It’s about 4,400 miles from Charlottesville, Virginia to Conakry, Guinea. That’s an unremarkable fact. Everyone knows it’s a long way from the United States to Africa. What is remarkable is that University of Virginia telemedicine professionals bridged that distance to combat the Ebola Crises of 2014.
UVA assembled a system that allowed health-care professionals in the hot zone to aid physicians in Guinea with their treatments, allowing health-care professionals in the hot zone to communicate with physicians in the US, saving critical time during the emergency.
Back in the states, Donald Hixson doesn’t remember his stroke, but Dr. Wayne Clark of the Oregon Health and Science University (OHSU) vividly recalls that night when he remotely examined Hixson as efficiently as if they were in the same room.
Clark could see Hixson and the ER physician from the rural hospital near the retired lawman’s home, and they could see Clark, enabling seamless communication. Clark was able to prescribe a clot-busting, brain-saving drug, and initiated Hixson’s rapid transfer to OHSU — likely saving Hixson from severe consequences.
Northern Oregon and western Guinea don’t have a lot in common, but they are both in largely rural areas and both know telemedicine’s benefits. It allows healthcare professionals to evaluate, diagnose and treat patients in remote locations using communications technology. Patients in distant locations can access medical expertise quickly, efficiently and without travel.
I have a rural perspective. For 28 years I represented Virginia’s most rural congressional district with 27 counties spread across two mountain ranges. A central focus of my work was the pursuit of rural opportunities through the use of the latest information technologies. Among the most pressing rural needs is the delivery of healthcare, and we found that telemedicine is a highly useful service step in meeting that need. The more than 50 rural clinics and hospitals we linked to centers of medical specialization performed thousands of remote patient consults annually.
Rural Americans face multiple challenges as they typically earn less and are located a greater distance from healthcare providers than their citified cousins. Moreover, alarming numbers of rural hospitals are closing. More than 120 rural hospitals have shut down since 2005 (three in the district that I represented), a trend that has accelerated since 2010.
Telemedicine helps fill that gap. It eliminates distance and opens doors to a new era of medical opportunity for rural residents where the only way to get specialized care has been a costly, time-consuming trip to a big-city hospital.
Telemedicine faces barriers: Patients are unaware of the services and fear for their health records’ security; insurance reimbursement issues exist; there’s apprehension of the technology; and despite its proven efficacy and reliability, some still question its quality.
Then there are structural, technological issues, as more than a third of Americans living in rural areas—23 million people—lack access to broadband, removing those homes from telemedicine access, and cutting a crucial link to rural clinics when they did not have access to broadband.
Rural areas are characterized by their challenging—often mountainous—terrain, long distances and small populations. It costs more to deploy fiber-optics in the countryside than in the city, presenting an economic barrier to telemedicine.
Looking forward, technology improvements are allowing telecommunications companies to push broadband access deeper into rural areas, making high-bandwidth uses like telemedicine easier to access.
Much of the US is now covered by the fourth generation of wireless networks. 4G ushered in wireless streaming video and the basics of interactivity, but soon to arrive 5G will supercharge our wireless universe.
With its superfast connectivity, intelligent network, and the ability to move massive amounts of data, 5G opens up broad new healthcare possibilities.
It sounds like science fiction, but 5G’s speed and negligible lag time make remote robotic surgery possible, and 5G can enable surgeons to manipulate more than one robot at a time.
As exciting as robotic surgery is, 5G may also save more lives by keeping people out of the hospital. 5G-connected homes will routinely become telemedicine-equipped, and real-time, continuous, remote at-home monitoring will become common.
Healthcare is being transformed as the traditional volume-based model is replaced with one that reimburses for outcomes and improved care. Assumed in the transformation is the greater ability to keep patients healthy and out of the hospital. 5G’s ability to handle massive amounts of data flowing from multiple points allows healthcare professionals to monitor patients and identify those at risk sooner and with greater accuracy than ever before.
Telemedicine is here—just look at what the University of Virginia did in Guinea and Oregon Health and Science University did in Oregon—and as communications technology improves, its future will only be brighter.
Rick Boucher was a member of the US House for 28 years and chaired the House Energy and Commerce Committee’s Subcommittee on Communications and the Internet. He is honorary chairman of the Internet Innovation Alliance (IIA) and head of the government strategies practice at the law firm Sidley Austin.
