Telemedicine’s Value in Rural America

The net neutrality ruling could be a bitter pill for a growing healthcare trend.

The FCC voted 3-2 in December to repeal net neutrality, and the repeal is set to take effect in the spring. Neutrality rules require internet service providers (ISPs) such as Verizon and Comcast to treat all internet content and access equally.

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The underserved and marginalized could be most adversely affected by the net neutrality repeal.

But now, ISPs will be able to increase or decrease broadband speeds for certain services and websites, even blocking access all together as long as customers are notified.

How this change will affect the healthcare industry still is uncertain.

According to The Advisory Board, a global research firm based in Washington, D.C., the repeal of net neutrality will have three critical effects on patients and care providers:

ISPs would be able to choose which providers of telemedicine, data centers and cloud computing services would have to pay more for services.

Prices for telecommunications services would increase for medical providers, especially hospitals, which means patients will pay more.

The infrastructure of reliable, low-cost connectivity that telemedicine systems depend upon would be diminished.

The need for speed

Those most adversely affected could be the underserved and marginalized. Take rural areas, for example, which already suffer from a shortage of physicians and specialists. Those doctors rely on technology and the internet to make medical care more accessible and efficient for their patients.

By using telemedicine systems, patients can connect with their doctors and other health resources, resulting in quicker treatment and less cost.

Opponents of the repeal fear that ISPs can steer healthcare systems with deeper pockets into “faster” lanes, while throwing other systems into slower lanes.

They argue that the largest systems will gain an unfair advantage over smaller, financially stressed, more rural health networks, medical practices and clinics, which have greater needs for affordable broadband speed to stay competitive and stay connected with patients with transportation challenges.

Telemedicine is growing

Telemedicine involves the remote diagnosis and treatment of patients by means of telecommunications technology. This turns the traditional model of patients receiving care by a medical professional solely in a clinical setting on its head.

Telemedicine happens from the home setting — as a complement to face-to-face visits — via records transmissions, home monitoring devices, video-conferencing (virtual visits or e-visits) and more.

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The U.S. telehealth market is expected to more than quadruple to $2.8 billion by 2022.

In 2014, the U.S. telehealth market size was valued at $572 million. According to a new report from Grand View Research, the market is expected to more than quadruple to $2.8 billion by 2022. Among the many drivers are rising healthcare costs, a rapidly aging population and demands for greater patient control and convenience.

Combine that with the spectacular growth of technology, and it all makes perfect sense. Doctors can treat more patients using technology and secure cost savings.

A prime example

Partners Healthcare based in Boston is a case in point of effective telemedicine. The system, which includes Massachusetts General Hospital and Brigham and Women’s Hospital, set up a “virtual follow-up” program for 3,000 patients suffering from congestive heart failure, according to a Becker’s Health IT & CIO Review article.

The report outlined patients using at-home monitoring devices to digitally send updates of their weight, blood pressure and other metrics to practitioners.

Software analyzed the data and helped identify those patients who needed interventions. Nurses subsequently administered care for 250 patients, according to the report, and ultimately re-admissions among the participating patients were reduced by 44 percent, generating cost savings of more than $10 million.

Boosting rural connectivity

Underserved and rural U.S. regions already struggle with affordable and reliable broadband access and are at risk of losing out on quality care options as a result.

Some reports show only 55 percent of Americans in rural areas have internet that qualifies as broadband-speed, versus 94 percent of those in major cities.

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Only 55 percent of Americans in rural areas have internet that qualifies as broadband-speed.

Affordable, equal broadband access is needed for telemedicine to work efficiently, for exchange of health information to happen expeditiously and to improve medical access in regions where staffs are limited. The possibility of ISPs controlling how we use the internet could shake up the healthcare industry but not entirely in a good way.

Lives are at stake

Dr. Wanda D. Flier, Board Chair of the American Academy of Family Physicians, noted, “The FCC must ensure that internet service providers do not place fees or constraints on health information exchange above and beyond the usual and customary fees to access the internet.”

“Our members in rural areas do not have multiple companies providing broadband access to the internet and therefore are at the mercy of those local monopolies to provide them enough bandwidth to be able to adequately exchange health information,” she added. “The FCC … must provide adequate protections to the physicians and the patients they serve in these rural (and other) locales where a single telecommunication company has a real monopoly, or functional monopoly.”

Healthcare is in a continually transformative state, and it’s become more technology-driven. Internet use as part of the continuum of patient care is becoming more mainstream.

There is real value in telemedicine and virtual care, and underserved communities can’t be casualties of a broadband tug-of-war when lives are at stake.

The growing use of telemedicine depends on high broadband speed in an open and fair internet environment administered equally and cost-effectively.

Disclaimer: The views expressed in this article are those of the author and do not necessarily reflect those of UPS or any of its personnel.

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Barry Hochfelder is a freelance journalist who covers a variety of industries, including healthcare and supply chain. Hochfelder is former editor of Supply & Demand Chain Executive magazine. He is based in Arlington Heights, Illinois.

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