Health and Media

President Donald Trump touted a new program to increase veterans' electronic access to medical care as part of a broader tele-health push at the Department of Veterans Affairs. The initiative connects veterans with health providers via mobile phones or computers, and is intended to improve medical care especially for those needing mental health and suicide prevention services, President Trump said. “It will make a tremendous difference for the veterans in rural locations in particular,” President Trump said at the White House with VA Secretary David Shulkin. The application allows veterans to schedule appointments via their smart phones. Shulkin also previewed a regulation allowing VA providers to provide tele-health services to veterans anywhere in the country.

Do Medicare and Medicaid pay when beneficiaries use two-way video visits to get care from their doctors? It depends. Medicare pays for some two-way video visits—referred to as "telehealth"—if the patients connect from rural health facilities. Medicare is testing new ways to provide health care that allow telehealth coverage regardless of location. Under Medicaid, states may cover different types of telehealth services from different types of care providers. In the 6 states we reviewed, officials from states that were generally more rural said they used telehealth more frequently than officials from more urban states.

The Federal Communications Commission’s Connect2Health Task Force announced updates to its Mapping Broadband Health in America platform. The 2017 platform now reflects the latest complete annual fixed broadband dataset from the Commission and updated health data from the Robert Wood Johnson Foundation’s County Health Rankings. As telehealth, telemedicine, and other cutting-edge mHealth initiatives gain momentum across the country, this web-based mapping platform enables more efficient, data-driven decision making at the intersection of broadband and health.

I am pleased that the Commission is demonstrating its continued commitment to the Connect2HealthFCC Task Force and the Mapping Broadband Health in America platform with the release of today’s update. For far too many rural and underserved consumers, the broadband health picture remains bleak By investing in this vital broadband health mapping platform and unveiling a new list of critical need counties, the Commission is providing the data needed to ensure connectivity reaches those communities most in need. I am confident that when relevant stakeholders work together across sectors, we will successfully break boundaries at the intersection of broadband and health policy.

The Subcommittee on Oversight and Investigations, chaired by Rep Tim Murphy (R-PA), held a hearing examining the Department of Health and Human Services’ (HHS) role in cybersecurity efforts within the health care sector. Discussed during the hearing were two reports that HHS was required to submit to Congress, following the implementation of the Cybersecurity Information Sharing Act (CISA), which became law in 2015. The reports outline the department’s internal cybersecurity processes and industry recommendations for what the federal government and industry can do to improve cybersecurity efforts in the health care sector.

The Federal Communications Commission’s Wireline Competition Bureau released a Public Notice on May 31, 2017 granting, denying and dismissing various petitions related to actions taken by the Universal Service Administrative Company (USAC) on the E-rate program and rural healthcare. Petitions for reconsideration or applications for review of these decisions must be filed within 30 days of the Public Notice.

[Commentary] Reverting back to a voluntary approach to network neutrality potentially threatens the well-being of many people, particularly those at risk for health disparities due to low income or rural residency. Not only does this voluntary approach shift winners and losers to favor large telecommunication giants, we are specifically concerned with several areas of health care being negatively impacted, including innovative solutions for telemedicine, health enhancement, and cost effective scalable sharing of health care data.

In summary, the new FCC may be proceeding in directions that may make it harder to use telehealth, cloud-based EHRs, and remote sensing technologies that improve access to care and potentially lower costs for all. A thoughtless move toward free enterprise on the Internet could have a negative impact on the health of the most medically underserved Americans. We urge the FCC to investigate the unintended consequences of policy changes to insure that they do not amplify issues of health disparities in lower income and rural populations.

TeleQuality Communications filed comments urges changes to the Federal Communications Commission rural healthcare-broadband programs, arguing that the Universal Service Fund (USF) rural healthcare, telecom and e-rate schools and libraries programs would be more effective if they did not operate as isolated silos. TeleQuality, an organization that provides network connectivity for healthcare providers funded, in part, through the USF rural healthcare program. The filing includes some compelling data points, along with some creative ideas for potential reforms to FCC rural healthcare-broadband programs – although some readers may find some of the ideas unrealistic. The most compelling data points in the TeleQuality filing:

• The number of physicians serving rural areas is insufficient. The filing cites a Health Resources and Services Administration (HRSA) report that found that a majority of rural counties have 1 practitioner serving 3,500 patients when 1 practitioner per 2,000 patients is recommended for adequate care – a finding that confirms similar data that Telecompetitor has reported previously. There is also a shortage of skilled IT personnel in rural areas, TeleQuality argues – another data point that is consistent with previous research on that topic.
• The number of FCC rural healthcare funding requests from healthcare providers has not increased as dramatically as the amount of funding requested – a phenomenon the filing attributes to the significant bandwidth increases needed to run electronic health records systems. At the same time, the FCC program remains underutilized because some healthcare providers do not have the resources to handle program filing and administration.