FCC's Carr previews $100M pilot program to support telemedicine

WASHINGTON—A $100 million telehealth initiative announced by the Federal Communications Commission (FCC) earlier this month will largely focus on delivering virtual medical technologies directly to low-income patients in remote areas of the country, according to Commissioner Brendan Carr.

At a Tuesday event held by the Connected Health Initiative (CHI) at the Microsoft Innovation & Policy Center, Carr spoke with ACT | The App Association President Morgan Reed about how stakeholders can expect the FCC's Connected Care Pilot Program to work.

The program is still in early days. The FCC has yet to vote on its Notice of Inquiry, let alone put out a Notice of Proposed Rulemaking, so the program still has plenty of time to change. Carr noted that he was eager to get comments back on those documents because, "we're not healthcare experts, so we need comments."

Still, the outlines of the pilot are clear: The FCC fund would be used to provide targeted support to connected care deployments for low-income patients. While the FCC has long targeted deployments in such a way to connect healthcare facilities, the move is a big step forward because it means connecting individual patients—including those who may live in extremely remote locations.

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Since the early 2000s, the FCC has supported rural broadband connections to brick-and-mortar healthcare facilities through the Universal Service Fund. This enabled some early rural telehealth applications, such as securely connecting with a specialist at a facility across the country while a patient visited their closest clinic.

The new pilot program aims to add to that foundation by supporting rural connectivity not just to facilities, but to patients themselves. That's a crucial prerequisite for any remote care arrangement that involves tracking a patient's medical data.

"For the first time, we now have technology that can make a difference. So that when you leave the confines of these connected brick-and-mortar facilities, you maintain access to high-quality care," Carr said. "Now patients are sent home with apps on their tablets or iPads, and they can daily track their progress, get access to video and other information, and we're seeing tremendous benefit in terms of outcomes for patients, but also really large savings for the healthcare industry. Particularly in terms of chronic diseases."

One example Carr gave came from a pilot program targeting diabetes patients in Mississippi. The program sent patients home with single-use tablet (one with just one app) that connected to a Bluetooth device measuring their A1C levels. The tablet would remind patients to prick their finger at the same time every day, then provide them advice based on readout.

Carr said the program saw a 1.7% reduction in A1C levels among patients using the remote patient monitoring system—a significant improvement.

"If just 20% of the diabetic population in Mississippi enrolled in that type of program, it's projected to save $189 million in terms of reduced Medicaid expenses in the state of Mississippi," Carr said.

RELATED: FCC says wireless networks are impacting healthcare costs and outcomes

The problem is that even when patients can get access to such a program, they don't always live in areas where the devices can connect to the internet. That's where the FCC comes in.

While Carr said the FCC lacks clear legal authority to support the apps and devices used in programs like Mississippi's, it can help by targeting broadband deployments at areas where patients need them.

"The easiest thing for us to fund from a legal authority perspective is the broadband connection to these devices. And in fact a lot of the time, we've seen that that is one of the things that holds these programs back, because there's no reimbursement on that side. The pilot program I mentioned in Mississippi, the local wireless provider, C Spire, donated the connectivity, so that's one thing we can support," he said.

Part of that effort will come with the continual push toward 5G, and Carr said telemedicine is one reason the FCC has put such a big emphasis on reaching rural areas with its deployments.

"Places like New York and San Francisco, they're going to get 5G and next-generation technology deployments almost no matter what we do at the Commission. The business case drives it, the economics of high-population density drive it," Carr said. "But our view is that we need to make some regulatory reforms so that every community has a fair shot at these networks."