Sunday, September 21, 2008

Broadband Topic at Hearing

Jonathan D. Linkous, Chief Executive Officer, American Telemedicine Association, appeared before the Senate Committee on Commerce, Science, and Transportation on September 16th to stress how providers and patients need to have access to broadband networks to effectively provide and receive distance healthcare.

He mentioned that thirty years ago telemedicine was largely composed of federally funded demonstration grants and small projects that connected large hospitals with rural clinics. This enabled people to have access to basic medical services and specialty care where it wasn’t previously available.

These first stage initiatives have blossomed into 200 hospital-based networks reaching out to cover 3,000 sites across America. According to Linkous, we now need to ensure the networks use by interconnecting them and to do this, we must have affordable broadband services available to all healthcare centers. Most importantly, physicians need to be fully reimbursed when they use telemedicine to provide care.

He continued to explain, that the second stage of telemedicine now provides healthcare directly into the home through the use of remote monitoring for those with chronic ailments. However, today telemedicine has moved to the third stage and is now beyond hospital and clinic walls and even beyond the home. In many cases, this is a consumer-based initiative, piggybacking on popular PC programs and using cell phones to help the patients communicate.

There are already over 100 health-related applications available for download on the new Apple iPhone. Other applications allow physicians to use their new cell phones to look at diagnostic images such as an MRI or to transmit images of tissue samples to pathologists. Online and video game support groups for patients have exploded and are a part how healthcare delivery is emerging around the world.

To emphasize the important and essential need for broadband in isolated communities, Gene Peltola, President and Chief Executive Officer of the Yukon-Kuskokwim Health Corporation (YKHC), in Bethel, Alaska appeared via video conferencing technology to speak to the Senate Committee to stress the enormous need for broadband in Alaska.

He detailed that YKHC is a consortium established by 58 federally recognized Native American tribes. The consortium provides comprehensive healthcare to 28,000 consisting of the largely Yup’ik Eskimo population living in 50 communities spread across the Yukon-Kuskokwim Delta in a road less region located on the Bering Sea on the western coast of Alaska. In addition to the lack of roads, the villages are only reachable by plane, boat, or snow machine, plus the fact that during the winter, the Bering Sea generates some of the most violent weather in the world. The villages can be isolated for days or weeks at a time.

Fortunately, investments have been made by the Universal Service Fund’s Rural Health Care program and other federal broadband programs. Private industry also has made a $50 million plus investment in a terrestrial microwave network, called DeltaNet. Now the region uses video teleconferencing to offer behavioral health evaluations, treatment, and consultation for veterans and other patients at residential facilities and at clinics. Using the terrestrial broadband network, YKHC can now offer full remote diagnostic imaging services that rely on teleradiology.

Peltola told the Committee, he wants to see Medicaid reimbursement cover telepsychiatry treatment, licensing, see reimbursement issues addressed when providing distance healthcare delivery, have the VA use IHS and IHS contracted medical facilities to provide medical and behavioral healthcare to rural Alaska veterans, and see RHC increase support mechanism percentage for internet access and add advanced services.