It has been a well-documented problem in the United States that if you plan on getting ill, you’d better live in a populated area, because that’s where the doctors are. 

Worse, it is also clear that going forward the situation is not likely to get better anytime for a host of reasons including shortages of doctors and nurses, the indebtedness of those getting healthcare degrees which encourages them to specialize and go where the money is, i.e., big cities, and a host of other factors. 

Being a primary care giver, or even a specialist, in less-densely populated areas is a labor of love. Economics have meant that the under-served are likely to remain so without some kind of intervention.

With this as context, the Federal Communications Commission (FCC) launched the Rural Health Care Pilot Program in 2006. It awarded 69 projects one-time funding for a defined period of time (a total of $418 million) to cover up to 85 percent of the cost of construction and deployment of broadband networks that connect participating healthcare providers in rural and urban areas.  

Spread across rural areas in the states and select U.S. territories, many of the 50 active projects (see map) have been established, and the FCC has issued a report on the Pilot Program that is encouraging.

 Broadband helps improve care

While it will come as no shock the report, “Wireline Competition Bureau Evaluation of Rural Health Care Pilot Program Staff Report,” goes into great detail about the projects funded, technology used and results achieved to date. If you’re a policy-maker it should be mandatory reading – all 108 pages. As the item about the report on the FCC website states: 

“Broadband networks of rural and urban providers save lives by providing rural Americans with instant access to specialized services that are not available in rural areas, saving time that is critical in stroke care and other emergencies. High-speed broadband networks capable of supporting telemedicine and telehealth applications also provide rural patients access to more routine telehealth consultations with medical specialists, efficiently transit health records, and facilitate training of nurses and doctors.

Examples of benefits from the Pilot-funded networks included in the summary:

• Physicians in Bacon County, Georgia saved the life of a young stroke victim by using a telemedicine connection to a specialist in Savannah in order to administer clot-busting medication.
• Remote psychiatric consultations for patients in rural South Carolina hospitals that lack staff psychiatrists speeds treatment and save days of waiting in expensive emergency rooms
• Hospitals in South Dakota’s Heartland Unified Broadband Network have saved $1.2 million in expenses through electronic intensive care unit services, which reduce the number of days patients spend in ICU and the number of transfers to other hospitals.

While this is an FCC program and thus contains mostly numbers about descriptions of the types of entities that got funded, how much they spent, the speeds of connections acquired, etc., what is most impressive are the kinds of things the networks are being used for, which include:

• Tele-psychology/tele-psychiatry
• Continuing medical education
• Electronic health records
• Tele-radiology
• Tele-echocardiology
• Tele-stroke
• Tele-pharmacy
• Tele-ICU
• Tele-emergency or tele-trauma
• Tele-maternal/fetal monitoring
• Tele-pathology
• Tele-infectious diseases
• Tele-EDG
• Tele-dermatology

In short, it is brining quality monitoring and diagnostic care to people and places that either have been unreachable or are under-served. One can only hope, given the escalating cost of medical care and what is likely to be a long-term shortage of physical presence of doctors and nurses in rural areas, that public private partnerships can pick up the ball on the seeds that have been sewn. The hard dollars saved may not be quantified in the report, but certainly the scope of services provided should be proof enough of the value of “tele” when it comes to healthcare.

Plus, the lessons learned here are not just for the care of those in rural settings but anywhere.

With the pilot program now coming to a close, it will be fascinating to see where we go from here.