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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.

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.

Europe

Helge Tiainen: Fiber Access Extension Eases Connectivity Worries for Operators, Landlords and Tenants

A new law presents an opportunity to reuse existing infrastructure for fiber broadband deployment.

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The author of this Expert Opinion is Helge Tiainen, head of product management, marketing and sales at InCoax.

Previously, tenants living in the United Kingdom’s estimated 480,000 blocks of flats and apartments had to wait for a landlord’s permission to have a broadband operator enter their building to install faster connectivity. But that is no longer the case.

At the beginning of the year, a new UK law change meant that millions of UK tenants are no longer prevented from receiving a broadband upgrade due to the silence of their landlords. The Telecommunications Infrastructure (Leasehold Property) Act allows internet service providers to access a block of flats 35 days after the ISP’s request to the landlord. It is estimated that an extra 2,100 residential buildings a year will be connected as a result.

Broadband companies have advised that currently around 40 percent of their requests for access to install connections in multi-dwelling units are delayed or blocked, due to no landlord response. Undoubtedly, tenants residing in these flats and apartment blocks are those most effected by a lack of accessibility to ultra-fast connectivity. So, how can ISPs grasp this newfound opportunity?

Harnessing the existing infrastructure

For many ISPs, MDUs pose a market that is largely untapped in the UK. Why is this? Well, for starters, typically these types of properties present logistical challenges, and are lower down in the pecking order in terms of the low hanging fruits readily available when it comes to installing fiber to the premises. The more attractive prospects are buildings in densely populated areas that can be covered easily with gigabit broadband.

Whereas, MDUs have typically been those underserved. Signing a broadband contract with a customer in a single-family unit is easier than an MDU as it involves securing permissions from building and apartment owners for construction works, as well as numerous tenants. For those ISPs tasked with upgrading tenants’ existing broadband connections, there are other challenges prevalent such as rising costs, wiring infrastructure changes and contract requirements, including minimum take-up rates.

So, there has been no better time to use the existing infrastructure readily available within the property. A fiber-only strategy can be supplemented if fiber to the extension point is employed where necessary. A multi-gigabit broadband service can be delivered at a lower cost and reach more customers over existing infrastructure for a short section of wire leading to the customer premises and inside the premises.

Bringing gigabit connectivity floor to floor

The UK government hopes that 85% of the UK will be able to access gigabit fixed broadband by 2025. However, installing fiber to every flat can be a challenge that is expensive, labor-intensive and disruptive to customers. Landlords may be hesitant to grant permissions due to the aforementioned reasons and potential cosmetic damage caused. Historically, fiber deployments in MDUs can be as much as 40% of fiber to the building deployment costs.

MDU buildings have existing coaxial networks, and reusing this infrastructure is a tangible possibility and time-saving alternative for ISPs instead of installing fiber direct to the premises. Which can be costly if the take-up rate is low for new services. The coaxial networks in MDUs can be used in an innovative way as in-building TV networks are upgraded to support higher frequency spectrums thanks to the analogue switchover to digital TV services.

ISPs can potentially opt to use fiber access extension technology for a cost-effective and less complex upgrade of broadband as it utilizes the existing in-house coax cable infrastructure. The technology provides multi-gigabit broadband services, positioning it as a clear frontrunner when optical fiber cannot be deployed due to construction limitations, a lack of ducts, building accessibility, and technical or historical preservation reasons.

Time for change

Not only does this landmark new law allow ISPs to seek rights to access a flat or an apartment if the landlord required to grant access is unresponsive, but it also prevents any situations where a tenant is unable to receive a service simply due to the silence of a landlord.

This is a crucial opportunity to reuse existing infrastructure for broadband access as TILPA enables subscribers and service providers to circumvent landlords who fail to provide access permission.

As many ISPs look to seamlessly execute their fiber deployment strategies, using cost-effective solutions can accelerate the addressable number of subscribers and allow for a major return on investment.

As head of product management, marketing and sales at InCoax, Helge Tiainen is responsible for developing sales and marketing of existing products and new business opportunities among cable, telecom and mobile operators by developing use cases and technologies within standard organizations as Broadband Forum, MoCA, Small Cell Forum and other working groups. He also manages partnerships of key technology partners suited with InCoax initiatives. 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.

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Asia

Dae-Keun Cho: Demystifying Interconnection and Cost Recovery in South Korea

South Korean courts have rejected attempts to mix net neutrality arguments into payment disputes.

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The author of this Expert Opinion is Advisor in Dae-Keun Cho, a member of the telecom, media and technology practice team at Lee & Ko.

South Korea is recognized as a leading broadband nation for network access, use and skills by the International Telecommunications Union and the Organisation for Economic Co-operation and Development.

South Korea exports content and produces platforms which compete with leading tech platforms from the US and China. Yet few know and understand the important elements of South Korean broadband policy, particularly its unique interconnection and cost recovery regime.

For example, most Western observers mischaracterize the relationship between broadband providers and content providers as a termination regime. There is no such concept in the South Korean broadband market. Content providers which want to connect to a broadband network pay an “access fee” like any other user.

International policy observers are paying attention to the IP interconnection system of IP powerhouse Korea and the lawsuit between SK Broadband (SKB) and Netflix. There are two important subjects. The first is the history and major regulations relating to internet protocol interconnection in South Korea. Regulating IP interconnection between internet service providers is considered a rare case overseas, and I explain why the Korean government adopted such a policy and how the policy has been developed and what it has accomplished.

The second subject is the issues over network usage fees between ISPs and content providers and the pros and cons. The author discusses issues that came to the surface during the legal proceedings between SKB and Netflix in the form of questions and answers. The following issues were identified during the process.

First, what Korean ISPs demand from global big tech companies is an access fee, not a termination fee. The termination fee does not exist in the broadband market, only in the market between ISPs.

In South Korea, content providers only pay for access, not termination

For example, Netflix’s Open Connect Appliance is a content delivery network. To deliver its content to end users in Korea, Netflix must purchase connectivity from a Korean ISP. The dispute arises because Netflix refuses to pay this connectivity fee. Charging CPs in the sending party network pay method, as discussed in Europe, suggests that the CPs already paid access fees to the originating ISPs and should thus pay the termination fee for their traffic delivery to the terminating ISPs. However in Korea, it is only access fees that CPs (also CDNs) pay ISPs.

In South Korea, IP interconnection between content providers and internet service providers is subject to negotiation

Second, although the IP interconnection between Korean ISPs is included in regulations, transactions between CPs and ISPs are still subject to negotiation. In Korea, a CP (including CDN) is a purchaser which pays a fee to a telecommunications service provider called an ISP and purchases a public internet network connection service, because the CP’s legal status is a “user” under the Telecommunications Business Act. Currently, a CP negotiates with an ISP and signs a contract setting out connection conditions and rates.

Access fees do not violate net neutrality

South Korean courts have rejected attempts to mix net neutrality arguments into payment disputes. The principle of net neutrality applies between the ISP and the consumer, e.g. the practice of blocking, throttling and paid prioritization (fast lane).

In South Korea, ISPs do not prioritize a specific CP’s traffic over other CP’s because they receive fees from the specific CP. To comply with the net neutrality principle, all ISPs in South Korea act on a first-in, first-out basis. That is, the ISP does not perform traffic management for specific CP traffic for various reasons (such as competition, money etc.). The Korean court did not accept the Netflix’s argument about net neutrality because SKB did not engage in traffic management.

There is no violation of net neutrality in the transaction between Netflix and SKB. There is no action by SKB to block or throttle the CP’s traffic (in this case, Netflix). In addition, SKB does not undertake any traffic management action to deliver the traffic of Netflix to the end user faster than other CPs in exchange for an additional fee from Netflix.

Therefore, the access fee that Korean ISPs request from CPs does not create a net neutrality problem.

Why the Korean model is not double billing

Korean law allows for access to broadband networks for all parties provided an access fee is paid. Foreign content providers incorrectly describe this as a double payment. That would mean that an end user is paying for the access of another party. There is no such notion. Each party pays for the requisite connectivity of the individual connection, nothing more. Each user pays for its own purpose, whether it is a human subscriber, a CP, or a CDN. No one user pays for the connectivity of another.

Dae-Keun Cho, PhD is is a member of the Telecom, Media and Technology practice team at Lee & Ko. He is a regulatory policy expert with more than 20 years of experience in telecommunications and ICT regulatory policies who also advises clients on online platform regulation policies, telecommunications competition policies, ICT user protection policies, and personal information protection. He earned a Ph.D. in Public Administration from the Graduate School of Public Administration in Seoul National University. This piece is reprinted with permission.

Request the FREE 58 page English language summary of Dr. Dae-Keun Cho’s book Nothing Is Free: An In-depth report to understand network usage disputes with Google and Netflix. Additionally see Strand Consult’s library of reports and research notes on the South Korea.

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.

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Expert Opinion

Luke Lintz: The Dark Side of Banning TikTok on College Campuses

Campus TikTok bans could have negative consequences for students.

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The author of this expert opinion is Luke Lintz, co-owner of HighKey Enterprises LLC

In recent months, there have been growing concerns about the security of data shared on the popular social media app TikTok. As a result, a number of colleges and universities have decided to ban the app from their campuses.

While these bans may have been implemented with the intention of protecting students’ data, they could also have a number of negative consequences.

Banning TikTok on college campuses could also have a negative impact on the inter-accessibility of the student body. Many students use the app to connect with others who share their interests or come from similar backgrounds. For example, international students may use the app to connect with other students from their home countries, or students from underrepresented groups may use the app to connect with others who share similar experiences.

By denying them access to TikTok, colleges may be inadvertently limiting their students’ ability to form diverse and supportive communities. This can have a detrimental effect on the student experience, as students may feel isolated and disconnected from their peers. Additionally, it can also have a negative impact on the wider college community, as the ban may make it more difficult for students from different backgrounds to come together and collaborate.

Furthermore, by banning TikTok, colleges may also be missing out on the opportunity to promote diverse events on their campuses. The app is often used by students to share information about events, clubs and other activities that promote diversity and inclusivity. Without this platform, it may be more difficult for students to learn about these initiatives and for organizations to reach a wide audience.

Lastly, it’s important to note that banning TikTok on college campuses could also have a negative impact on the ability of college administrators to communicate with students. Many colleges and universities have started to use TikTok as a way to connect with students and share important information and updates. The popularity of TikTok makes it the perfect app for students to use to reach large, campus-wide audiences.

TikTok also offers a unique way for college administrators to connect with students in a more informal and engaging way. TikTok allows administrators to create videos that are fun, creative and relatable, which can help to build trust and to heighten interaction with students. Without this platform, it may be more difficult for administrators to establish this type of connection with students.

Banning TikTok from college campuses could have a number of negative consequences for students, including limiting their ability to form diverse and supportive communities, missing out on future opportunities and staying informed about what’s happening on campus. College administrators should consider the potential consequences before making a decision about banning TikTok from their campuses.

Luke Lintz is a successful businessman, entrepreneur and social media personality. Today, he is the co-owner of HighKey Enterprises LLC, which aims to revolutionize social media marketing. HighKey Enterprises is a highly rated company that has molded its global reputation by servicing high-profile clients that range from A-listers in the entertainment industry to the most successful one percent across the globe. 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.

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