The Federal Communications Commission (FCC) is moving forward with developing a three-year, $100 million Connected Care Pilot program to support telehealth and remote patient-monitoring services to improve healthcare access to underserved populations.
The commissioners voted unanimously to adopt a notice of proposed rulemaking (PDF) calling for public comment on testing a new program, using the FCC’s existing Rural Health Care Program authority, that would defray the costs of purchasing broadband internet access service necessary for providing connected care services directly to low-income patients and veterans.
The program, unveiled by FCC Commissioner Brendan Carr in July 2018, would establish a three-year pilot to be funded by the FCC's Universal Service Fund to help healthcare providers defray the costs of broadband service.
The proposed pilot program would cover up to 85% of certain internet connectivity costs for broadband-enabled telehealth services that connect patients directly to their doctors and are used to treat a wide range of health conditions.
These services can facilitate the effective treatment of chronic conditions outside of the doctor’s office at significant savings for patients and healthcare providers, according to the FCC.
Despite the numerous benefits of connected care, many low-income Americans and veterans, particularly those in rural areas and tribal lands, don’t have broadband access, said Rashann Duvall with the Telecommunications Access Policy Division in the Wireline Competition Bureau of the FCC during the open meeting Wednesday.
Agency Chairman Ajit Pai said at an open meeting Wednesday that the future of healthcare is connected care. "The $100 million budget we propose for the Connected Care Pilot program is a smart investment for us and for the country," Pai said.
Carr said telehealth and virtual visits represent "life-changing care," citing examples of rural residents to whom he has spoken who have benefited from the use of remote monitoring and virtual care to help them manage chronic conditions. "This pilot program will extend treatment beyond the four walls of the hospital and enable patients to receive high-quality care. This pilot has the potential to make a real difference for low-income individuals who lack access to care," he said.
FCC Commissioner Jessica Rosenworcel said connected devices could help bridge gaps in healthcare access for pregnant women in rural areas and potentially help reduce maternal mortality rates in the U.S.
Rosenworcel cited the example of an expectant mother in the upper delta of Arkansas diagnosed with preeclampsia who was given a blood pressure cuff, a weight scale and connected devices to remotely send her blood pressure and weight data to her physicians. The problem was, the woman did not have broadband access, Rosenworcel said. That patient had to drive a mile to access a wireless signal to send the data.
"We have broadband problems and that can prevent us from solving healthcare problems," she said.
Expanding connected care could make a meaningful difference in rural and urban communities, she said. "This effort may not be able to solve all our connectivity problems, but it will put us on a course to do good," she said. "I want these pilot projects to reach far and wide; I want it to reach every state and every territory across the country."
Mark Prather, M.D., CEO of DispatchHealth, a startup that provides urgent care services to patients' homes, said the FCC's approval "accelerates healthcare's inevitable expansion outside the walls of the hospital."
While telemedicine is a useful service for underserved communities to connect with medical professionals, it won't be able to address all of the healthcare problems rural communities face, he said.
"There are often situations that require more advanced care than a video chat can provide, especially if the patient has a more complicated medical history or social circumstance," Prather said.
FCC Commissioner Michael O'Rielly raised concerns at the open meeting about budgeting for the program. The proposed connected care pilot would be funded by the Universal Service Fund, a fund managed by the FCC and paid for by contributions from telecommunications providers.
O'Rielly said that the FCC has not proposed including the pilot within any of the Universal Service Fund's existing programs.
Several organizations commended the FCC for moving the project forward. ACT | The App Association tweeted that the pilot is a "significant step forward in delivering efficient and effective care to America's most vulnerable patients."
Joan Marsh, AT&T executive vice president of regulatory and state external affairs, said in a statement: "The Commission should be commended for leaning in on such a critical issue and creating a pilot program designed to directly impact low-income patients and veterans. As 5G is rolling out, more and more of our health services will benefit from next-generation broadband technologies and programs like this will help ensure those benefits are available to those who need and deserve them the most.”
Today’s @FCC vote on the Connected Care Pilot is a significant step forward in delivering efficient & effective care to America’s most vulnerable patients. Without broadband access, digital health tools won’t reach the people who need them the most. 1/2— The App Association (@actonline) July 10, 2019
Today’s @FCC vote on the Connected Care Pilot is a significant step forward in delivering efficient & effective care to America’s most vulnerable patients. Without broadband access, digital health tools won’t reach the people who need them the most. 1/2— Connected Health (@HealthIsMobile) July 10, 2019
The FCC also is seeking public comment on the appropriate budget, duration and structure of the pilot as well as other issues such as:
- Funding the pilot program separately so it would have no impact on the budgets of the four existing Universal Service Programs—lifeline, rural healthcare, E-rate and high-cost (rural broadband support)
- Who should be eligible to participate in the pilot, including the types of eligible healthcare providers and broadband service providers
- Limiting the pilot program to healthcare providers serving areas with a shortage of healthcare professionals or with lower-income residents
- Targeting support toward tribal lands, rural areas and veteran populations, for which there are well-documented healthcare disparities
- Targeting support toward health conditions that have risen to crisis levels or affect significant numbers of Americans such as opioid dependency, diabetes, heart disease, mental health conditions and high-risk pregnancy
FCC commissioners said data gathered through the pilot program would be used to analyze the possible benefits of supporting broadband service for connected care.