Biggest FCC-Funded Telehealth Project Faces Hurdles from Commission Red Tape to Clueless Medical Outposts
SILICON VALLEY -- FCC-subsidized rural telehealth projects face obstacles from excessive commission paperwork to hooking up servers located in shower stalls, the head of California’s program said Tuesday. “Those forms … they're pretty onerous,” said CEO Eric Brown of the California Telehealth Network. Asked about the complaint, the Wireline Bureau’s spokesman said by email that “the FCC launched an NPRM in 2010, which, among other things, is looking at the lessons learned in the Pilot as part of broader reform of the universal service Rural Health Care program.”
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Managers at some remote sites are so uncommunicative that the program must send installers out without appointments and wait for someone to allow them to make the connections, Brown said at a Wireless Health Summit of Joint Venture: Silicon Valley, held in connection with the American Telemedicine Association conference. Often someone at a connected site “will go in behind us and unfortunately unplug everything we've done because they weren’t there the day we came in,” Brown said. He added, “Folks won’t always tell you that they don’t have the resources or the expertise to do this.”
"One of the powerful lessons that we've learned” is that “there are some profound digital literacy issues, especially in rural areas,” Brown said. “Unfortunately, the FCC program doesn’t provide for that.” United Healthcare this month donated $700,000 for telemedicine training and for tech support for clinics and hospitals in California. The telehealth network received the FCC’s largest state award, $22.1 million, but that “doesn’t go very far,” Brown said. “So we have to be very judicious in how we spend those funds.” The project is fortunate in that, unlike counterparts elsewhere, it has a source for the 15 percent of spending that the USF program doesn’t cover, he said: The California Emerging Technology Fund. The state Public Utility Commission’s California Teleconnect Fund pays 7.5 percent of recurring costs, he said.
The network has asked the FCC to expand the pilot beyond cities, nonprofits and qualified care providers, to assisted-living facilities and patients’ homes, Brown said. “Patient monitoring is front and center,” and there has also been strong interest from urban areas in Internet-based services “particularly around care for the elderly” to avoid “having to send them to some kind of institutional setting,” he said. Brown said he hopes “to have tests in place this year.”
The California program also is considering “which apps we can offer in our own cloud,” to help become self-sustaining financially and offer “value-added” services that small facilities can’t support individually, Brown said. The network charges sites based on the capacity of the broadband connection it installs, starting at $62 monthly for a T1, he said. The network is extending its services to unsubsidized for-profit organizations such as medical groups and rural and safety-net physicians, he said.
The network has connected 100 sites, in unserved urban as well as rural areas, mostly in the past six months, Brown said. Approximately 400 additional sites, about 40 percent urban, have signed up, he said. Urban sites are important in providing scale and specialty care for the project, Brown said. “We're making great strides,” adding 10-15 sites a week, he said. Video consultation over reliable broadband connections is the service most in demand, Brown said. Patient record exchanges and X-ray and MRI transfers are other major uses, he said.