Did you know?

Expanded broadband service can enable improved care at a reduced cost for more people? This is extremely important in these difficult economic times and as health care facilities work to provide a high quality of care for patients. With lack of funding available to expand broadband services, health care organizations need to look for partnerships in order to move forward in the world of medicine.

Statistics below outline cost savings and benefits made possible through a higher level of broadband connection.

·         Small pilot projects focusing on broadband use have produced significant reductions in hospital admissions and the cost of care. 1

·         A Veterans Administration study of one remote monitoring program showed a 40 percent cut in emergency room visits and a 63 percent reduction in hospital admissions. 1

·         Penn StateUniversity estimated that remote home health monitoring for one group of diabetes patients cut costs for hospital care 69 percent, from almost $283,000 to approximately $87,000 per patient. 1

·         A study by economist Robert Litan projected that broadband-based monitoring could cut medical costs for senior citizens by about 30 percent. 1

·         A study from the University of Texas Medical Branch estimates that the US health care system can save $4.28 billion from the elimination of patient transfers. This benefit of high speed internet does not include the potential savings from remote monitoring of interpretive services. 2

·         In a study published in 2005, Robert Litan estimated that using broadband more extensively in caring for senior citizens and persons with disabilities could result in cost savings and productivity gains of at least $927 billion through 2030. Litan noted that such benefits would occur in three main ways: by directly lowering health care costs, by postponing or eliminating the need for institutionalized care, and by enabling increased workforce participation. According to Litan, certain policies that Litan recommends could increase the payoff by another $530 to $850 billion. 3

·         According to a paper prepared for the Internet Innovation Alliance, reviews found that diabetic patients using a telehealth system average hospitalization costs of $87,000, versus $232,000 for members of a control group who received only traditional in-person nurse visits. 3

·         Remote monitoring of health conditions could reduce the number of emergency room visits by 40 percent, cut hospital admissions by 63 percent, and reduce the number of days in the hospital by 60 percent, according to a paper prepared for the Internet Innovation Alliance. 3

·         A paper by Alliance for Public Technology outlined the telehealth program in Alaska that cut Medicaid-reimbursed travel costs by 82 percent, and a rural telehealth program in Arkansas that saved millions in Medicaid costs and decreased infant mortality. 3

·         Statistics have shown that telemedicine services reduce re-hospitalization, reduce admission to nursing homes and overall lower the cost of health care. In rural areas, telemedicine has allowed 85% of patients to remain in their local community and has led to improved outcomes. In Arkansas it has even reduced infant mortality rates by providing early access to prenatal care. 4

·         In central Wisconsin, telemedicine services include telehealth exam rooms, clinic exam technologies, telepharmacy, Head Start programs and teledentistry. Approximately 45 clinical services are offered to approximately 4,000 patients a year. Ideally, creating telehealth partnerships with entities including hospitals, the Department of Defense and Veterans Administration, rural and free clinics, the Health Department, schools, nursing homes, work places and retail clinics can improve healthcare. In fact, telehealth in the work place has proven to reduce lost days of work by 65%.  4

Did you know?

Using high-speed connections could improve the quality of health care for patients:

·         Among the most advance initiatives using broadband to improve health care is enhanced medical recordkeeping that knits together electronic databases, giving patients and authorized providers instant and centralized access to information such as health histories, treatment regimens and medical images. Digital records available over high speed networks can reduce waste, improve patient outcomes and cut costs. By making test results, medical history and medical images available to health care professionals, it is beneficial as they guide diagnosis and treatment decisions. 1

·         Telemedicine applications that enable real-time clinical care involving geographically distant patients and providers can deliver the highest quality care to even the most remote communities. Remote monitoring made possible by broadband can facilitate post-operative care and chronic disease management without hospitalization or institutionalization. 1

Broadband can assist the medical community in a variety of ways including:

·         Enhancing quality and decision making by connecting patients and practitioners to information sources about best practices, health care innovation, quality care measures, and data on the effectiveness of medical institutions and practitioners.1

·         Reducing costs and creating efficiency in health care management by streamlining recordkeeping and administration. 1

·          Empowering patients by improving access to information and enabling them to control their personal health record. 1

·         Closing the medical care gap between urban and rural America and expand access to care through the use of telemedicine for a range of clinical care programs.1

·          Improving the quality of care for all Americans by linking patients and practitioners to the top specialists in every branch of medicine through real-time Internet consultations.1

·         Reducing medical care costs and improving life quality through remote monitoring that brings more care directly into the home.1

·         Overcoming healthcare provider shortages through Internet-based care that connects distant practitioners to communities where local medical resources are in short supply.1

·         Enhancing disaster preparedness and recovery with seamless communication that can help medical care givers respond quickly to areas of greatest need.1

Telemedicine, made possible by high speed broadband, can be used to assist people in distant locations – a recent example of this the victims of the Haiti earthquake. Outlined are ways that other organizations are optimizing broadband in their facilities:

·         The University of Miami Jackson Memorial Hospital plans to export cutting-edge technology to help its medical colleagues perform life-and-death surgeries, in Haiti. UM has dispatched doctors and other medical teams to Haiti and is setting up a telemedicine program with a satellite connection to help physicians in Haiti better triage patients.8

·          In Japan, NTT has a system that helps small-town doctors by relaying images of cell slides, X-rays and other medical data to pathologists in well-staffed city hospitals. Hitachi has developed a rubber mat that can monitor and transmit a person’s pulse, blood pressure and other data. Both of these applications rely on fast, dependable broadband connections. 3

·         A cardiac patient in a small hospital in Guam was able to undergo a life-saving heart operation supervised by an expert doctor located 3,500 miles away at TriplerArmyMedicalCenter in Honolulu. The surgery was relatively routine for Dr. Benjamin Berg, who was able to dictate the procedure to a less experienced colleague, monitoring every move and heartbeat with a high resolution video camera and instant sensor gathering data from the catheter as it was slid carefully into the right chamber of the patient’s heart. 3

·         In Fort Wayne, Ind., the extensive fiber optic network deployed by Verizon enabled the City to set up a system in which retired nurses help provide health evaluations for low income residents without health insurance over two-way broadband video. 3

·         The Alaska Federal Healthcare Access Network (AFHCAN) is linking more than 248 sites including: military installations; Alaska Native health facilities; regional hospitals; small village clinics; and, state of Alaska public health nursing stations for a range of healthcare services using a variety of high-speed broadband services including satellite. 3

·         In WareCountyGeorgia, the public health department is using T1 connections over a Wide Area Network to link 16 county health departments in Southeast Georgia to establish critical service links for children with special health care needs. 3

·         The Downstate Illinois Regional Telehealth Program is using T1 lines, DSL, and Cable to develop community-institutional partnerships to strengthen local health care capacity through the use of advanced technologies. They provide medical education and training to 52 rural hospitals – including 32 critical access hospitals – using videoconferencing, satellite broadcasts and web streaming.

·         Although still in its infancy, remote robotic surgery has been successfully demonstrated on many occasions including recently at the 86^th Annual Congress of the AmericanCollege of Surgeons, where Johns Hopkins physicians at McCormick Place in Chicago performed a remote-controlled and computer assisted minimally invasive procedure on a patient located in Baltimore. 3

·         The 82 site Missouri Telehealth Network has provided services in more than 15 different medical specialties, with a majority of the work coming from radiology, mental health, dermatology and cardiology. To date, more than 11,000 interactive video encounters and 57,500 Teleradiology exams have been conducted. The Missouri Telehealth Network uses T1 (Frame Relay) connections to each site to provide dynamic bandwidth allocation for voice, video and data. 3

·          Since its inception in 1993, the Eastern Montana Telemedicine Network has conducted 15,728 clinical encounters averaging over 1200 encounters annually. Tele-mental Health services are EMTN's leading medical application. Other clinical applications include specialty areas of cardiology, nephrology, diabetes education, emergency medicine, ENT and radiology. The program uses T1 connections for videoconferencing. 3

·         The REACH program, initially established by the Medical College of Georgia, puts stroke specialists in touch with rural hospitals and physicians statewide for consultation on key treatment options during the critical three hours after a stroke. 3

·         In connection with the Virginia Tech Network Virginia program, the Southwest Virginia Alliance for Telemedicine is using ATM T1 connections at each site to provide clinical consultations for pediatric cardiology, diabetic retinopathy, radiology, and dermatology. 3

·         The Tillamook, Oregon Lightwave Telehealth Technologies project is designed to provide broadband service between emergency care providers, the county health department and hospital using a virtual private network to share critical information in support of emergency care services. 3

·         University of South Dakota Health System is using T1 terrestrial lines and Satellite connections to frontier rural areas of the state to provide teleconsultation for high-risk newborns. 3

·         University of Tennessee Health Sciences Center is using Satellite links to provide Telehealthservices for diabetic patients in largely Hispanic and underserved frontier communities. The University of Arkansas’ ANGELS program connects physicians at more than 40 sites with pregnant women in rural communities to improve pre-natal care and reduce the number of low birth weight babies. In 2005, the program’s call center received an average of 2,500 calls a month and facilitated more than 400 critical hospital transports. 3

The magnitude of the benefits that can provide is dependent on the connection speed.

·         The tremendous promise of broadband-enabled health care would be severely hamstrung if it had to rely solely on a few Megabits of capacity. A crucial part of effective telehealth services is the transmission of high-definition medical images. Under the FCC’s former definition of “broadband” (200 kbps), it would take nearly a full day to download a 10minute diagnostic video clip. At current DSL speeds, it would take almost three hours. Moreover, because DSL and CMS are typically asymmetric – i.e., upload speeds are much slower than download speeds – it would take much longer than three hours for the patient or his local doctor or health care facility with only DSL or CMS to upload the images to forward them to the reviewing health care facility. With a symmetric 100 Mbps broadband connection, it would only take three minutes to transmit the video clip. 3

·         A T1 internet connection could take up to an hour to move an image study on the network and today providers like Internet2 can move these same data sets in a few seconds. This time for broadband is critical, especially in emergency medicine. Other factors contributing to increased bandwidth usage are activities in medical education (5-10MB for each participant) and patient evaluation in remote clinics. It is important to recognize the cost saving potential of remote clinics and benefits to the patient such as eliminating transportation costs and increasing access to care. 4

Summary

The future of health care depends on your health care facility connecting to the Northeast Middle Mile Fiber Project.  “Today, telemedicine has the greatest probable impact in preventative and wellness care.” 4 And the potential for using high speed internet technology to expand access and quality of health care in the US is enormous. The use of advanced communications technology to transmit medical data and imaging in real-time, while linking patients to providers for direct consultation, removes geographic barriers and allows people to receive the medical care they need when and where it’s needed. 2
“In the face of rising medical costs and increasing gaps in insurance coverage, the cost-cutting efficiencies of telemedicine – the delivery of quality health-related services and information using telecommunications technologies are more valuable than ever. Universal high speed Internet access would help bring the prospect of affordable and quality health care for all Americans closer to reality.” 2 For local providers, partnering with a project of this magnitude will provide a cost savings and will bring fiber into unserved and underserved areas. 
“Systemic reforms have proven elusive to date, and a comprehensive national overhaul of the health care system may take years more to achieve. But information technology tools, including broadband, are already improving care, expanding access and cutting costs in a variety of locations across America. We know how to use Telemedicine and advanced information technologies to help close the economic and geographical gaps in coverage that routinely separate many rural and inner city poor patients from needed medical services. Today there are literally thousands of successful examples of new communications and IT services being pressed into service for patient care, administration and management, improved service delivery, medical research, and teaching.” 1
“Broadband enables patients and caregivers to overcome geographic barriers to care. Indeed, the broadband-supported Internet service has given birth to the emerging field of “telemedicine” to link medical experts to patients and practitioners in remote locales hundreds or even thousands of miles away. New telemedicine applications ranging from remote monitoring of chronic diseases to robotic surgery are delivering new hope and better life quality to patients who would otherwise be beyond the reach of the highest levels of care. Even as we work for overall reforms, we can accomplish much by taking advantage of broadband to share information and deliver clinical solutions.” 1
“The magnitude of the benefits that broadband can provide is highly dependent on connection speed. The transmission of huge, detailed medical imagery and diagnostic files, the use of two-way video communications to facilitate patient monitoring as a substitute for travel between homes and medical facilities, and particularly such bandwidth-rich applications as telesurgery, all require massively more bandwidth than is available to most Americans today.” High-capacity broadband can not only reduce the costs of modern health care, but it can also improve the quality of care and quality of life of those not located near urban facilities. 3
“New technology developments such as the picture archiving and communication system,electronic health records, remote diagnostic testing, telemedicine and other health information technology (IT) initiatives are driving up bandwidth requirements in healthcare. By creating multi-purpose networks, broadband capabilities can be brought to areas where none exist today. To sustain the continued expansion of health IT broadband is essential anywhere a person has healthcare needs. High bandwidth is crucial in supporting the ever-expanding technical infrastructures prevalent throughout many of the nation’s hospitals, clinics and doctors’ offices.” 4
“High speed internet access, which was once considered a luxury – is viewed increasingly as a necessity, as it revolutionizes critical areas, such as education, public safety and health care.” 4

Health Care Article References

1 Advancing Heatlhcare through Broadband: Opening up a World of Possibilities. A White paper for the Internet Innovation Alliance. Neal Neuberger, CISSP President, Health Tech Strategies, LLC.

2 Speed Matters. Benefits of Broadband 2009. A project of Communications Workers of America. AFL-CIO, CLC. www.speedmatters.org

3 e-NC.org: Economic Development Benefits of Broadband. Health Care Excerpt from the Bailer-Herbst Report.

4 HIMSS. FCC Broadband Workshop on Health Care. Heather Mikulski, HIMSS Foundation Intern. Sept. 17, 2009.

5 A Life-saving Technology. John Borland. Jim Hu. CNET News.com 2004

6 Vision for Health Care connectivity: Broadband at the Point of Care. John Clarey, Chairman, National Medical Wireless Broadband

Alliance. Sept. 15, 2009

7 Broadband Internet Access: A Primer for Health Care Professionals. Connect the Docs, Bringing High Speed e-Medicine to the Patient-Doctor Relationship. Pennsylvania Medical Society project.

8 Haitian Earthquake Survivors Receive Medical Treatment in

Miami. Roxana Romera. Miami. Jan 23, 2010. VOANews.com