A lack of broadband service is limiting the deployment of telemedicine services in some places of the U.S., and not just remote rural areas, some experts say.
Panasonic of North America, while providing Internet-based heart monitoring services for elderly residents of the New York City area, found several places were there were no wired broadband, Wi-Fi or strong mobile signals available, Todd Rytting, CTO for the company, told a U.S. Senate committee Tuesday.
The SmartCare monitoring service significantly reduced the numbers of heart patients who had to return to the hospital, but "the biggest problem we faced was the lack of broadband to some of our citizens," Rytting said. Some potential users of the service couldn't get a broadband connection in "downtown New York City," he added.
Panasonic experienced the same problems in nearby Newark, New Jersey, particularly in some large apartment buildings, Rytting said. In many cases, wired broadband wasn't available, and Wi-Fi signals didn't reach the upper floors of high-rise buildings, he said.
"What I did not dream of was the unavailability of broadband in urban settings," Rytting said. "To be able to be a heartbeat away from New York City and not be able to get a signal in a structure that had thousands of tenants in it just boggled my mind."
Several members of the Senate Commerce, Science and Transportation Committee focused on rural broadband deployment, with Chairman Roger Wicker, a Mississippi Republican, noting that more than half of U.S. rural residents lack access to broadband, as defined by the U.S. Federal Communications Commission. Early this year, the FCC redefined broadband as Internet services with download speeds of at least 25 Mbps.
Many committee members also noted other problems with deploying telemedicine services, including a lack of coverage for many services by the federal government's Medicare program and a lack of interstate licensing for doctors. A Washington doctor treating a rural Montana patient using telemedicine would need medical licenses in both states, said Jonathan Linkous, CEO of the American Telemedicine Association.
While telemedicine is leading to improved health care in parts of the country, growth has been slow in other areas, witnesses told senators. Hundreds of thousands of U.S. residents are treated each year with telemedicine, but the technology has so much more potential, Linkous said.
The FCC has moved slowly over the past several years to promote telemedicine, Linkous said. While the Telecommunications Act of 1996 provided telecom subsidizes for rural health-care providers, "I am constantly disappointed that the Federal Communications Commission has not done more on this program," he said.
A pool of money targeted for rural health-care providers has been underused, he said. The program is "too engineered and needs a lot of fixes," Linkous said.
Current FCC Chairman Tom Wheeler has focused on telemedicine and appointed a task force in March 2014 to look at ways to accelerate its deployment, said Dr. Chris Gibbons, scholar in residence at Connect2HealthFCC.
While most committee members voiced support for faster deployment of telemedicine, one senator raised questions about the privacy of health records. Congress may need to pass new legislation to require data security practices for telemedicine providers, said Senator Edward Markey, a Massachusetts Democrat.
"The records can now be up in the cloud," he said. "The medical providers can be using the least costly way of storing this information, using pretty much the same connection that we watch YouTube videos on."
Linkous and Dr. Kristi Henderson, chief telehealth and innovation officer at the University of Mississippi Medical Center, said they haven't seen any problems so far with leaked information on telemedicine systems. Henderson's organization encrypts patient data, she said.