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Coronavirus May Have Changed Everything, But Not the Human Capacity For Good

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Photos of Joshua Ladle on his bike ride for Leukemia and Lymphoma Society

BOCA RATON, Florida, April 6, 2020 – Walking along Massachusetts Ave in Washington, D.C. to an event in which I promised my editor I would sit far away from other attendees, I could not have foreseen how swiftly my life would change – along with the rest of the country.

Within days I was ordered to evacuate my university housing amid rising coronavirus concerns, and drive nearly 15 hours to my family’s home in Boca Raton, Florida.

Instantly I was working remotely and attending class online while social distancing. But despite the sudden isolation, one thing remained dependable and beautifully stagnant in my life—kind human beings who overdeliver in times of struggle.

This brings me to one such human being, a family friend, Joshua Ladle. For the last year, Josh planned and organized a solo bike ride down the entire east coast of Florida to raise funds and awareness for the Leukemia and Lymphoma Society.

In 2017, my older brother, Ian, was diagnosed with Hodgkin’s Lymphoma. His diagnosis came as an utter shock.

I postponed my next semester at Brigham Young University to return to Boca and take care of him during chemotherapy.

I dreaded the bimonthly drives to chemotherapy, while my brother sat in solemn silence. Watching his once athletic body diminish and his demeanor turn sullen became a dark and heavy chapter for my family.

Josh came by regularly to take Ian to a local sandwich joint. He always came back lighthearted and smiling from his outings with Josh, a glimpse of the pre-chemo persona I dearly missed. While my brother avoided visitors during this time, Josh persisted.

In the wake of coronavirus, Josh decided to go ahead with the bike ride for lymphoma.

Hotels could not donate rooms along the route due to mass cancellations, and family members could not travel to support him for fear of exposure to the virus.

Last week Josh completed the 565-mile bike ride along the east coast of Florida in 60 hours. He rode in honor of my brother and in memory of his beloved friend, Duben Wilde, who passed away after battling Hodgkin’s Lymphoma.

Along the path, he encountered road blockades discouraging gatherings or beach activity and emotional and physical exhaustion.

“There were definitely some low moments,” said Josh. “When you’ve been riding through the night, it can be challenging, like mentally and also physically,” he recalled.

At times in his exhaustion from expended calories, his body shut down and resisted nourishment.

With 100 miles left to get to Boca, where Josh planned to rest for only six hours before finishing the ride, his friend Joey showed up to bike alongside him.

He said Joey saved the day. Josh called Joey’s companionship and encouragement in the ride an “answer to prayer.” By the time they arrived in Boca, Josh had already been awake and biking for well over 24 hours, but he continued with an unfettered commitment to his goal.

On March 27, in the late afternoon, Josh reached Key West, where restaurants and hotels were closed and empty. Even though the ride turned out differently, the sparse streets created a safer and almost surreal environment.

While the world continues the fight against a global pandemic, that has left many feeling isolated, ordinary people keep our communities connected through quiet feats of extraordinary good.

Follow the link to a short video of Josh’s ride.

Adrienne Patton was a Reporter for Broadband Breakfast. She studied English rhetoric and writing at Brigham Young University in Provo, Utah. She grew up in a household of journalists in South Florida. Her father, the late Robes Patton, was a sports writer for the Sun-Sentinel who covered the Miami Heat, and is for whom the press lounge in the American Airlines Arena is named.

Health

Senate Subcommittee Hears Broadband Affordability, Regulatory Flex Key to Reducing Hospital Burdens

Health providers testified before a Senate subcommittee that Congress should be open to all forms of telehealth.

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WASHINGTON, October 7, 2021 – A Senate subcommittee heard Thursday that affordability is the greatest barrier to broadband adoption and that lawmakers should exercise regulatory flexibility when it comes to the forms of telehealth to help reduce inessential hospital visits.

Covid-19 often brings about extreme shortness of breath, the severity of which is best assessed by a doctor, Deanna Larson, president of Avel eCARE, told the Senate Subcommittee on Communications, Media, and Broadband, which convened a hearing on the state of telehealth and removing barriers to access and improving patient outcomes.

Patients with affordable, high speed internet access can be monitored at home by doctors so that they don’t enter an emergency room or take up a hospital bed prematurely, she said.

Larson urged Congress to extend or make permanent their regulatory flexibility toward telehealth especially as it relates to being neutral on the kinds of telemedicine, such as phone-only care, asynchronous care, and remote patient monitoring. An economic benefit of which would be keeping medical commerce local, she said. Patients wouldn’t be required as often to move to a higher level of care out of town.

Physicians would have 24-hour access to the patient through video calls, monitoring patients in a way which significantly lightens the burdens of the healthcare system, added Larson. With telehealth, doctors can advise patients on exactly when and if they need to go to an emergency room.

Steps to improve telehealth

The committee also heard testimony from Sterling Ransone Jr., president of the American Academy of Family Physicians. Ransone, a strong proponent of telehealth, has found that the digital divide touches rural, tribal and urban communities alike and proposed a series of steps Congress could take to increase public health through broadband policy, including investing in universal affordable broadband service, digital literacy services, end-user devices, audio-only telehealth and data collection in the determinants and outcomes of telehealth as it relates to key factors such as race, gender, ethnicity and language.

Defining broadband as a social determinant of health, Ransone highlighted that affordability is possibly the greatest barrier to broadband adoption and that affordability and access disproportionately affect rural communities.

Sanjeev Arora, founder of Project ECHO and distinguished professor of medicine at the University of New Mexico, agreed: “expanding access to high-quality, high-speed broadband connectivity is critical. It’s a prerequisite for the success of any telehealth model in rural communities and urban underserved areas.”

Telehealth isn’t just vital and broadly popular, it is cost saving. Federal Communications Commissioner Brendan Carr, who also appeared before the subcommittee, shared an estimate that widespread telehealth availability could save the health care system $305 billion a year.

Carr, in an effort to reduce inessential hospital visits and decrease the risk of spreading Covid-19, endorsed the CONNECT for Health Act, the RUSH Act of 2021, the Telehealth Modernization Act, and the Protecting Rural Telehealth Access Act, which in combination would remove geographic restrictions to telehealth services, foster use of telehealth in skilled nursing facilities, grant the Secretary of Health and Human Services greater ability to reduce telehealth restrictions and more.

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Expert Opinion

Craig Settles: Libraries, Barbershops and Salons Tackle TeleHealthcare Gap

Craig Settles describes the important role that community institutions have played in promoting connectivity during the COVID-19 pandemic.

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Photo of Urban Kutz Barbershops owner Waverly Willis getting his blood pressure checked used with permission

Today, Senator Ed Markey, D-Mass., Senator Chris Van Hollen,D-Maryland, and Representative Grace Meng, D-N.Y., led 40 members of Congress to introduce the Securing Universal Communications Connectivity to Ensure Students Succeed (SUCCESS) Act. The bill would extend the Emergency Connectivity Fund by five years and provide $8 billion a year to schools and libraries for student connectivity off-campus.

Barbershops and hair salons are long-time anchor institutions in African-American communities that have shown promise for advancing telehealth. Their partnering with libraries (a broadband anchor institution), and the Biden Administration’s enlisting of 1,000 shops and salons to help combat COVID-19, telehealth and public health in these communities could go into overdrive.

Missing their July 4 COVID-19 vaccination goals, the Biden Administration raised money to transform the shops into mini-medical centers. This success is motivating shop owners to do more. As one of the targets for $7 billion in broadband funds, libraries are idea partners that can provide broadband services, digital content, and digital and health literacy shops’ customers. 

Mike Brown manages a barbershop in Hyattsville, Maryland, and participated in the vaccination program. Brown and others owners talks with their customer about how the vaccines have been proven to work. “I use my platform to advocate for truth and dispel myths,” said Mr. Brown in an Wall Street Journal article, who has also held a vaccination clinic in his shop. “I’ve gotten about 60% of my clients to get vaccinated.”

The program has opened shop owners’ eyes to the power they have to make a difference in the healthcare of their communities. It’s a logical transition from the vaccination program to hypertension screening. Urban Kutz Barbershops in Cleveland have been screening customers for 12 years, recently with telehealth assistance from the famed Cleveland Clinic’s. 

Owner Waverley Willis says “Barbers and hairdressers are part-time marriage counselors, psychiatrists, spiritual advisers, and expert listeners. So many customers listen to our medical advice.” He has made a noticeable impact on many of his customers’ healthy eating habits as well.

Think differently about broadband, public health and telehealth

On July 1, the Federal Communications Commission began a 45-day Emergency Connectivity Fund of $7.1 billion in broadband and digital technology funding to support libraries and schools. By August 13, libraries interested in grants from the program must present a proposal on how they plan to spend money for libraries laptops, hotspots, Internet services, and other resources to advance education and remote learning. 

A generous interpretation of “education“ enables libraries to serve any patrons with broadband. If libraries are situated in areas in which there are no ISP services, they can request money from ECF to build their own broadband infrastructure for unserved patrons. Unlike traditional E-rate proposals, ECF doesn’t require a competitive bid for services, meaning libraries can present a quote from the first vender they contact.

Libraries partnering with shops and healthcare organization could give shops laptops, telehealth software, and portable hotspots to provide hypertension screening and other healthcare services that are suited to their customers’ needs up to three years. Shop owners often don’t have computing devices or Internet access in their shops. Telehealth devices such as portable digital blood pressure monitors and digital scales will have to be provided separately and possibly through funds from another government agency such as Health & Human Services.

For hypertension screening, for example, shops can take customers’ blood pressures digitally. The healthcare provider takes that data through telehealth and recommends treatment when necessary or advisable. The partner likely would have established rates for their healthcare services. Shops can then decide on additional telehealth services they want to provide.

The shops could work with libraries to develop health information and interactive Web content to reduce hypertension and other medical issues through healthier living, plus the libraries can provide telehealth services beyond what the shops can do.  

Libraries and shops can also designate customers who need a laptop, hotspots and telehealth software for chronic illnesses such as severe hypertension, diabetes, heart disease, mental health treatments, and so forth. However, these devices in this scenario would need to be given out for longer periods then just a couple of weeks. For occasional medical appointments, libraries can loan out laptops and hotspots for limited times such as two or three weeks. Libraries are good at delivering digital training and literacy programs.

Why barbershops, hair salons and libraries? 

Facilitating telehealth and healthcare does have an educational element for barbershop and hair salon customers as well as for general library patrons. These health services and information help both groups of people learn more about their own health, enables them to react effectively to medical issues, and be more proactive in taking care of their health.  

The ability for shops and salons to reach and impact African-American communities is legendary. “This type of barbershop health initiative has been shown to be effective,” said Cameron Webb, a senior White House health equity adviser on the coronavirus. Willis adds, “On more than one occasion, a guy’s blood pressure would be so high we would urge him to skip the haircut and go straight to the emergency room.”

The author of this opinion is municipal broadband expert and industry analyst Craig Settles.

Libraries have years of experience introducing new technology such as broadband to underserved populations. Matt McLain, Associate Director for Community Engagement at Salt Lake County Library, said, “We’ve had a pretty good amount of success reaching Hispanic populations at their markets. We have Asian markets out here too. And our health initiatives are quite important with the church leadership in these communities.”

The healthcare and broadband gaps are real and they are deadly! So many elements of the COVID pandemic reiterates the deadliness of those gaps. According to the Centers for Disease Control, of the data collected as of June 14 nearly two-thirds of people who got at least one dose of the vaccine were White. Only 9% were African-Americans. 14 million urban household cannot get any broadband, without which you cannot get telehealth, and 75% are Black or other people of color. 

There may never be as many federal broadband and health-related grant programs as we are seeing now. Partnership potential between libraries and haircare shops are many. Will public health practitioners and advocates, broadband builders, and community leaders step up?

Craig Settles conducts needs analyses with community stakeholders who want broadband networks to improve economic development, healthcare, education and local government. He hosts the radio talk show Gigabit Nation, and is Director of Communities United for Broadband, a national grass roots effort to assist communities launching their networks. He recently created a guide to help librarians uncover patrons’ healthcare needs, create community health milestones and effectively market telehealth. This piece is exclusive to Broadband Breakfast.

Broadband Breakfast accepts commentary from informed observers of the broadband scene. Please send pieces to commentary@breakfast.media. The views expressed in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC.

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Health

Institutions Must Continue Riding Telehealth Growth Momentum for Post-Pandemic Care

Governments and health providers have an opportunity to carry the momentum of 2020 for telehealth’s future.

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Anthem President Gail Boudreaux

July 15, 2021 — The average healthcare organization completed two years’ worth of digital transformation during the first two months of the pandemic, according to IDC Health Insights data. This is only the beginning of telehealth advancement, and governments and health providers should continue to push for further development even after the pandemic slows, the Western Governor’s Association said in a virtual event last month.

The WGA launched its Western Prosperity Roundtable to work on policies such as telehealth and other technologies that have the potential to connect unserved and underserved communities.

While telehealth technologies have been gaining traction for some time, the past year led to a tremendous increase in usage. David Pryor, regional vice president and medical director for Anthem Inc., said that 2020 saw 80 times more utilization of telehealth than the year prior.

With the help of innovation, health centers were able to pivot from in-person care to digital. Digital kiosks have been implemented in states such as California to help improve specialty care and decrease language barriers. These kiosks give patients access to cameras put them in touch with healthcare professionals for important services including mental health.

Empirical experiences

In one experience that Pryor shared from a frontline women’s health clinic in California, a deaf patient came in for an exam and the clinic was able to utilize the video feature with a sign language interpreter on the digital kiosk. “The patient started to cry because she [had] never had such a caring visit,” Pryor said.

Technology advancement has created opportunities for those that previously were overlooked, including rural communities that were forced to commute long distances to receive healthcare and urban centers that lacked options.

The WGA aimed for the panel to push state legislators to continue increasing healthcare access for their constituents through digitalization.

Some states have established their ongoing commitment to telehealth already. In a statement released in August 2020, the Governors of Colorado, Nevada, Oregon and Washington shared their goals to support telehealth services for residents of their states. “Telehealth is here to stay.” they wrote. “We will have individual state-driven approaches to implementing telehealth policies, but our work will be guided by seven overarching principles: access, confidentiality, equity, standard of care, stewardship, patient choice, and payment/reimbursement.”

Over the course of the pandemic, Congress has created and helped fund several programs, many of which focus on telehealth, programs to help accelerate broadband deployment across the country in efforts to connect minority communities, Tribal lands, and other qualifying households.

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