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Telemedicine is rural health care safety 'net' that must remain neutral

January 08, 2018 | Dusty Nix | Columbus Ledger-Enquirer

One of Georgia’s most serious challenges is access to health care in rural parts of the state.

To call the situation a crisis is no overstatement. The shortage of physicians, nurses and other health care professionals outside the state’s metro areas is worsening, and rural hospitals in Georgia, which serve disproportionately poor and indigent populations, have been closing at an alarming rate.

Now, according to Georgia Health News, rural health care access in Georgia and elsewhere faces a new threat that most of us probably didn’t think of in health terms at all — the Federal Communications Commission’s recent decision to end “net neutrality” rules that prohibited telecom companies from giving (or selling) different levels of priority connectivity — to divide the Internet, as GHN put it, into “slow” and “fast” lanes.

This becomes a health care issue because one of the most critical and increasingly important alternatives to direct access is telemedicine, which provides interactive communication for patients and/or local professionals with health care providers elsewhere. To cite one example from the American Telemedicine Association, almost a million Americans are using remote cardiac monitors. Another: The VA reports that “more than 700,000 veterans made more than 2 million telehealth appointments” in 2017 (GHN).

If broadband companies don’t provide telemedicine services with priority connections — or if those services (or the patients they serve) can’t afford them — then the gap in rural care that digital technology is helping to close will widen again, at the cost of human lives.

“Without that connectivity, telemedicine doesn’t work,’’ Mei Kwong of the Center for Connected Health Policy told GHN. “You need it on the patient end and the provider end.” Rural clinics “don’t have a lot of cash,” she said.

Georgia House Speaker David Ralston, R-Blue Ridge, acknowledged to reporters last week that lawmakers had not yet delved into the net neutrality decision’s possible effects on rural health care: “Telemedicine, we all recognize, is going to be a larger part of our health care future … But it’s not going to be in areas where you don’t have high-speed internet.”

The American Academy of Family Physicians appealed directly to FCC Chairman Ajit Pai last summer, in a letter that said in part, “Lack of health information exchange is literally life-threatening. It is paramount for the health and well-being of U.S. citizens that no barriers be placed hindering the free and open appropriate exchange of health information.”

GHN noted that there is some speculation the new FCC rules, which have not yet been made public, will include an exemption for health care from the “net neutrality” repeal, meaning (one would hope) high-speed connections.

But Kwong, of the Center for Connected Health Policy, remains skeptical: If the patient isn’t in a hospital or other health care facility, how would that work?

Continue reading the full op-ed in the Columbus Ledger-Enquirer.