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Debra Berlyn: Telehealth is Here Today and Here to Stay

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The author of this Expert Opinion is Debra Berlyn, president of Consumer Policy Solutions

The COVD-19 pandemic has been an extremely difficult time for everyone and has led to the implementation of major changes in our daily behaviors. In order to overcome this adversity and adapt to living in a new age, great innovations have been advanced.

New tech devices and programs have offered many solutions to help solve some of our struggles during this pandemic and raise our spirts.

The pandemic has also highlighted how technology supports consumers who are homebound or living distant from essential services.  In a post-pandemic environment, we can already predict that many consumers, particularly older adults, will continue to rely on many tech services they have adopted during COVID-19.  Services such as online shopping and telehealth have been particularly indispensable during this era of stay-at-home orders, social distancing and quarantine.

The benefits of telehealth options for all consumers have been demonstrated during this pandemic. Telehealth has replaced many routine doctor’s visits, has been used for setting-up COVID testing appointments, and conducting all too critical mental health sessions during periods of isolation. It has also served to keep medical workers safe during the pandemic.

According to a Center for Disease Control report, there was a “154 percent increase in telehealth visits during the last week of March 2020, compared with the same period in 2019….”

During the emergence of COVID-19, both a majority of doctor’s offices were closed, and their patients were staying in their homes.  Options for medical appointments were limited to a telehealth visit only, and while most medical offices reopened with safety protocols in place, many consumers opted to continue with telehealth medical appointments.

The reduction of red tape and the number of doctors who quickly adapted to virtual services was one of the greatest developments of 2020; however, only those who have adequate access to broadband internet are able to take advantage of this tool, leaving out the unconnected population.

As we contemplate permanent integration of virtual care into our medical health system, we must acknowledge that consumer demand for telehealth requires access to ubiquitous high-speed broadband. In 2021, policymakers need to take aggressive steps to deliver broadband to those who do not have access, or who are unable to afford the service.

The $900 billion-dollar COVID Relief package approved by Congress in the final days of 2020 provides $7 billion to increase access to broadband. In addition, Telehealth expansion is included within the broadband funding priorities. The package more broadly includes overall support for these initiatives, with funding for:

  • Expanding telehealth access to mental health services for Medicare patients
  • Closing rural telehealth gaps to provide increased funding to the Health and Human Services agency’s Health Resources and Service Administrations pilot project for Telehealth Centers of Excellence, to access broadband capacity available to rural health providers and patient communities
  • The Federal Communications Commission to support the efforts of health care providers to address coronavirus by providing telecommunications services, information services, and devices necessary to enable the provision of telehealth services.

The FCC has made a broad commitment to telehealth programs, initially under the leadership of Chairman Ajit Pai, and now in the most capable hands of Acting Chairwoman Jessica Rosenworcel. The Chairwoman recently visited the Washington, D.C., Whitman-Walker Clinic, which provides community-based health and wellness services specializing in LGBTQ and HIV care.

Rosenworcel said: “Through expanded and affordable access to broadband for all, organizations like Whitman-Walker and clinics around the country can continue to grow their telehealth efforts to support their communities.”

The Acting Chair is committed to closing the digital divide and sees access to telehealth care services—especially for underserved and marginalized communities—as a top priority. The FCC has initiated a number of COVID-19 Telehealth Programs and the Connected Care Pilot Program to focus on implementing innovative telehealth initiatives.

Telehealth has met the demand of health care management during the pandemic and has become particularly essential for older adults unable to leave their homes for medical visits.  It is vital that programs and policies supporting this technology continue to be a significant priority. In addition, access and affordability of high-speed broadband must be ubiquitous and affordable for all.

Debra Berlyn is executive director of the Project to Get Older Adults onLine (Project GOAL), and president of Consumer Policy Solutions, a firm centered on developing public policies addressing the interests of consumers and the marketplace. 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 reflected in Expert Opinion pieces do not necessarily reflect the views of Broadband Breakfast and Breakfast Media LLC. 

Debra Berlyn serves as the Executive Director of The Project to Get Older Adults onLine (GOAL), and she is also the President of Consumer Policy Solutions. Ms. Berlyn is a seasoned veteran of telecommunications and consumer policy issues and an advocate for consumers of technology services. She represented AARP on the digital television transition and has worked closely with national aging organizations on several Internet issues, including online safety and privacy concerns.

Expert Opinion

Sen. Michael Bennet: Broadband Infrastructure Legislation Follows Colorado Model

Senate-passed legislation for broadband investment inspired by Colorado’s experience, says senator.

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The author of this Expert Opinion is Michael Bennet, U.S. Senator from Colorado

Washington may soon make the biggest broadband investment in U.S. history, and the first draft was written in Colorado.

Last month, the Senate passed a bipartisan infrastructure bill that includes a historic $65 billion for broadband. This section draws directly from the BRIDGE Act, the bill I wrote with Coloradans to reflect our state’s struggles and successes against the digital divide.

Long before the pandemic, broadband was a consistent source of frustration for people across our state. Parents on the Front Range, farmers on the Eastern Plains, and nurses on the Western Slope all told me the same thing: broadband was too slow or expensive to be of any practical use.

Too often, Washington’s answer was to shower the biggest telecom companies with billions in subsidies to build networks, usually in rural areas, that were outdated almost as soon as they were finished. At the same time, Washington had no good answer for working families, many in cities, who couldn’t afford existing broadband options.

As usual, Colorado didn’t wait on Washington to act. Cities created their own municipal networks, like Longmont’s NextLight, which PC Magazine named one of the fastest broadband providers in America. Electric coops like the Delta-Montrose and Yampa Valley Electric Associations deployed fiber-optic networks in rural communities at world-class speeds and prices. Through it all, the Colorado government demonstrated that it could get money out the door for broadband faster and more effectively than Washington.

With these lessons in mind, I wrote the BRIDGE Act with Republican U.S. Sen. Rob Portman from Ohio and Independent U.S. Sen. Angus King from Maine. Our bill became the model for the broadband provisions in the bipartisan infrastructure bill, which is now on the cusp of becoming law.

Based on the BRIDGE Act, the infrastructure bill gives the lion’s share of the broadband funding to states, not Washington. This is a sea change in policy, because it puts states and local leaders — not federal bureaucrats — in the driver’s seat. After all, they have the best understanding of needs on the ground and the greatest incentive to spend limited funds wisely.

Second, the bill more than quadruples the minimum speeds for new broadband networks, while prioritizing even faster networks. For a typical family, this means kids could download homework (or stream Netflix) even as parents work remotely — all without their connection slowing to a crawl.

Third, the bill includes $2 billion for broadband on tribal lands, including the Southern Ute and the Ute Mountain Ute here in Colorado. According to the FCC, one in three homes on tribal lands lack access to high-speed broadband — a significantly higher rate than the rest of the country. Closing this gap is an economic and moral imperative.

Finally, the infrastructure bill prioritizes affordability by requiring new broadband networks to provide at least one low-cost option. Inexplicably, Washington has never insisted on this before. And it can’t come soon enough.

All of these ideas came directly from the BRIDGE Act and what I’ve learned from Colorado. Now we have to pass them into law.

If we do, it would represent the biggest broadband investment in our history, but also one of the most transformative investments in our future. It will mean every worker in our mountain communities can connect remotely for their jobs. It will mean every farmer and rancher can deploy the latest technologies for precision agriculture. It will mean every family can connect with their doctors online, instead of traveling hours to the local clinic. And it will mean no student will be left without broadband, which today is no different than leaving them without textbooks.

We are on the verge of connecting every American to affordable, high-speed broadband. And if we succeed, we can take satisfaction in knowing that Colorado led the way.

Michael Bennet is U.S. Senator from Colorado. This piece was originally published in the Grand Junction (Colo.) Daily Sentinel, and is reprinted with permission.

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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Expert Opinion

Shrihari Pandit: States Can Enable Broadband Infrastructure Through Open Access Conduits

By creating open infrastructure systems, states can reduce the barriers to entry and foster increased broadband competition.

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The author of this Expert Opinion is Shrihari Pandit, CEO of Stealth Communications

Now that the infrastructure bill has passed the Senate, we see key provisions included for broadband in America. In fact, a whopping $65B will go toward broadband funding — provided it passes the House this month. But, will throwing more money at broadband help to solve key issues like closing the digital divide and making broadband access more affordable for millions?

The short answer is: not necessarily. For years the federal government has provided subsidies to incumbent ISPs hoping they will solve key issues with broadband in America and still access to the internet continues to be a challenge. What we need is a radical broadband overhaul where we can level the playing field for smaller ISPs to compete in the marketplace and fill the gaps incumbent ISPs have neglected for years.

As the broadband infrastructure funding provisions emerge, it appears that states will have a major role in determining how to allocate these resources. And, they must make careful considerations to help connect the unconnected and meet the needs of their residents. As access to a robust digital communications network is so critical now – in an ongoing pandemic era – states also have to look ahead and ensure they are creating sustainable and long-term infrastructure in the public interest.

Creating open-access conduit systems

State governments should focus on enabling key infrastructure, namely conduits, rights of way and utility poles – as these are the biggest hurdles for ISPs looking to extend fiber. Sometimes referred to among pros as “layer zero”, the telecom market can be transformed with open-access conduit systems running across the country and extended locally. A conduit highway would be akin to the interstate in which fiber could be easily run between cities and towns across multiple states.

An open-access conduit system can help create a more approachable marketplace for new ISPs to enter and help to fill coverage gaps left un-served by incumbent ISPs. Easier and cheaper access to neutral utility poles would help to reduce the cost of broadband access and allow providers to easily pull their fiber optic infrastructure to homes, businesses, and wireless towers, especially vital for longer-distances in rural areas. In NYC, for example, there is a robust competitive marketplace enabled by a shared conduit system managed by Empire City Subway.

Although currently limited to boroughs of Manhattan and The Bronx, this carrier-neutral system allows multiple ISPs to run cables up and down streets with ease and provides a pathway to extend fiber access to additional NYC neighborhoods. Across the country, open-access models are proliferating, including Ammon, Idaho, as summarized in a recent report by Benton Institute for Broadband & Society.

Leveling the ISP marketplace

By creating open infrastructure systems, more providers can enter the marketplace and create increased competition as the barriers to entry are reduced. Previously, incumbent ISPs have received billions of dollars to close the digital divide, – the divide, as well as their market power, persist.

By creating infrastructure that brings additional private ISPs into the marketplace, states can give residents and businesses  more choices to meet their internet needs which is in the best interest of everyone. More competition also means that incumbent ISPs need to step up their game and offer the services they boast about – or they risk losing market share to private competition. In other words, a long-term, sustainable solution.

Embracing the public infrastructure/private service model

When considering a new infrastructure project, oftentimes, the burden of proof lies with the state. However, with the public infrastructure/private service model, the risk is shared between the state and the ISP. This model enables cities and counties to finance and maintain infrastructure while also managing rights-of-way. And, private or incumbent ISPs can ensure broadband access including cable, fiber optic, or wireless. This is a scalable option for communities that are unaware of how to operate communications networks but want to own and control core communications assets.

States have a major undertaking ahead as they consider how to utilize their infrastructure funding to boost public works projects. As broadband infrastructure development has been so crucial in the last year, creating an improved marketplace for ISPs through open-access infrastructure should be their priority in their long-term public interest.  And with a public infrastructure/private service model, the risk will be shared with providers.

Shrihari Pandit is CEO and co-founder of the New York City-area fiber provider Stealth Communications. 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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Expert Opinion

Ben Bawtree-Jobson: Internet Service Providers Benefit From a Shared Fiber Network Infrastructure

Both emerging and established internet service providers will stand to gain from SiFi Networks’ shared broadband model.

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The author of this Expert Opinion is Ben Bawtree-Jobson, CEO of fiber infrastructure developer SiFi Networks

“Capitalism without competition isn’t capitalism, it’s exploitation.” These were words spoken by President Joe Biden in July 2021, minutes before he signed an executive order to promote competition in the U.S. economy. This is poignantly relevant to telecom companies in the United States. In the U.S., an industry that limits consumer choice makes it hard for small Internet Service Providers to break through.

As the CEO of fiber infrastructure developer SiFi Networks, I can attest that both emerging and established ISPs stand to gain from a shared broadband model.

Indeed, without healthy competition in the economy, big players could potentially change and charge whatever they want for services that don’t suit the needs of the consumer. For many Americans, this means limited options in terms of providers and services. So, how have we got here?

Monopolies: A competitive advantage?

ISPs have always seen it as a competitive advantage to own and operate their own broadband infrastructure. This makes it difficult for smaller companies to break through, stifling competition and maximizing profits for established corporations. However, heavy investments in network infrastructure can be a double-edged sword — companies have so far disregarded the costs of tying themselves up in long-term infrastructure projects and are now struggling to divest and adapt to a rapidly changing market.

This is why many U.S. towns are still served by slow, outdated cable and the national fiber coverage sits at a meager 32 per cent. But, in an age where the internet is critical for education, healthcare and business growth, consumer demands for high-speed connectivity make fiber optic the only viable option.

As it stands, only the big telecoms players can feasibly upgrade their cable networks. However, this is costly, disruptive, and takes years to complete, meaning ISPs cannot expect a quick return on investment.

A new broadband ecosystem is needed to give ISPs of all sizes the chance to respond to consumer demands without necessarily overhauling their existing network infrastructure, a costly and time-consuming option. It is here that embracing open access broadband models may prove effective and helpful.

Don’t miss Broadband Breakfast’s annual Digital Infrastructure Investment mini-conference, which is sponsored by entities including SiFi Networks. The event unites infrastructure investment fund managers, institutional investors, private equity and venture capitalists with senior broadband leaders and brings clarity to the next business model for advanced digital infrastructure. 

Fostering competition with open access

Open access infrastructure essentially means sharing a fiber optic network. Many companies are reluctant to use this model because they believe that increased competition could negatively affect their profits. In reality, there are many benefits to be gained from using a shared network infrastructure. The first is that open access broadband gives ISPs access to a larger pool of potential customers. Giving consumers more choice over their broadband packages and providers will attract a more diverse demographic of customers and thus, promote overall revenue.

At a time when customer demand dictates the need to upgrade services and improve connectivity speed and quality, open access can also help ISPs of all sizes minimize costs. Construction and maintenance of a network is carried out by the infrastructure developer, freeing up budget for ISPs, who can redirect it into areas of the business that need extra attention, such as boosting customer relationships. Larger ISPs, who spend millions of dollars per year maintaining their network infrastructure, could pull their savings into improving and diversifying their product offerings.

Sharing an infrastructure will mean more ISPs can operate in the market, fostering competition, lowering prices and offering better consumer choice. Citizens who previously felt cut-off from basic educational and healthcare services because they couldn’t afford their only broadband option, should then be able to pursue more affordable packages. This will naturally encourage more residents and businesses to subscribe, creating a larger pool of potential customers and ultimately improving economic growth and social mobility.

Open access is attractive to larger ISPs too. As it stands, the telecoms sector ranks at the bottom of 46 industries for customer satisfaction according to the American Consumer Satisfaction Index. Therefore, if they didn’t need to budget for the operation and maintenance of their fiber, and to upgrade outdated copper-based networks that no longer satisfy consumers’ demands, more money could be invested in bettering customer communication and service. If customers are happy with their ISP, and a good brand reputation can be established, this will be a huge competitive advantage.

“Fair competition is what made America the wealthiest, most innovative nation in history,” said Biden during his White House press conference. If smaller ISPs had a fair chance to enter the market, the well-established big players could stay competitive by improving their customer experience and tailoring their services to satisfy the needs of their customers. Ownership of the network infrastructure is no longer the only or even the best way to compete in the high-speed internet space. An open-access model will diversify the market and allow a variety of ISPs to thrive.

Ben Bawtree-Jobson is CEO of SiFi Networks, which funds, builds and owns FiberCity networks. Internet Service Providers, 4G/5G carriers and other service providers wishing to deliver ubiquitous high-speed broadband services to business and residential properties in cities make use of FiberCity networks, which also offer connectivity for city-wide Internet of Things applications. 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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