FCC wireless plan would be good for IT: ex­perts

Modern Healthcare - - The Week In Healthcare - Shawn Rhea

An am­bi­tious 10-year plan by the Fed­eral Com­mu­ni­ca­tions Com­mis­sion to beef up the na­tion’s broad­band in­fra­struc­ture and ex­tend re­li­able, af­ford­able wireless ser­vice into un­der­served com­mu­ni­ties could pro­vide a huge boost to health­care in­for­ma­tion tech­nol­ogy ef­forts, in­dus­try ex­perts say.

But they say that the plan’s suc­cess will largely de­pend on law­mak­ers’ will­ing­ness to pro­vide bud­getary sup­port of the ini­tia­tive and fed­eral agen­cies’ abil­ity to work in tan­dem to clar­ify reg­u­la­tory is­sues in ar­eas of cross ju­ris­dic­tion.

“A lot of this stuff can be done through the reg­u­la­tory process, but a lot of it—like the pro­posal to in­sert more re­im­burse­ment for e-care adop­tion and us­age—also de­pends on Congress,” said Joel White, ex­ec­u­tive di­rec­tor of Health IT Now, a coali­tion of or­ga­ni­za­tions that sup­ports the ex­pan­sion of health IT. “But I’m hop­ing there are things we can do in the very near fu­ture, the midterm and over the long term.”

The Na­tional Broad­band Plan re­leased March 17 in­cludes a sec­tion ded­i­cated to health IT in­fra­struc­ture and us­age. The plan of­fers 11 rec­om­men­da­tions for how the gov­ern­ment could pro­vide in­cen­tives for health­care providers to use elec­tronic care tech­nol­ogy, which FCC of­fi­cials es­ti­mate would save the coun­try $700 bil­lion over the next 20 years.

The rec­om­men­da­tions in­clude re­im­burse­ment in­cen­tives that pay providers for adop­tion and use of e-care ser­vices—such as re­mote di­a­betes mon­i­tor­ing and mo­bile med­i­cal applications—that are shown to im­prove out­comes and save money. The agency also pro­poses set­ting up a ded­i­cated health­care broad­band ac­cess fund that would help providers pay for broad­band ser­vices in ar­eas where con­nec­tiv­ity is more ex­pen­sive be­cause of a dearth of avail­able ser­vice providers.

“Providers are ex­pected to pay for equip­ment and train­ing and ad­just to al­tered work­flows,” FCC of­fi­cials noted in the broad­band plan doc­u­ment. “Th­ese costs of­ten out­weigh the di­rect ben­e­fits they can rea­son­ably ex­pect to gain in terms of re­im­burse­ment for ser­vices fa­cil­i­tated by health­care IT.”

Mo­hit Kaushal, the FCC’s di­rec­tor of con- nected health, said the rec­om­men­da­tions are based on re­cent FCC re­search find­ings. “Un­for­tu­nately, there are re­ally no data out there around con­nec­tiv­ity for health­care providers, so we had to do a lot of re­search” to de­ter­mine what ser­vices are avail­able to hos­pi­tals and physi­cians, Kaushal said. “The big­gest prob­lem that it high­lighted is the sever­ity of costs. Some physi­cian offices are go­ing to have to pay more for broad­band ser­vice than physi­cians in other ar­eas.”

Ac­cord­ing to the FCC’s find­ings, many providers in ru­ral and low-wage ur­ban com­mu­ni­ties have lim­ited ac­cess to con­nec­tiv­ity prod­ucts ad­dress­ing the needs of busi­nesses that use large amounts of band­width to send and re­ceive in­for­ma­tion. As a re­sult, those providers of­ten pay more for broad­band ser­vice.

To ad­dress the dis­par­ity, FCC of­fi­cials said they will pur­sue re­vamp­ing the Ru­ral Health Care Pro­gram. The move would in­clude re­plac­ing one bucket of the pro­gram—the In­ter­net ac­cess fund—with a health­care broad­band fund. The fund’s el­i­gi­bil­ity would be opened up to providers in com­mu­ni­ties with in­ad­e­quate broad­band ser­vices re­gard- less of whether they are in ru­ral com­mu­ni­ties. Providers could tap the funds to help off­set their higher costs for ser­vices.

FCC of­fi­cials also pro­pose es­tab­lish­ing a health­care broad­band in­fra­struc­ture fund to pay for ex­pan­sion of ser­vices in un­der­served ar­eas.

Among the is­sues that fed­eral of­fi­cials will need to tackle in or­der to ad­vance the plan are re­claim­ing un­used ra­dio fre­quen­cies from broad­cast­ers in or­der to free up space for the ex­pan­sion of broad­band; clar­i­fy­ing and sim­pli­fy­ing reg­u­la­tory rules on emerg­ing med­i­cal de­vices that fall un­der the ju­ris­dic­tion of the FCC and Food and Drug Ad­min­is­tra­tion; and se­cur­ing law­mak­ers’ sup­port of a fund­ing mech­a­nism for the plan.

“Things like des­ig­nat­ing ra­dio fre­quen­cies, that’s some­thing I think the FCC can move for­ward on without con­gres­sional ap­proval,” said Rus­sell Fox, a health­care com­mu­ni­ca­tions lawyer with the firm Mintz Levin Cohn Fer­ris Glovsky and Popeo. “But the fund­ing process is more con­tentious, be­cause there’s not that big of a pie, and you’ll prob­a­bly have to take money from some­where else” to fund the ef­fort.

Mike Cum­mins, chief in­for­ma­tion of­fi­cer for the health­care sup­ply-chain and qual­i­ty­im­prove­ment or­ga­ni­za­tion VHA, said he be­lieves the FCC’s plan could prove ben­e­fi­cial to health­care providers and pa­tients. “I do think this is a very good first step,” he said. “I think that it will be of in­ter­est to hos­pi­tals if it doesn’t cost them a lot of time and cash to get into it. I think the ef­fort is cru­cial to get­ting doc­tors, pa­tients and the health­care sys­tem to work to­gether.”

White: “A lot of it ... also de­pends on Congress.”

Fox: “The fund­ing process is more con­tentious.”

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