Ensuring that every American has access to broadband throughout the country has been declared to be an essential health care imperative by the Joint Advisory Committee on Communications Capabilities of Emergency Medical and Public Health Care Facilities in a recently released report. The Joint Advisory Committee was established pursuant to legislation Congress passed in 2007 to implement the recommendations of the 9-11 Commission.
The Committee found that home broadband can enable access to distant telemedicine applications, remote monitoring technologies, health information, and the ability of health care workers to work remotely in an emergency. Broadband communications systems can help ensure that each patient receives the most appropriate care, at the optimal location, with the minimum delay.
Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients’ health status. It has been in existence in various forms for over 30 years. There are roughly 200 telemedicine networks in operation in the U.S. connecting about 3,500 sites. The advent of broadband technology allows for a fuller, end-to-end, real-time and reliable integration of simultaneous audio, video and data transmission which can be extremely useful in diagnosing and treating medical conditions from remote locations.
The Joint Advisory Committee’s report highlights the need for improved nationwide communications between emergency responders and health facilities, and the importance of nationwide standardized broadband access in facilitating such communications.
A prime example of the power of Internet technology took place when medical experts in New York switched on an inner-ear device, allowing a man in Uganda to hear for the first time in two years. Activating the device from halfway around the world is a first, and highlights a trailblazing way in which the growing realm of telemedicine – conducting medical procedures from remote locations – can enhance the lives of people in struggling nations. The inner-ear device, a cochlear implant, is a device of numerous complexities that go well beyond the intricate surgery. Once in the ear, the implant had to be turned on. A doctor, eight time zones away, conducted the programming to activate the device. The patient knew the operation was a success because he could respond to questions the doctor posed by cell phone.
Ten years ago, it was difficult to conceive of the dizzying array of Internet-enabled communications technologies that are now at our doorstep, or the opportunities they would present for inter-operability, health IT, or health transformation.
Today, eHealth is an overarching term used to describe the application of information and communications technologies in the health sector. It encompasses a whole range of purposes from purely administrative through to health care delivery.
Within the home care setting, examples include teleconsults and remote vital signs monitoring systems used for diabetes medicine, asthma monitoring and home dialysis systems. Specialist referral services typically involves of a specialist assisting a general practitioner in rendering a diagnosis. This may involve a patient “seeing” a specialist over a live, remote consult or the transmission of diagnostic images and/or video along with patient data to a specialist for viewing later.
Recent surveys have shown a rapid increase in the number of specialty and subspecialty areas that have successfully used telemedicine. Radiology continues to make the greatest use of telemedicine with thousands of images “read” by remote providers each year. Other major specialty areas include: dermatology, ophthalmology, mental health, cardiology and pathology. According to reports and studies, almost 50 different medical subspecialties have successfully used telemedicine. The Joint Advisory Committee’s key findings are:
o Foster inter-operable broadband networks, both wireline and wireless, that permit critical health related information to be transmitted rapidly, reliably, and securely.
o Improve inter-operability through better inter-agency coordination and the use of internet protocol (IP).
o Use mobile services and applications to create virtual hospitals at the scene of accidents, crimes, and disasters.
o Advance lifesaving capabilities such as telemedicine, remote monitoring, and telecommuting by encouraging network and application innovation and deployment.
Key Recommendations: 1. Encourage the deployment of inter-operable, standards based broadband networks built on common and standardized Internet Protocols that can transmit bandwidth intensive information such as video and graphics in a rapid, reliable, and secure manner. Policymakers must set a new national goal of transitioning EMS, 911, and public health communications to broadband capable networks.
2. Improve inter-operability through better inter-agency coordination with Congressional establishment of a federal inter-agency coordinating committee on emergency communications systems to establish strong, consistent national (federal)guidance, standards and direction to insure consistent development of compatible communication systems across the nation.
3. The the Department of Homeland Security should lead an effort to create and coordinate a geospatial Command and Coordination System, based on open enterprise architecture, to allow common patient and emergency vehicle tracking for better situational awareness for all Emergency Medical and Public Health Care Facilities.
4. Ensure that first responders, health care personnel, and patients have ubiquitous access to broadband services and applications by fostering a regulatory environment in which private sector companies build robust broadband networks and providing targeted funding.