Friday, September 4, 2015

More Spectrum, Better Health


Alan Morgan, Chief Executive Officer for the National Rural Health Association.

For people who live in rural areas, traveling considerable distances may be a necessity for work, shopping, school and health care. 

The distance may be an inconvenience at times, but it is an acceptable tradeoff for the benefits of rural life. But when it comes to health care, distance can be a matter of life and death.

Technology is helping to bridge that gap. High-speed wireless access is the most groundbreaking development in decades for rural health.  It allows patients and their doctors to connect remotely, exchange vital health information and conduct real-time video consultations. 

Those connections between rural patients and their physicians, however, are going to be increasingly dependent on broadband connections. And broadband connections in rural America will demand more investment and an expansion of the wireless spectrum — a topic now under consideration by the Federal Communications Commission. More spectrum will mean more and better care for rural Americans.

For example, apps have been developed that help monitor patients via smartphones and tablets.  A home health monitoring initiative is in the works. These kinds of breakthroughs will allow rural patients to be treated and monitored at home rather than at a hospital that may be many miles from families and support networks.

Expectant and new mothers can receive tips on prenatal care, baby health and parenting over text message.

Emergency medical responders can wirelessly receive a patient’s health history or transmit vital statistics and test results to emergency room personnel from the road.

A bevy of new medical devices that communicate wirelessly with health professionals are starting to have an impact.  A patient at risk for congenital heart failure can step on a scale each morning, knowing that any drastic increases in weight, which would signal a problem, will be communicated immediately to a clinic for evaluation. 

Thousands of people use their smartphones or tablets to access the web each day in search of information about a recent diagnosis or to socialize with others facing the same medical challenges.  Many more turn to mobile applications and the web to support diets and exercise programs.

All of these medical breakthroughs depend on one thing – a robust wireless broadband network that enables the use of sophisticated eHealth applications. This would give rural high-speed wireless users the same access to health care as their urban counterparts.

Unfortunately, wireless coverage is insufficient in many areas, and with explosive growth in demand, the problem isn’t going to going to go away without impressive investment in infrastructure. This investment will take the combined goodwill of both government regulators and private industry.

Right now, the ball is in the court of the Federal Communications Commission, which was recently instructed by Congress to auction additional spectrum.  It can take years from auction to actually put the new spectrum to work, so it is important that the FCC move quickly to get this vital resource into the pipeline.

Immediately, the agency should get to work on Congress’ provision to free up 65mhz of spectrum within the next three years.

Wireless can revolutionize rural health. Imagine the impact that these improvements can have in the care and well being of patients from rural communities who lack easy access to a doctor or hospital.  

But rural American will only benefit from these innovations if wireless providers are given the spectrum they need to provide quality, far-reaching service. We can’t sit back quietly just waiting for change. The FCC needs to work to bring rural America the quality wireless service it needs and deserves.

Alan Morgan serves as Chief Executive Officer for the National Rural Health Association, a nonprofit membership organization with a mission to provide leadership on rural health issues.



Spectrum and Rural Broadband

Many great points in this article on how broadband can improve rural health care but I believe there is some confusion on how new spectrum will or will not help.  

I believe you'll find the large carriers hold plenty of spectrum to deploy broadband in rural areas. They do not deploy it because it is not profitable enough or not profitable at all.  They do not need new spectrum to fix this problem.

The spectrum crunch is primarily in urban areas where there are a very high number of users per cellsite.  When the FCC auctions any spectrum they should design the auction in a way that license areas are small enough that companies other than large corporations could actually obtain the spectrum. They should also require equipment manufacturers to build equipment that will work in many spectrum bands rather than just building equipment that will only work in large company bands. These two ideas would do much more for rural areas than just giving the big guys more spectrum covering large regional parts of our country.

The Universal Service system in the United States is being overhauled by the FCC to try and provide broadband service in rural areas that don't have it today.  The overhaul actually harms small companies that are committed to serving these areas today.  If the big carriers control all the spectrum, and they do not want governmental mandates on how they build their networks, the promise of bringing broadband to rural areas will not be met.  

The FCC must design auctions that give others the opportunity to build these rural networks and the FCC must understand that their recent reform orders only produce windfalls for large carriers and very little broadband deployment in rural areas.  

Spectrum in rural areas

I totally agree with Gregorya on the issues regarding spectrum and wireless deployment.  Most spectrum in rural areas goes unused.  Lack of coverage is a much bigger issue than spectrum shortages.  Lack of fiber backhaul is also a big issue in many rural areas that limit the bandwidth available at individual towers.

I looked at the National Rural Health Association web site, but could not find a member list.  I am wondering if the big cellular carriers are members?


New spectrum to accommodate Rural?

With all due respect, in the rural areas there is little or no wireless available anyway.  Spectrum in use is far from populated or "max'd out."  In many areas we work, there is no wireless available, or cable. Satellite is the most a rural farmer can hope for and it is deficient.  Wireless operators in the WiMax or LTE areas have a wide-open field if they truly want to enter the space, and spectrum isn't a factor in most areas of the country.  Your argument that "more spectrum" needs to open up doesn't really hold.

In the mean time, one major factor we wireless builders have a problem with is that the FCC maps claim wireless connectivity exists in areas where it doesn't.  When speaking to a farmer about all his options for broadband (based on those maps), you quickly learn there are none.  A spectrum analyser will quickly alert you to that fact.  I'm not sure why the maps are so inaccurate, but they are.

Another problem with mapping is that where "broadband" does exist, the speeds are so over-reported that unless you personally check them, you'd think the local carrier was a real superstar.  Sadly, the maps must be dependent on companies reporting areas of coverage and speeds, probably to protect for themselves those areas from being exploited by wireless companies who actually could deliver broadband.

Last, the real culprit seems to be regulation on the local front.  Small town politics is not always good, and in rural areas, local politicians are generally less tech-savvy than in the big cities.  Safe assumption?  So, a company coming in to build much-needed new capacity for the area meets much resistance.  We had a city council member in South Texas who shot down a new WiMax network in her town of 17,000 desperately needing service, because she was against porn!  A former school teacher, she was just simply against the internet and all the porn and resulting new crime that would fall upon her town.

We have many challenges in rural broadband building, but adding additional spectrum is not high on the list.  While I do hope new spectrum opens, exploiting the spectrum already existing in rural America is the challenge.

Bobby Vassallo


Distance may affect health that is sure.