Making the Case for Telehealth and Community Broadband

When you’re writing a book, you hear a lot of people say, “You gotta bury yourself in the topic.”

So I had a stroke.

Too bad I was not writing about stroke care. At the time (January 2015), I was actually in the middle of writing my latest book on broadband. But I did have a stroke of enlightenment.

On a scale of 1 to 10 (with 10 being dead), I was hovering around a 6 when they rolled me into the emergency room at 10:35. Luckily for me, the analytical part of my brain was able to resume writing my book, “Building the Gigabit City, Vol. 2.”

While I worked through my recovery, rehab, and my book, a thought hit me: The process of my recovery would have been limited — if not actually impossible — had I been living without broadband in a small, rural or even urban low-income community. Telehealth is revolutionizing health care, but that evolution won’t happen in many parts of the United States because broadband there is abysmal.

Telehealth and broadband give doctors a leg up on strokes

When people suffer a stroke, they have three hours to get serious treatment, including a shot of the magic anti-stroke drug tPA, or they often will not recover from the stroke’s debilitating effects. I was lucky, but a person living alone in a community with bad communications infrastructure can easily fall outside of that three-hour window.

I lived fewer than five minutes from Alameda Hospital. But many rural people live two or three hours away from the nearest hospital. The University of Arkansas for Medical Sciences is a hub in a fiber network that connects 54 of the state’s 80 hospitals to a telestroke application. UAMS is pilot testing wireless routers for use inside ambulances, so doctors can start treatment as soon as emergency medical technicians arrive at a stroke victim’s home. They need reliable broadband to pull it off.

When I hit the ER, the neurologist who runs the stroke center was 35 miles away. She has computers, monitors and a server at her home and directed the entire ER team of doctors and nurses from there. She saw everything they saw, which is highly unlikely in broadband-deprived communities. My door-to-needle time: 25 minutes.

After a stroke, family and friends are valuable to a patient’s recovery. Facebook, Twitter, audio messages and video are just what the doctor ordered. Reliable broadband makes these communication tools possible and effective.

If people are left impaired after a serious illness or injury, whether temporarily or permanently, it helps to get them back to functioning as close to 100 percent soon — particularly the self-employed.

It was easier to deal with physical limitations to my work thanks to dictation software. Internet capability enabled me to “teach” the software to conform to my business vocabulary. I was able to resume my Gigabit Nation radio show in April, and the broadband capabilities that enabled the show also allowed me to conduct interviews and research for the book.

Telehealth in not just about medicine

Physical rehab is key. My rehab therapists were invaluable, but they couldn’t be there all day.

Only 35 percent of physical therapy patients fully adhere to their plans of care, according to WebPT, and just 30 percent of patients who receive outpatient physical therapy services actually attend all the visits their insurance company authorizes.

Why the low numbers? Rehab activity, though vital, is terminally boring. Second, except for time spent with a therapist, rehab is often a solitary endeavor. Third, it is financially and logistically impossible to have as many hours of rehab as a patient needs. A good dose of telehealth and broadband, however, can potentially and dramatically increase these numbers.

You can try to entice someone to build a custom web application.

Flint Rehab’s Facebook page and website include pictures, videos and user stories that help customers use the company’s digital products to recover from strokes. It uses entertainment, collaboration and simplicity to impart knowledge.

Flint Rehab Chief Executive Dr. Nizan Friedman believes broadband is particularly valuable in small rural communities because it bridges the gap to knowledge — medical or otherwise.

“People can access and use applications such as ours,” he says. “Patients can tap into the expertise of leading medical facilities in the country. Furthermore, social networks such as Twitter and Facebook enable collaboration and motivation between patients. It all helps the healing.”

Community broadband’s role in telehealth

Both good and bad, broadband is magic that directly or indirectly enables us to do things we could not do before, or do them more easily, whether in entertainment, health care, education, business, the way we govern ourselves, or the way we “do” life.

In many ways, we have no idea what magic we’ll be able to do. But this is why more of our communities must get off their hands and join in the community broadband movement. As Next Century Cities Executive Director Deb Socia said, “We’re not going to have these great creations and opportunities we’ve been promised unless we have the networks that help support those creations.” 

Why community broadband? The giant telcos and cablecos are among some of the most despised companies in America. As an example, Santa Clara County firefighters were battling one of the most destructive fires in California’s history when Verizon, which provides cellular service to the firefighters, throttled their service down to 1/200 of what the county was paying for and suggested they upgrade their data plan — while the fires were raging. Verizon responded by saying it was a “customer support mistake.” Do you really want these companies overseeing your community’s telehealth?

Many municipalities and co-ops are providing gigabit speeds for much less than incumbents charge for their crappy speeds and crappier customer service. Wireless internet service providers deliver fast broadband where incumbents fear to trod. And often the local private-sector providers are the epitome of quality customer service, especially if the municipality provides core fiber.

Community broadband deals telehealth a winning hand.


Craig Settles is a broadband business planner who helps communities get more from their broadband investment, and his latest analysis report is Telehealth and Broadband: In Sickness and In Health, Pt. 2which makes the case for uniting telehealth providers and community networks efforts.

Morning Consult welcomes op-ed submissions on policy, politics and business strategy in our coverage areas. Updated submission guidelines can be found here.

Morning Consult