Craig Settles

What can make people enthusiastic about broadband? What if a community, using the creation orientation, views broadband as the means to build or invent things that didn’t exist before? Essential Families is a 501c3 nonprofit that provides virtual parental education and mental healthcare services. The organization conducted a telehealth pilot in one of the poorest communities in Kansas City (MO) with stellar results.

Too often policymakers, political leaders, contractors, and consultants want to tell communities just how broadband should work for their unserved and underserved.

As wonderful as telehealth is, it has a serious Achilles' heel. The fate of telehealth adoption is tied to the fate of broadband adoption. And broadband in millions of additional homes isn't strong enough to drive telehealth. Redlining, politics, and adverse economics leaves low-income communities stuck with outdated, broken infrastructure. Annually, billions in government spending to replace obsolete networks passes over big cities and are squandered by large telecom and cable companies before broadband reaches rural homes.

The share of U.S. adults using the internet has not grown significantly since 2013, according to the Pew Research Center. It’s a trend reflected in rural broadband subscription rates that continue to lag significantly behind rates in urban areas. The gigabit elephant in the room is the ridiculous amount we spend for broadband relative to the quality of services communities, especially rural areas, get. Federal agencies have been spending $6 billion per year since 2009 for rural broadband.

The state of broadband in the US’s farmlands is a mixture of the good, the bad, and the apprehensive. The good: successes and advancements brought on by broadband and various digital technologies. The bad: many farms still have to rely on pitifully weak technologies such as satellite and DSL. The cloud of apprehension: we spend $6 billion in broadband grants yearly with surprisingly little to show for it, and yet we’re ready to do it again next year.

In community broadband, libraries are considered “anchor institutions.” Like anchor tenants in a mall, libraries and other institutions, such as schools, hospitals and assisted living facilities, all contribute to the financial stability of broadband networks. Libraries drive large numbers of people onto networks. Now they can drive thousands to telehealth through those networks. Libraries are realizing that they can be in the vanguard of transforming health care delivery in urban and rural areas.

The FCC's Emergency Connectivity Fund is providing $7 billion worth of broadband and leading digital technology for two critical anchor institutions – libraries and schools. Three US Senators launched the BRIDGE Act to bring $40 billion to these and other anchor institutions. The Elementary and Secondary School Emergency Relief Fund (ESSER) opened a $122 billion grab bag of tech and non-tech funds.

The Federal Communications Commission and the US Treasury Department are giving schools a tremendous opportunity to close both the homework gap and the healthcare gap.

Libraries may be on the brink of a great mobilization to narrow the digital divide. The needs are there, and money is certainly available. If given creative reign with telehealth, great things can come from even the smallest of libraries in these areas:

Currently there are 14 million people living in urban communities in the U.S. who cannot access telehealth service, yet the Federal Communications Commission and USDA will spend $5 billion this year to get telehealth and broadband to 4 million rural households.