FCC Rural Health Care Program coming up woefully short

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While mobile devices such as smartphones and tablets offer great potential in running telemedicine applications, without access to broadband services in rural areas of the United States, the promise of telemedicine remains just that--an unfulfilled promise.

Access to affordable broadband services is critical to telemedicine adoption and improving healthcare for patients, particularly those who live in rural areas where there are shortages of primary care physicians and specialists and who must often travel long distances to obtain medical care.

Rural healthcare providers stand to benefit from the use of telemedicine, reducing patient wait times and travel costs, but first they must be able to utilize broadband infrastructure and services. Yet, many rural areas of the country lack access to broadband technology.

Fifteen years ago, the Federal Communications Commission established the Rural Health Care Program to provide discounts on rural healthcare providers' telecommunications and information services and to fund broadband infrastructure and services.

However, according to a November 2010 GAO report, the FCC "has not conducted an assessment of the telecommunications needs of rural healthcare providers as it has managed the primary Rural Health Care Program, which limits FCC's ability to determine how well the program has addressed those needs." In addition, government auditors found that the FCC has not developed specific performance goals for the Rural Health Care Program and has developed "ineffective" performance measures.

The FCC in 2006 launched the Rural Health Care Pilot Program, which has awarded 69 projects (totaling $418 million) to cover up to 85 percent of the cost of construction and deployment of broadband networks that connect participating health care providers. Nevertheless, the GAO concluded that FCC's "poor planning and communication during the design and implementation of the pilot program caused delays and difficulties for pilot program participants."

In an August 2012 staff report, the FCC provided its own evaluation of the successes and challenges of these pilot projects to date, in order to help reform the overall Rural Health Care Program. Among the FCC's findings: the 50 pilot projects that are active in 38 states (which include urban areas) have "done much to foster the creation and extension of broadband networks of health care providers throughout the country."

Last year, however, the American Telemedicine Association charged that the commission failed to follow through on several projects that could improve telehealth delivery, and that the FCC was spending less than 20 percent of the funds it had slated for healthcare.

Despite the FCC's own positive assessment, the Rural Health Care Program is another government initiative plagued by delays that has struggled to meet requirements that clearly were not defined from the outset. The sooner the FCC addresses these problems, the sooner America's rural healthcare providers will receive the broadband services they desperately need to make the benefits of telemedicine a reality for their patients.