The wireless route to telehealth (Reader Forum)

There is not much to recommend this current coronavirus pandemic. But there were two silver linings. 

One was that the virus took telehealth mainstream. Two years ago, only 10% of healthcare consumers had tried telehealth. In a March 2020 consumer survey conducted by demand generator Sykes, “60% say that COVID-19 pandemic has increased their willingness to try telehealth.” Unfortunately, 35%-50% of some urban and 53% of rural communities lack broadband. Oh broadband, no telehealth.

Fortunately, the second silver lining is that wireless technology received a serious boost because of COVID-19. Also in March 2020, a survey of Wireless ISPs revealed “83% of WISPs are adding new subscribers, with this business being 33% above normal.” When you need connectivity quickly and affordably, wireless effectively fills in the breach.

“Telehealth is furthered by broadband connectivity, and WISPs [Wireless ISPs] are uniquely suited to this type of app,” says Mike Wendy, Director of Communications at WISPA. “With line-of-sight technology they can shoot broadband on a daily basis, and even in emergency situations, across a distance into an area that can’t get wireline access.”

Only thing moving faster than toilet paper was wireless routers

“In the early days of the pandemic, wireless equipment was flying off the shelves as everyone suddenly had to have Internet, says Casper Faust, Field Operations Manager at Paladin Wireless in Georgia. Paladin found a way to offer an effective LTE solution for emergency Wi-Fi access using available technology and a GIS platform. 

“I could see deploying an LTE solution for emergency Wi-Fi access across neighborhoods using quick and ruggedized set-ups based on our existing network technology and frequency access,” says Faust. “It’s similar to how your smartphone instigates a personal, secure hotspot.” But instead of getting a little hotspot, a WISP plugs a device straight into a Wi-Fi router that enables it to become a super-powerful router that’s sped up by the network’s LTE connection.

Rather than living on towers, dealing with wiring installation, and semipermanent fabrication on the equipment, “‘Here’s a little piece of white plastic, go plug it in and everybody can have Wi-Fi.’ We can deploy this a hundred times faster,” Faust says. “The Beamfly GIS platform lets one staff person connects to and track dozens or hundreds of routers. Even before the customer realizes there’s a problem with the network, the operator is addressing the issue.”

The FCC updated its Rural Digital Opportunity Fund (RDOF) so small broadband owners can bid on more opportunities, and the US Senate are making a couple of billion dollars available to deploy telehealth. If your community has a comprehensive telehealth strategy plan and you can move quickly, telehealth can drive subscribers to your wireless network.

Telehealth is a marketing decision

Whether you’re a WISP, a municipal, or a co-op owner of a wireless community network, there is a good marketing case for facilitating telehealth. Your network can be just a set of “dumb” routers that pass on data, or you can harness telehealth to be a marketing tool. Every home doesn’t have kids, not everyone works from home, but everybody gets sick.

Telehealth enables healthcare professionals to use intranets and Internet networks to observe, diagnose, initiate or otherwise medically intervene, administer, monitor, record, and/or report on the continuum of care – everything that’s done to get you healed. Wireless can support the telehealth continuum and redefine what a hospital is. That sells!

A comprehensive telehealth strategy can reduce the healthcare gap between those who have access to affordable quality healthcare, and those who do not. That strategy can achieve these six objectives: 

  1.  Re-imagining the doctor visit 
  2.  Marrying chronic healthcare and home care
  3. Enhancing emergency response and trauma care
  4.  Mental health care
  5. Improving senior care and Aging In Place
  6. Re-imagining hospital care

Increasing wireless coverage in general can increase telehealth adoption, but some cultures are reticent to trust the healthcare industry. Communities can get creative at how they define “doctor’s visit.”

There’s a 10-city pilot program launching in which barbershops do hypertension screening by telehealth. DiFrent Level Barber Studio partnered with the Wilson County [NC] Department of Health. Owner Kahmahl Simmons says, “The value of this program is more than getting valuable information out of the barbershop experience, but the experience you might help or change your life.”  

“I can see equipping barbershops with telehealth being successful,” says Matt Larsen, owner of WISP Vistabeam. “I would designate barbershops as a ‘community anchor institutions”, which are the magic words broadband industry people understand. Then you use telehealth to drive subscribers onto the network in neighbors around the barbershop.”

Telehealth is more than video chats with you doctor 

Many rural residents are two-to-three hours from the nearest hospital. Communities are equipping emergency vehicles with portable ultrasound devices, CT scanners and defibrillators and wireless hotspots. 

Consider strategically deploying roadside high-powered wireless hot spots in case patients need immediate medical attention while still en route to the hospital. Mobile satellite hotspots configured for telehealth could be helicoptered in to areas where communities may be isolated following natural disasters, such as earthquakes or floods. 

A recent survey conducted by CVS pharmacy revealed individuals 65 and older have a strong desire to maintain their independence for as long as possible, with nearly eight in 10 seniors (79%) noting that they plan to “age in place.” Add to the technology mix Internet of Things (IoT) and Smart Home sensors that can determine a health crises before it happens, remind patients to take a pill, or guide someone through rehab routines.

Mitigating hospital closings may be telehealth’s greatest challenge. These closings in poor urban and rural communities are making the country’s healthcare crises worse. For example, since 2010, 120 rural hospitals have closed and 453 of the 1,844 are vulnerable for closure. 

Wendy believes in out of the box thinking. “Let’s say there’s an office complex that’s been abandoned and it doesn’t have connectivity,” he says. “The community may decide it needs a ‘overflow center’ if regular hospitals fill up because of COVID-19, or they need temporary space for treating itinerant workers. A WISP can go out there and in two days provide broadband service for telehealth.

There’s no reason that healthcare has to be delivered in a hospital. In fact, patients are best served in an environment where they are made comfortable. By trusted members of their own community. Hospitals have to go meet patients where they are, not the other way around.” (Dr. Max Goodwin, Medical Director on TV show, New Amsterdam)

Start with broadband, telehealth, core medical equipment and an available building. Then step outside the box. Re-imagine your community hospital.  Re-imagine Healthcare.

 Saved from a stroke by telehealth, Craig Settles is paying it forward by uniting community broadband teams and healthcare stakeholders through telehealth initiatives. He’s a community broadband analyst and consultant assisting communities with broadband and telehealth planning.  

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