Commissioner Mignon L. Clyburn
“Health IT and Rural Healthcare:
Embracing Opportunities and Overcoming Challenges”
February 23, 2014
HIMSS Pre-Conference Symposium
Thank you, Matt, for that kind introduction and good morning everyone! It’s
great to join you this Sunday morning for the first-ever HIMSS Pre-Conference
Symposium on Embracing Opportunities and Overcoming Challenges.
When this audience thinks of the Federal Communications Commission, I suspect
that the first thing that comes to mind is our role in spurring broadband deployment and
adoption, promoting an open Internet, unleashing spectrum for wireless, and/or ensuring
the reliability of our public safety networks. But, health? Probably not the first thing that
crosses your mind.
But the reality is that the FCC has played, and will continue to play, a key role in
digitizing our healthcare system. So allow me to spend a few minutes today to explain
how we are working with the health IT community to improve the lives of so many
I want to share with you some news about an important initiative I will be
launching in the coming days, which seeks to leverage the human and technical resources
we have at the FCC to address health care disconnects in our society.
I plan to work with our partners in government and stakeholders in the healthcare
sector to research, review and recommend how our current and evolving communications
infrastructure can more efficiently and effectively solve basic health challenges and
disparities. My office will take the lead on coordinating this effort, and will build and
complement the fine work of Matt Quinn. And together, we are excited about working
more closely with all of you who share our concerns, passion, and vision.
What is so great about this new initiative is that the FCC has played an active role
in assisting rural healthcare organizations to take advantage of the ever growing promise
of health IT. I have had unique opportunities to see first-hand the power of technology to
transform medicine, especially in rural places. I visited Kotzebue, Alaska, a town that is
remote even by Alaskan standards.
Historically, residents of this Alaskan town have had to travel hundreds of miles,
usually by aircraft, to receive medical care. Health IT has and will continue to enable
these folks to receive much needed care through remote consultations, without having to
leave familiar surroundings.
I have heard how a patient with a head injury in rural Montana, had his CT scan
read in minutes, and averted a several hundred mile trip to Kalispell in an ambulance,
saving time, money and more importantly, his life.
I have met with the operators of the Palmetto State Providers Network, from my
home state of South Carolina, who told me that they were able to save $18 million in
Medicaid costs, over an 18-month period, as a result of their tele-psychiatry program.
Previously, patients would spend valuable time and resources by having to wait for days
to receive psychiatric consults. Those consults are now available 24 hours a day, 7 days a
week. The FCC’s Rural Health Program provides federal universal service support for
broadband connectivity, which is necessary for these telemedicine efforts.
But it is understandable that most would not naturally think about the FCC and
health in the same breath. But if you pause to think about it, it is not that big of a stretch
at all. Universal service has been an unwavering commitment for our nation since the
Communications Act of 1934. It has evolved over time as technology has evolved. The
statute today recognizes the importance of access to advanced services like healthcare
and education, in addition to connecting homes with advanced services. Of course, we
realize that broadband-powered health solutions have the potential to be a great equalizer
in rural, poor and underserved communities, and the FCC is doing its part to close
technology divides and realize key national priorities.
A central pillar of the FCC’s health agenda is connectivity, both at health care
facilities and in the home. With broadband, you can use mobile diabetes management
tools to monitor patients remotely, and free them from the burden of logging their
glucose measurements -- but only if patients have high speed internet access.
Broadband connectivity is also essential to the concept of “patient centeredness,”
which is seen as a core component of quality health care. Patient centeredness requires
that individuals have the education and support they need to participate in their own care.
This means having access to broadband as a portal of information, and for the patient and
doctor to effectively communicate.
But I am here to affirm that there is some good news. Over the past few years, the
nation has made significant progress toward our goal of getting all Americans online.
Since 2008, the percentage of those who subscribe to broadband at home has increased
from about 60% to about 70%, and the adoption gap between whites and African-
Americans has been nearly cut in half since 2009. But roughly 100 million Americans
are still unconnected at home, and nearly 15 million Americans could not even get fixed
broadband if they wanted it because the infrastructure is not there.
Only 50% of rural Americans, 35% of the elderly, 42% of people living with
disabilities, 59% of African-Americans and 49% of Latinos have adopted broadband
service at home. In today’s digital age, remedying health disparities requires narrowing
the disparities in broadband deployment and adoption.
These Americans are being bypassed by the benefits of broadband for healthcare,
not to mention education, employment, civic participation, and more. And there are
certain communities, which consistently appear on the wrong side of the digital divide.
That is why I was proud to take a leadership role in the FCC's historic overhaul of
our universal service program by converting what had become an outdated, inefficient
program that supported voice service into the Connect America Fund. The Connect
America Fund leverages private funding with public support for broadband-enabled
services. It has already begun connecting Americans with access to the Internet for the
very first time, and reforms include a path forward to connect millions more over the next
You may know of the FCC’s rural healthcare program, but what you may not
know is that we are doing some new things as well. The new Healthcare Connect Fund
subsidizes broadband for individual healthcare organizations, as well as for consortia,
consisting of both rural and non-rural providers. It even supports network equipment and
connections to data centers and administrative offices for consortia. It is a $400 million
annual fund, returning some positive health care dividends, but it continues to be
underutilized. We need your help to get the word out so more facilities get connected.
But simply connecting facilities is not enough to bridge the divide and ensure that
all Americans, particularly those in rural areas, have access to the same advanced
telemedicine available in urban and suburban areas. So last month, the FCC unanimously
agreed to seek comment on and solicit proposals for trials that focus on the impact of the
technology transitions on healthcare providers and their patients. We also seek comment
on soliciting experiments, which focus on ensuring that consumers have access to
advanced services to address the already increased, and growing, demand for
telemedicine and remote monitoring. The FCC proposed using federal universal service
support to fund these trials.
We recognize the importance of healthcare organizations, and view them as
anchors in those communities we are dedicated to connecting. They are the critical, direct
links to other healthcare organizations in rural America, as well as for people in their
I strongly encourage interested parties to consider participating in this proceeding.
And, for your ease, we just happen to have copies of the Technology Transitions Order.
We are eager to get your views on this and ask that you get the word out about these
This brings me to the next leg in FCC's health strategy: promoting greater
collaboration. I have talked to enough innovators and entrepreneurs – not only in Silicon
Valley, but in those rural areas where you are often forced to be innovative – to know that
many of you feel both pushed and pulled with one government agency telling you one
thing, and another agency telling you something else. And I will not stand here and
proclaim that everything is perfect.
But what I can assure you is that the FCC is doing its best to make sure everybody
is rowing in the same direction. That is one of the reasons we are here today with our
federal partners like the Office of the National Coordinator for Health IT, HRSA, AHRQ,
Veterans Health Administration, CMS and others.
Just as we need better coordination among government and private sector
partners, we also need better collaboration among healthcare providers as well as
technology vendors. For healthcare organizations and their patients to fully take
advantage of the next great network revolution, we need to work with everyone here
today, along with other stakeholders back home, to build not only technical solutions that
interoperate with each other … but also inter-organizational ones that result in working
and collaborating with each other to overcome common challenges in order to seize
common opportunities. Through the predecessor Pilot of our Healthcare Connect Fund,
we have seen 50 consortia of healthcare providers … some numbering in the hundreds …
come together to establish broadband networks that can – and should – become the
foundation for both collaboration among organizations and our digital health future.
Believe me: It is not easy to get everyone in the federal government on the same
page. Or to directly interface with the people and organizations that we seek to best
serve. But days like today make it much easier. So let us take full advantage of the time
we have to share our insights and experiences. Let’s challenge each other to meet at least
two additional friends each day. No matter where we live or who we directly serve, we
have more things in common than not, and the chances are really great that these
encounters would allow for the exchange of some novel ideas that, when more widely
instituted, can truly transform this space.
The challenges facing our healthcare system are far too great for any one of us to
solve on our own. By joining forces, we can and will truly harness the power of
technology to improve the quality and delivery of healthcare for all Americans. And I
offer myself and my agency as key conduits to that end. Please stick around for a deep
dive into the FCC’s Healthcare Initiatives from our very own Matt Quinn and learn more
about some incredible successes from Kim Klupenger, of Oregon Health Network, one of
our superstar broadband consortia leaders.
And if you are a Federal employee, please join me and Dr. Jacob Reider from
ONCat the HIMSS Federal Health Community Breakfast bright and early at 6:45
tomorrow morning. And if you are not a Federal employee, please feel free to sleep in.
You’ll need the rest because there is much in store this week at HIMSS.
Thank you and have a great conference.