National Broadband Plan Targets Rural Healthcare Program Revamp

The National Broadband Plan proposes significant changes in the FCC’s rural health-care program, Mohit Kaushal, the commission’s digital health care director, said on a panel Wednesday held by the Health IT Now Coalition.

Under the plan, participating institutions would be judged on outcomes-based performance measures like “meaningful use,” Kaushal said. It also proposes subsidizing ongoing broadband costs at a higher rate, expanding eligibility to include urban and some for-profit institutions and subsidizing network deployment to delivery locations where networks are inadequate, he said. Upgrading broadband for Indian health care also is in the recommendations, Kaushal said. The main barriers to health IT include the lack of broadband access, cost, misaligned economic incentives, outdated regulations and the lack of data and information, he said.

The plan calls for creating incentives for adoption of e-care technologies, improving health-care data and modernizing health IT regulations, Kaushal said. That means providing Congress with a plan to realize the value of e-care, increasing e-care pilots that evaluate cost savings and clinical outcomes and expanding reimbursement for e-care under the current fee-for-service model where outcomes are proven. The plan calls for revising credentialing, privileging and state licensing requirements to enable e-care. It also urges clarification of regulatory requirements and the approval process for converged communications and medical devices. The plan recommends creating next-generation interoperability across clinical, research and administrative data and ensuring that patients have access to and control over their health data.

Hank Fanberg, technology advocacy manager for Christus Health, said the plan’s health-care proposals provide for all the pieces needed, though “there might be some minor issues.” Cost is a key barrier for access to health care in rural areas and the plan has some great recommendations to deal with that, he said. But the lack of coordination at federal agencies responsible for health care remains a key issue, he said. Karen Rheuban, the American Telemedicine Association’s president, praised the plan, saying infrastructure and a policy revamp are needed. “We hope the National Broadband Plan serves as a driver for both innovation and connectivity, which are two key elements to lowering costs and improving patient care,” said Joel White, executive director of the Health IT Now Coalition, which promotes health IT deployment. Modernizing the health-care system means clinical IT advancements for access, health information exchange at work and automated higher quality paperless administration, said John Santelli, the chief information officer of UnitedHealth Group, adding that they all depend on reliable broadband infrastructure.

Meanwhile, the use of smartphones by physicians, access to communications tools and the importance of cellular network reliability were underlined by the panelists. Making more spectrum available for mobile broadband could also be critical for health care, Mohit said. How these technologies can be reimbursed for is important, he said.