FCC panel lays out barriers to implementing telehealth nationwide

The successful implementation of telehealth nationally is dependent on broadband availability and access, as well as on updating laws, regulations and other restrictions impeding its adoption.

That’s the conclusion of the Federal Communications Commission’s Intergovernmental Advisory Committee, which issued a report on Thursday meant to help state, local, tribal and territorial officials to better promote the use of telemedicine.

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The report finds that the “lack of access to adequate broadband presents a significant barrier to telehealth” while noting that “fundamentally all of the digital divide concerns and challenges that face urban and rural America, the U.S. territories and the tribal nations are applicable to telehealth.”

Specifically, the FCC panel identified two primary elements of broadband deployment that affect telehealth—an overall shortfall in rural areas of access to adequate broadband limits the ability to deploy telehealth, and a shortfall in implementing proper redundancies for broadband infrastructure to ensure around-the-clock connectivity to healthcare affects those areas where broadband access exists.

According to the report, redundancy of access to broadband is important so patient care is not interrupted. “The task is to identify the facilities (hospitals, clinics, shelters) that require broadband infrastructure for telehealth implementation that requires many different types of telecommunications, software and equipment in order to realize a successful outcome and service and redundancy.”

When it comes to software and equipment, the FCC panel contends that the technology must be interoperable—and ideally, equipment owned by one provider should be able to be accessed by other providers. “Accordingly, providers must also make sure that any equipment and software they purchase meets industry standards for interoperability and can be used to connect to multiple telemedicine platforms.”

In terms of capabilities, the report makes the case that the required technical features of telehealth should include live video with image and audio quality sufficient for a provider to assess a patient. “Broadband networks must provide low latency, sufficient upload bandwidth, resiliency and reliability to support the requirements for audio and video.”

While access to the latest patient data should include lab results, medication and previous telehealth video recordings, the FCC panel determined that “full access to the patient chart is desirable in the long term, but not mandatory to derive benefits from telehealth.”

However, at the same time, the report recommends that “access to data from remote monitoring medical devices installed at the patient’s mobile device (smartphone and/or tablet) should be accessible, and wireless devices used for telehealth should have battery strength lasting long enough for a telehealth session.”

On the regulatory front, the report includes “insight into the various state, territorial, tribal and local laws or regulations that prevent telehealth providers from treating patients across state lines; and the possible intrastate restrictions that may inhibit the provision of telemedicine.”

The FCC panel charges that federal and state laws and regulations lag industry innovation in broadband deployment.

“While telehealth has been utilized for decades, the policy and regulatory landscape has not kept pace with the rapid development and ability of the technology,” concludes the report. “However, over the last few years, this has slowly been changing as state and the federal governments have attempted to resolve barriers to encourage the utilization of telehealth.”

Nonetheless, the FCC panel contends that there are six policy areas where regulatory barriers to deploying telehealth remain. These include reimbursement, licensing, health information exchanges, insurance parity and malpractice coverage, privacy-information sharing and HIPAA, as well as establishing a doctor-patient relationship based on telehealth.

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