Broadband Communities

OCT 2018

BROADBAND COMMUNITIES is the leading source of information on digital and broadband technologies for buildings and communities. Our editorial aims to accelerate the deployment of Fiber-To-The-Home and Fiber-To-The-Premises.

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TELEHEALTH 7 2 | B R O A D B A N D C O M M U N I T I E S | w w w. b r o a d b a n d c o m m u n i t i e s . c o m | O C T O B E R 2 0 1 8 Telehealth Initiatives Show Promise Telehealth is beginning to prove its worth as a means of delivering better health care at lower cost. Better broadband is needed to make the promise of telehealth a reality. By Jordana Barton / Federal Reserve Bank of Dallas I ncreasingly, health care systems are pressured to deliver cost-effective, quality care to more people. To meet this demand, health care systems often rely on digital health information and tools to enhance continuity of care and increase efficiency, timeliness and reach. One promising tool, telehealth, is a platform that can be deployed to address access-to-care issues for both underserved urban and rural populations. However, broadband infrastructure and access gaps, particularly in low- and moderate-income (LMI) and rural communities, are barriers to unleashing telehealth's full potential. ose who find themselves on the wrong side of the digital divide – including low-income people, those with little formal education, rural populations, the elderly and minorities – suffer further economic, social, political and health disparities resulting from disconnection. For example, U.S. households making $25,000 or less have a broadband adoption rate of 47 percent, while those making more than $100,000 have an adoption rate of 92 percent. According to the FCC's 2016 Broadband Progress Report, 34 million U.S. residents lack access to fixed broadband at speeds of at least 25 Mbps for downloads and 3 Mbps for uploads. Rural areas have the least connectivity with 39 percent – 23 million people – lacking sufficient access to high-speed broadband. Given this gap, the use of telehealth can be stymied because broadband is the basic infrastructure for reaching people through this tool. us, a sizeable portion of the U.S. population is missing out on a transformative, necessary platform for accessing health care. e speeds necessary for different types of telehealth activities vary. 100 Mbps may suffice for a videoconference between a primary care physician or specialist and a patient; 200 Mbps may suffice for the transmission of some patient records such as CT scans or heart images; and 25 Mbps may allow remote monitoring through a mobile phone for a diabetes patient. However, for medical schools and health systems to conduct advanced research, for surgeons to perform remote operations or for a specialist to remotely assist in a surgery, 1 Gbps or higher is required. Additionally, telehealth applications often require download and upload speeds to be symmetrical, as two-way data sharing is common. e first three telehealth case studies described here use satellite technology for internet access on mobile service vehicles because they operate in locations with limited or no broadband infrastructure. Satellite technology remains the most expensive form of broadband access and has limitations related to speeds, data caps and latency because of the time it takes data to travel to and from the outer atmosphere. e last two case studies are based in San Antonio and Houston respectively, urban areas where there was sufficient broadband fiber optic infrastructure to enable wireless solutions for the programs to operate. It should be noted, however, that San Antonio and Houston ranked among the "worst connected" of the 75 cities in the United States with 100,000- plus households, each with 38.2 percent of households without fixed broadband. If not addressed, this digital divide could limit the use of telehealth.

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