The pandemic reveals the need for better telemedicine

As the COVID-19 crisis grew, areas that lacked high-speed internet access couldn’t benefit from remote telehealth exams.

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The global pandemic is creating a new normal where every aspect of the way we work, live, learn, and play is changed, and one of the industries that will undergo the greatest transformation is healthcare.

Doctors may never go back to pre-COVID-19 days when routine face-to-face consultations were the norm. The coronavirus opened the floodgates and put existing networking technologies to a test. While many service providers passed with flying colors by handling spikes in network traffic, COVID-19 revealed connectivity shortcomings that must be addressed going forward.

Telehealth is the way of the future

The current healthcare model of having to get in a car, drive across town, sit in a waiting room to see someone is archaic. Over the past few years, I have interviewed many healthcare professionals about telehealth, which was starting to see some usage, although it was the exception, not the norm.  COVID-19 accelerated something that was a “good idea” into actual deployments although there is more work to be done.

For the University of Texas Galveston Medical Branch (UTMB), which consists of hospitals and emergency departments on four campuses, shifting 50% of its patient visits to telehealth video visits had to happen quickly. Fortunately, UTMB already had the infrastructure in place to provide remote patient care years before the pandemic, so its own network handled the increase in telehealth visits effectively.

The big issue UTMB ran into was internet access for patients. Telemedicine often lacks the quality-of-service controls that internal networks have, Mike King, UTMB’s director of network and telecommunications, said during a recent Cisco virtual roundtable focused on internet connectivity during COVID-19. UTMB found itself at the mercy of carriers, and found that some applications fail more frequently than others.

“When you have telemedicine encounters that are only 10 or 15 minutes to start with, you don't have time for an elaborate setup of an app or dropped calls. That can fracture the patient experience quite a bit,” said King.

UTMB’s CIO Todd Leach said it had to train its providers to make sure they became comfortable with the needs of telemedicine. A big part of UTMB’s telehealth program serves the state prison system, with many of those prisons located in rural areas where internet service is spotty and where the available access devices are outdated, he said.

About 20% of the Texas prison system doesn’t have access to high-speed internet, and without it nearly 40,000 inmates cannot get telehealth services. UTMB is currently conducting a wireless internet pilot to enable high-quality audio and video visits with physicians for the prison population bypassing the need to wire costly networking infrastructure.

COVID-19 strained critical services

Critical services were also put to a test during the pandemic, revealing that disaster relief can use some connectivity improvements. AT&T and the First Responder Network Authority (FirstNet) together operate a nationwide network that supports emergency communications. Even with FirstNet’s extensive disaster response experience, COVID-19 was like “a fire, flood, and tornado in every city across the country at the same time,” said Jason Porter, FirstNet’s senior vice president who participated in the Cisco forum.

FirstNet helped modernize emergency response when the demand for critical services spiked during the initial COVID-19 crisis. It worked with supply-chain partners to make sure first responders had enough devices, and it mustered auxiliary network infrastructure where existing infrastructure was insufficient. The network requires extensive coverage in remote locations for first responders, who need immediate access to data and communications.

The auxiliary support included deployables, a FirstNet fleet of 76 rapidly deployable units that can bring internet access to places that don’t have it. This includes ground assets such as cell towers on wheels (COWs) and light trucks. 

FirstNet sent out all 76 deployables for the COVID-19 response, but Porter wants to “innovate the fleet” in the future by including other options like drones – flying cell on wings known as Flying COWs, which should be available later this year. These can broaden coverage in case of disasters, add capacity or be used to bring Internet to new places.

Executives from Cox and Verizon chimed in on the subject, outlining what service providers can do to create a more ubiquitous internet. In addition to expanding internet access and connectivity, forming partnerships to bring devices and content to the underserved is critical. Providers said they’d work with the government to ease the construction process and lower costs to accelerate deployments. But, they emphasized, subsidies may be required to deploy broadband in areas where it’s currently not profitable to do so.

Access to health and social services in the future will need to be continuous, said UTMB’s Leach. “And it can’t happen without being continually connected. Telehealth applies in more situations than we've traditionally thought comfortable applying.”

The global digital divide

No single company has the technology or the business model to singlehandedly close the digital divide. Industry collaboration and small investments in expanding connectivity options is what will make a big difference in people’s quality of life.

3.8 billion people – nearly half the worldwide population – lacks internet access, limiting their access to information, education and healthcare, according to Cisco’s Inclusive Future Report 2020. Gaps in access exist not only in developing countries but also in rural areas and impoverished communities in the U.S.

Cisco called on tech leaders to direct their energy and resources toward developing solutions focused on global inclusion. This means creating broader access to healthcare and social services powered by cost-effective, efficient technologies that meet local needs.

Bringing the internet to underserved populations could lift 500 million people out of poverty and add more than $6 trillion to the global economy, said Jonathan Davidson, senior vice president, and general manager of Cisco’s Mass-Scale Infrastructure Group.

This story, "The pandemic reveals the need for better telemedicine" was originally published by Network World.

  
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