Commissioner Mignon L. Clyburn “Health IT and Rural Healthcare: Embracing Opportunities and Overcoming Challenges” February 23, 2014 HIMSS Pre-Conference Symposium Orlando, Florida Thank you, Matt, for that kind introduction and good morning everyone! It’s great to join you this Sunday morning for the first-ever HIMSS Pre-Conference Symposium on Embracing Opportunities and Overcoming Challenges. When this audience thinks of the Federal Communications Commission, I suspect that the first thing that comes to mind is our role in spurring broadband deployment and adoption, promoting an open Internet, unleashing spectrum for wireless, and/or ensuring the reliability of our public safety networks. But, health? Probably not the first thing that crosses your mind. But the reality is that the FCC has played, and will continue to play, a key role in digitizing our healthcare system. So allow me to spend a few minutes today to explain how we are working with the health IT community to improve the lives of so many Americans. I want to share with you some news about an important initiative I will be launching in the coming days, which seeks to leverage the human and technical resources we have at the FCC to address health care disconnects in our society. I plan to work with our partners in government and stakeholders in the healthcare sector to research, review and recommend how our current and evolving communications infrastructure can more efficiently and effectively solve basic health challenges and disparities. My office will take the lead on coordinating this effort, and will build and complement the fine work of Matt Quinn. And together, we are excited about working more closely with all of you who share our concerns, passion, and vision. What is so great about this new initiative is that the FCC has played an active role in assisting rural healthcare organizations to take advantage of the ever growing promise of health IT. I have had unique opportunities to see first-hand the power of technology to transform medicine, especially in rural places. I visited Kotzebue, Alaska, a town that is remote even by Alaskan standards. Historically, residents of this Alaskan town have had to travel hundreds of miles, usually by aircraft, to receive medical care. Health IT has and will continue to enable these folks to receive much needed care through remote consultations, without having to leave familiar surroundings. 2I have heard how a patient with a head injury in rural Montana, had his CT scan read in minutes, and averted a several hundred mile trip to Kalispell in an ambulance, saving time, money and more importantly, his life. I have met with the operators of the Palmetto State Providers Network, from my home state of South Carolina, who told me that they were able to save $18 million in Medicaid costs, over an 18-month period, as a result of their tele-psychiatry program. Previously, patients would spend valuable time and resources by having to wait for days to receive psychiatric consults. Those consults are now available 24 hours a day, 7 days a week. The FCC’s Rural Health Program provides federal universal service support for broadband connectivity, which is necessary for these telemedicine efforts. But it is understandable that most would not naturally think about the FCC and health in the same breath. But if you pause to think about it, it is not that big of a stretch at all. Universal service has been an unwavering commitment for our nation since the Communications Act of 1934. It has evolved over time as technology has evolved. The statute today recognizes the importance of access to advanced services like healthcare and education, in addition to connecting homes with advanced services. Of course, we realize that broadband-powered health solutions have the potential to be a great equalizer in rural, poor and underserved communities, and the FCC is doing its part to close technology divides and realize key national priorities. A central pillar of the FCC’s health agenda is connectivity, both at health care facilities and in the home. With broadband, you can use mobile diabetes management tools to monitor patients remotely, and free them from the burden of logging their glucose measurements -- but only if patients have high speed internet access. Broadband connectivity is also essential to the concept of “patient centeredness,” which is seen as a core component of quality health care. Patient centeredness requires that individuals have the education and support they need to participate in their own care. This means having access to broadband as a portal of information, and for the patient and doctor to effectively communicate. But I am here to affirm that there is some good news. Over the past few years, the nation has made significant progress toward our goal of getting all Americans online. Since 2008, the percentage of those who subscribe to broadband at home has increased from about 60% to about 70%, and the adoption gap between whites and African- Americans has been nearly cut in half since 2009. But roughly 100 million Americans are still unconnected at home, and nearly 15 million Americans could not even get fixed broadband if they wanted it because the infrastructure is not there. Only 50% of rural Americans, 35% of the elderly, 42% of people living with disabilities, 59% of African-Americans and 49% of Latinos have adopted broadband service at home. In today’s digital age, remedying health disparities requires narrowing the disparities in broadband deployment and adoption. 3These Americans are being bypassed by the benefits of broadband for healthcare, not to mention education, employment, civic participation, and more. And there are certain communities, which consistently appear on the wrong side of the digital divide. That is why I was proud to take a leadership role in the FCC's historic overhaul of our universal service program by converting what had become an outdated, inefficient program that supported voice service into the Connect America Fund. The Connect America Fund leverages private funding with public support for broadband-enabled services. It has already begun connecting Americans with access to the Internet for the very first time, and reforms include a path forward to connect millions more over the next five years. You may know of the FCC’s rural healthcare program, but what you may not know is that we are doing some new things as well. The new Healthcare Connect Fund subsidizes broadband for individual healthcare organizations, as well as for consortia, consisting of both rural and non-rural providers. It even supports network equipment and connections to data centers and administrative offices for consortia. It is a $400 million annual fund, returning some positive health care dividends, but it continues to be underutilized. We need your help to get the word out so more facilities get connected. But simply connecting facilities is not enough to bridge the divide and ensure that all Americans, particularly those in rural areas, have access to the same advanced telemedicine available in urban and suburban areas. So last month, the FCC unanimously agreed to seek comment on and solicit proposals for trials that focus on the impact of the technology transitions on healthcare providers and their patients. We also seek comment on soliciting experiments, which focus on ensuring that consumers have access to advanced services to address the already increased, and growing, demand for telemedicine and remote monitoring. The FCC proposed using federal universal service support to fund these trials. We recognize the importance of healthcare organizations, and view them as anchors in those communities we are dedicated to connecting. They are the critical, direct links to other healthcare organizations in rural America, as well as for people in their homes. I strongly encourage interested parties to consider participating in this proceeding. And, for your ease, we just happen to have copies of the Technology Transitions Order. We are eager to get your views on this and ask that you get the word out about these unique opportunities. This brings me to the next leg in FCC's health strategy: promoting greater collaboration. I have talked to enough innovators and entrepreneurs – not only in Silicon Valley, but in those rural areas where you are often forced to be innovative – to know that many of you feel both pushed and pulled with one government agency telling you one thing, and another agency telling you something else. And I will not stand here and proclaim that everything is perfect. 4But what I can assure you is that the FCC is doing its best to make sure everybody is rowing in the same direction. That is one of the reasons we are here today with our federal partners like the Office of the National Coordinator for Health IT, HRSA, AHRQ, Veterans Health Administration, CMS and others. Just as we need better coordination among government and private sector partners, we also need better collaboration among healthcare providers as well as technology vendors. For healthcare organizations and their patients to fully take advantage of the next great network revolution, we need to work with everyone here today, along with other stakeholders back home, to build not only technical solutions that interoperate with each other … but also inter-organizational ones that result in working and collaborating with each other to overcome common challenges in order to seize common opportunities. Through the predecessor Pilot of our Healthcare Connect Fund, we have seen 50 consortia of healthcare providers … some numbering in the hundreds … come together to establish broadband networks that can – and should – become the foundation for both collaboration among organizations and our digital health future. Believe me: It is not easy to get everyone in the federal government on the same page. Or to directly interface with the people and organizations that we seek to best serve. But days like today make it much easier. So let us take full advantage of the time we have to share our insights and experiences. Let’s challenge each other to meet at least two additional friends each day. No matter where we live or who we directly serve, we have more things in common than not, and the chances are really great that these encounters would allow for the exchange of some novel ideas that, when more widely instituted, can truly transform this space. The challenges facing our healthcare system are far too great for any one of us to solve on our own. By joining forces, we can and will truly harness the power of technology to improve the quality and delivery of healthcare for all Americans. And I offer myself and my agency as key conduits to that end. Please stick around for a deep dive into the FCC’s Healthcare Initiatives from our very own Matt Quinn and learn more about some incredible successes from Kim Klupenger, of Oregon Health Network, one of our superstar broadband consortia leaders. And if you are a Federal employee, please join me and Dr. Jacob Reider from ONCat the HIMSS Federal Health Community Breakfast bright and early at 6:45 tomorrow morning. And if you are not a Federal employee, please feel free to sleep in. You’ll need the rest because there is much in store this week at HIMSS. Thank you and have a great conference.