connected care absorbed into the healthcare system" and less reliant on USF.

SHLB also asked the FCC to reconsider plans for an overall cap on USF spending and reexamine the USF contribution mechanism. In a Q&A, Carr told us the Joint Board on Universal Service continues to examine including assessments on broadband access in the USF contribution mechanism. "It's always a push and pull," he said. "We have to be careful," he said, because adding consumer costs can drive customers at the bottom pricing tiers out of the market. Later Thursday, Commissioner Geoffrey Starks told us "more than anything, it's important for the [Joint] Board to continue to do its work."

SHLB Executive Director John Windhausen asked Carr whether anchor institutions will receive funding under an upcoming Rural Digital Opportunity Fund program. "I'm certainly open-minded," Carr said, adding he welcomes additional feedback in the docket. If RDOF includes funding for anchor institutions such as hospitals or libraries, the program "must marry up" with other USF programs so they're not working in conflict and government doesn't pay the same costs twice.