Feds Urged to Include TV White Spaces in Telehealth Expansion Plans

Amid the calls for expanded telehealth coverage beyond the coronavirus pandemic, one group is pressing federal officials to boost wireless broadband connectivity to give remote patient monitoring programs more room to flourish.

In a letter sent last week, the Connected Health Initiative, an offshoot of ACT | The App Association, calls on the government to support television white spaces (TVWS) technologies” for much-needed last-mile wireless broadband connectivity that will support new and innovative digital healthcare innovations for rural Americans.”

“It is imperative to provide rural Americans across the country with robust broadband access and to enable rural healthcare providers to utilize such connectivity to deliver improved care at lower costs,” Brian Scarpelli, CHI’s senior global policy counsel, said in the latter to Health and Human Services Secretary Alex Azar, Federal Communications Commission Chairman Ajit Pai and Agriculture Department Secretary Sonny Perdue.

Lack of reliable broadband is often cited as one of the top impediments to telehealth adoption and expansion in rural parts of the country. With geography and weather affecting access to care and a limited supply of care providers – particularly specialists – health systems need a reliable broadband platform to connect with remote practices, clinics and patients.

Support for TVWS technologies to improve telehealth programs has been growing for some time, and advocates see President Donald Trump’s August 3 Executive Order on Improving Rural Health and Telehealth Access as the ideal avenue for pushing the platform.

TVWS technologies provide fixed wireless broadband services through unused spectrum channels located between TV broadcast channels. Supporters say the technology is more economical and can transmit data at high speeds over longer distances without interruption from obstacles such as land, tress or structures.

Trump’s Executive Order gives the HHS Secretary 30 days to report on existing and future policy initiatives to increase access to healthcare by removing regulatory burdens, “prevent disease and mortality” by developing incentives to improve rural outcomes, “reduce maternal mortality and morbidity” and improve mental health services in rural areas.

According to the CHI, that plan can accommodate TVWS technologies through three actions

First, HHS should support expanded CMS coverage for telehealth services through Medicare, including asynchronous technologies and remote patient monitoring platforms;

Second, the FCC should reduce barriers to broadband deployment and expand the reach of both its Rural Health Care Program and COVID-19 Telehealth Program. In addition, the agency “must maximize the use of spectrum and advance much-needed TVWS rules as soon as possible.”

The “FCC has already done much to responsibly enable TVWS technologies and is currently considering proposals to allow for wider broadband coverage through increased antenna height and power with proper interference safeguards; create geofenced mobile platforms; and deploy narrowband internet of things (NB-IoT), representing necessary steps to enable robust last-mile connectivity, as well as the development of new network edge innovations,” the letter reads. “The FCC should advance these proposals as soon as possible hopefully not later that the end of the summer or early fall.”

Finally, the USDA should commit to modernizing its Rural Utility Service (RUS) to move beyond wireline deployments and support new projects that use TVWS technologies.