US makes $300 million available for telehealth initiatives

The Federal Communications Commission (FCC) has announced a $200 million programme to bring telehealth initiatives to US citizens, and an additional $100 million fund to help telcos build the networks.

As part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed through Congress last week, $200 million will be made available for healthcare providers to purchase the necessary broadband contracts and devices to deliver telehealth services, while the separate Connected Care Pilot Program will provide up to $100 million from the Universal Service Fund (USF) to add more to the pot.

“Almost two years ago, former FCC Chairman Newt Minow and I advocated for telemedicine as ‘a critical tool for making Americans healthier’ and called for forward-thinking policies that could ‘bring our health care system more fully into the digital age’,” said FCC Chairman Ajit Pai.

“Now, in the midst of the national emergency caused by the coronavirus pandemic, our call has taken on serious urgency.  Connected care can help us treat coronavirus patients, enable patients with other conditions to get care while maintaining social distancing, and protect health care professionals from greater exposure.”

The concept of digital health solutions are of course in their infancy, but now would seem like an excellent time to accelerate the development and adoption of such services. The US might have been one of the latter nations to be impacted by the coronavirus outbreak, but it appears the consequences are becoming much more serious.

Employment has steadily decreased over the last decade, since the largest impacts of the 2008 global recession, though coronavirus has snuck its teeth deep into the US economy and society in recent weeks.

US Unemployment as percentage of workforce (2011-2020) at February-end
Year 2011 2012 2013 2014 2015
Unemployment 9% 8.3% 7.7% 6.7% 5.5%
Year 2016 2017 2018 2019 2020
Unemployment 4.9% 4.6% 4.1% 3.8% 3.5%

Data curtesy of US Bureau of Labor Statistics (BLS)

While the Dow Jones has been showing signs of stability, down 27% since the end of February but the sharp decline has halted, the unemployment numbers are a blow. According to the new statistics, 9.95 million individuals have filed for unemployment in the US over the last two weeks. This fortnight period is higher than the previous ten months aggregated.

The figures for March will be made official by the BLS Statistics in the coming days, but with COVID-19 closing many businesses and high streets across the US, unemployment figures could return to the early part of the decade. The BLS estimates the total US workforce was over 164 million in February; 9.95 million individuals, the number who have filed for unemployment over the last two weeks, would represent 16.4% of this workforce now being unemployed.

And it will be the poorest communities which will be hit the hardest.

“I am also glad that the pilot program focuses on meeting the needs of low-income people and veterans,” said Commissioner Geoffrey Starks. “As the coronavirus pandemic continues, more and more Americans face unprecedented economic challenges.

“Just last week, a record 3.3 million American applied for unemployment benefits. More hardships are ahead. I am hopeful that this pilot program will both provide targeted assistance to communities in need as soon as possible and pave the way for a broader commitment to improving health care and connectivity for low-income people.”

The demands on the telecommunications industry over the last few weeks have been to ensure home and remote workers are able to perform their duties, but as the pandemic impacts more elements of society, the scope will have to be widened. Healthcare is an obvious area where connectivity can bolster daily life.

While the healthcare industry has been propositioned as one which would greatly benefit from improved connectivity, little progress has been made. This is a very traditional and risk-adverse industry which is resistant to change. There is little evidence of evolution of healthcare systems around the world through the last few decades, but digital transformation is seemingly being thrust on the industry.

The idea of a connected healthcare system, where doctors and other health professionals can perform duties remotely, seems like a very obvious solution. It keeps people in their homes, preventing further spread and protecting essential workers, but could also make appointments more efficient. There will be growing pains of course, but this is a very sensible and logical solution.

This is not an initiative which will bed-in overnight, the purchasing of contracts, equipment and devices will take time, but it is certainly one which the rest of the world should be watching and wondering why they haven’t implemented such a scheme.

FCC allocates $20bn to close US digital divide

One of the genuine risks of the accelerated journey towards the digital economy is the widening digital divide, though an extra $20 billion from the FCC could help even the landscape.

Although the US is one of the most advanced digital nations in the world, the difference between the haves and have nots is quite staggering. If you were to compare the connectivity options for a millennial in San Diego to a farmer in rural Ohio, you wouldn’t assume it was the same country. Some might see it as a first world problem, however with the benefits of connectivity being applied to areas such as education and healthcare, it is irresponsible to allow this divide to continue.

This is the conundrum which the FCC has faced in recent years. It is of course commercially attractive to drive connectivity options in the densely populated urban areas, but such are the sparse and environmentally challenging regions across some of the US, vast numbers of people are being left behind.

Here, the FCC is proposing the establishment of the Rural Digital Opportunity Fund, which will direct $20.4 billion towards closing the digital divide.

“In short, we’re proposing to connect more Americans to faster broadband networks than any other universal service program has done,” said FCC Chairman Ajit Pai.

“I’m excited about what this initiative will mean for rural Americans who need broadband to start a business, educate a child, grow crops, raise livestock, get access to telehealth, and do all the other things that the online world allows. And I look forward to kicking off this new auction next year.”

This fund will have a broader scope than the previous Connect America Fund (CAF), and will aim to assist regions which are not currently able to access download speeds of 25 Mbps and upload speeds of 3 Mbps, significantly higher than the caps placed on the CAF funds.

The funding will be allocated in two phases. Firstly, using data which has already been collected by the FCC, a reverse auction will be implemented to hand out the funds. Alongside this auction, a new data collection tool will be implemented to offer greater depth to the insight. In the second phase, the intelligence gathered through this tool will help allocate funds as well as to those communities which missed out in the first phase.

With what will be known as the Digital Opportunity Data Collection initiative, the FCC will aim develop more granular broadband deployment data. This initiative will aim to collect geospatial broadband coverage maps from fixed broadband ISPs, and also develop crowd-sourcing portal that will gather input from consumers as well as from state, local, and Tribal governments. Through crowd-sourcing the data, the FCC will hope to validate the information put forwards by the ISPs.

This is a sensible approach from the FCC, as while the ISPs will have the biggest treasure troves when it comes to data, they have also shown themselves to be misleading in the past. With such a tool at its disposal, the FCC can become a more intelligent organization, taking proactive steps towards fixing the digital divide as opposed to simply signing blank cheques for the telcos to cash.

“I appreciate the hard work that went into this item to fix the Commission’s broken mapping process,” said FCC Commissioner Michael O’Reilly.

“Like some of the very laudable mapping bills being considered by Congress, including those by Chairman Wicker and Senator Capito, this item takes important steps in creating a more accurate and useful picture of broadband coverage, which should allow the Commission’s universal service policies to better focus on those millions of Americans left behind without access to broadband service today.”

And while this might sound like a positive step-forward, Commissioner Jessica Rosenworcel, a political opponent of Pai and O’Reilly, has found something to be irked about. Rosenworcel fears the maps might be replaced by a difficult to find URL and handing control of data collection to the administrator of the funds is not the best way forward.

Although we should not be surprised by the objections, they are incredibly weak. Rosenworcel has said she likes the idea, though her objections are seemingly just trying to be awkward, playing the childish role of political opponent wherever possible. While we rarely have anything positive to say about Pai and his cronies in the FCC, this is a sensible move forward and Rosenworcel seems to be finding objections purely because it adds to the theatrics of politics.

What is incredibly difficult to understand is how severe the digital divide actually is in the US. The FCC suggests there are 21 million US citizens who cannot access acceptable broadband speeds, though Rosenworcel has quoted a report which claims the digital divide is as high as 162 million.

This outlandish claim pays homage to a report from Microsoft which should be taken with a bucketful of salt. Let’s not forget, Microsoft is a firm which will benefit from stoking the fire and attracting additional funds to fuel connectivity deployments in the rural community.

This in itself is one of the significant problems when attempting to tackle the digital divide; no-one actually knows what the starting point is. Depending on your commercial aims and political allegiance, the number of underserved citizens will vary wildly. How can one address a problem when the variables remain unknown? It is nothing more than shooting in the dark, hitting the mark occasionally but likely to miss the most important targets.

Alongside these changes in funding connectivity, the FCC has also released a statement which will address how funding for telehealth services is allocated.

This is where the idea of connectivity can be more than simply a means to access entertainment, taking the digital divide beyond the realms of first world problem. There are communities in the US who are underserved by medical services thanks to doctor shortages and hospital closures. The Rural Health Care Programme aims to address these challenges, making use of connectivity to ensure all US citizens have access to medical services as and when they need them.

The latest proposal is another reform to how funds are allocated, attempting to identify the regions which are most severely underserved. Funding will be increased by 43% to $571 million.