Wanted: Widespread Broadband

Mobile health may be the future of health IT, but it can't fulfill its promise unless broadband Internet is "ubiquitous" nationwide, says the chairman of the Federal Communications Commission.

"Done right, this will unleash innovations and breakthroughs in how care is delivered -- from improvements in remote diagnostics and treatment, to new devices that can save lives while helping contain rising health care costs," FCC Chairman Julius Genachowski said in a keynote speech this week at the mHealth Summit, presented by the Foundation for the National Institutes of Health.

He said the FCC's health strategy has three main components: promoting connectivity, ensuring optimal allocation and management of the broadband spectrum, and enabling the development of wireless medical devices.

Although broadband Internet is increasingly available, it is not yet ubiquitous, Genachowski said in his prepared remarks. Roughly 20 million Americans live in areas lacking broadband infrastructure, and another 80 million do not subscribe to broadband services in their homes. Additionally, as many as three in 10 rural medical clinics lack adequate broadband service, he said, leaving them unable to use telemedicine services or easily exchange electronic health records with other providers.

A recent FCC agreement to modernize the Universal Service Fund, the main federal program supporting rural communication networks, will help deliver broadband to all Americans by the end of the decade, he said. The agreement includes a goal to get broadband to all rural "community anchor institutions," including hospitals and clinics. A separate program is "specifically focused on expanding rural health-care connectivity," he said.

The FCC also plans to expand the radio frequency spectrum for mobile broadband dramatically by 2020, he said, allowing "robust, reliable wireless data communications," including mobile communications inside hospitals.

The plan is to get broadcasters that currently own much of the spectrum to voluntarily auction it off to mobile providers, Genachowski said. Another plan involves harnessing more unlicensed spectrum for medical applications that rely on Wi-Fi and Bluetooth technologies.

The FCC's mHealth strategy also addresses medical devices. There are plans to help developers of mobile applications and devices tap into technologies that use spectrum in new ways, or in some cases allowing expanded use of spectrum, he said.

"Last week we authorized Second Sight Medical Products to market a retinal prosthesis that exceeds our ordinary power limits, but that will help restore functional sight for individuals with certain eye diseases while preventing harm to the operation of other devices," he said.

The FCC also has begun allowing medical micropower networks to access the broadband spectrum, he said. Patients with spinal-cord and traumatic-brain injuries, strokes and other neuromusculoskeletal disorders use the networks.

Next year, the commission plans to introduce a program to accelerate development of health devices that use mobile spectrum and reduce restriction on testing by university and other researchers, he said.