Health
Telehealth Has Potential to Shift Medical Focus to Preventative Care and Wellness
Experts say continued investment in telehealth is necessary to improve care systems.

WASHINGTON, December 24, 2021 – Medical experts say continued investment in telehealth systems expanded during the coronavirus pandemic has the potential to improve medicine’s focus on preventative care and wellness.
However, some concern exists over what will happen to telehealth advances made during the pandemic should Congress fail to renew waivers that allowed telehealth provision in government-aligned health programs such as Medicare.
Experts discussed this current juncture in telehealth at a Federal Communications Bar Association event last week.
They remarked on just how quickly telehealth systems were able to grow in the past two years because of Congress’ waivers and the major impacts revoking these waivers could have for these systems and the access of many individuals to healthcare.
A discussed example of virtual medicine’s growth was observed “exponential” increases in new overall patient engagement at Veterans Affairs medical providers through telehealth during some of the deadliest phases of the pandemic.
During a Senate hearing in October, witnesses such as Deanna Larson, president of Avel eCARE, testified that regulatory flexibility from Congress is necessary to address telehealth access, as well as that broadband affordability issues often prevent access to telehealth.
Witnesses also raised that telehealth’s prevalence would increase emergency room bed availability during the pandemic
At the FCBA event, Miller Nash attorney David Rice emphasized that beyond giving medical access to individuals that face obstacles in traveling to medical facilities for treatment, telehealth is simply more convenient than in-person treatment for almost everyone and allows patients to fit medical appointment attendance more easily in their schedules.
In terms of challenges robust telehealth systems would face going forward, Mayo Clinic Platform President John Halamka cited potential licensure issues for providing care, and some argument existed between Rice and Jeffrey Neal, T-Mobile for Government’s national director of federal sales, over whether data privacy issues are likely to be a serious hindrance to virtual treatment.
On Monday, the Federal Communications Commission announced $42.7 million in awards from its COVID-19 Telehealth Program which supports continued care for patients by reimbursing them for telecommunications services, information services and connected devices.
Expert Opinion
Craig Settles: And a Little Child Shall Lead Them — Digitally
How many communities are leveraging their teen populations in the pursuit of broadband and digital equity?

In 2011 at the MoBroadbandNow Summit in Missouri, I listened to the CIO of the City of Springfield explain why his city included teenagers in important broadband needs assessment and planning meetings. “In your home, who do you call when you’re trying to figure out how to use the VCR?”
His point? Springfield learned a valuable lesson: Teens push the edges of technology, and understand how to use technology better than many adults do. Therefore, it is imperative to include teenagers in the planning of what is and will be their main future technologies. The brain power and the creativity alone will lead to the success of tapping this demographic.
Fast forward to 2023. How many communities are leveraging their teen populations in the pursuit of broadband and digital equity? “Kids want to get a look into the future,” said Kevin Morris in a video. “That’s the thing that drives many of them in school.” Morris talks to many students as the director of college, careers and community services for the Duarte Unified School District.
What about their future in broadband, I wondered, when a friend talked to me about her efforts to recruit internship positions for the K12 Foothill Consortium? Many of the high school students in the Consortium are anxious to intern remotely or in-person near their homes in Southern California. It hit me — take the Springfield model of teen engagement to the rest of America!
Imagine the possibilities for local broadband or digital equity teams, local government and nonprofits if they can channel bright, tech-savvy, energetic, inquisitive teens on a mission to help bring the digital equity solutions to communities. Remote or in person interns can help with focus groups, town halls logistics, preparing and writing newsletters, usability testing and Affordable Connectivity Program enrollments.
The K12 Foothill Consortium is recruiting internship hosts for the June through August period and for at least 60 hours total. Those groups and organizations engaged with broadband and digital inclusion projects get the benefit of interns’ prior training in coding, health care, web design, engineering and other related disciplines. Since interns prefer paid internships, the Consortium also raises money for organizations that may be too cash-strapped to offer a stipend but can offer meaningful internships.
Internship hosts view the relationships as a win-win for everyone involved. Ivan Ayro, director of adult and career technical education at Charter Oak Unified School District, agrees. “Students are able to connect the educational experience they’re getting from Career Technical Education classes with real-life experience from workplace learning. Through the internships, many of our students are able to realize in high school if this is something that they want to do for the rest of their lives.”
A recent US News & World Report article states that, although internships are traditionally for college students, high school students increasingly are participating in them. Benjamin Caldarelli, co-founder of Princeton College Consulting, a New Jersey-based educational consulting company, said, “High school students want to work somewhere that interests them and potentially make what they feel is a more meaningful contribution. They see internships as an enrichment activity and opportunity to make an impact rather than simply trading time for a little money.”
More than 205,000 new jobs will need to be created to complete the Broadband Equity, Access and Deployment expansion plans, many of them skilled workers. “There is a lot of focus placed on building broadband networks, but we cannot build them without a proper workforce,” Fiber Broadband Association CEO Gary Bolton said in a press release. “Failure to ensure the availability of high-skilled labor will result in workforce bottlenecks, which will ultimately lead to higher costs and project delays.”
The National Telecommunications and Information Association is requiring every state to have a five-year workforce development strategy. FBA published a guidebook to help states develop that strategy. Broadband and digital inclusion teams need to pencil in “internships” as part of their plans.
High school broadband and digital inclusion interns may not be considered skilled workers, obviously, but the interns should be considered the beginning levels of workforce development campaigns in every community. Start people thinking about broadband and all things digital in high school and use internships to shape their college or post-high school plans. Don’t forget that Gen Z can be an important part of broadband discussions, even if they’re not interns.
Amy Foell, principal of Amy Foell Consulting LLC, heads the K12 Foothill Consortium for Azusa, Charter Oak, Duarte and Monrovia Unified School Districts’ CTE. Their mission is to educate and train students to provide a community-sourced talent pool to sustain a healthy, balanced, local economy. Foell also supports workforce development programs across the San Gabriel Valley, including Pasadena Unified School District.
“I like to have an initial phone call and 15 to 20 Zoom sessions to ensure prospective internship sites understand the program,” said Foell. “Before we meet, it’s advisable to create a brief description of the internship project — be sure to share the organization’s purpose and mission. We’ll help hosts identify and interview candidates in May to early June, and students can start mid-June.”
Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. 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.
Expert Opinion
Craig Settles: There’s a TAP for That!
Through Telehealth Access Points, we can consider broadband and telehealth as the double-edged sword of digital health.

By one estimate, there are over 400,000 healthcare-related apps at the App Store. But what’s a Telehealth Access Point?
TAPs are self-contained spaces that are furnished with an internet connection, a computing device equipped with a camera, speaker and microphone, and a dedicated private room or kiosk open to the general public. It is telehealth broken down to its essential elements.
A TAP could be a blessing if a person having a mental health crisis needs a safe place. Rural residents can find TAPs are low-pressure environments to try out telehealth. TAPs at trusted places such as barbershops, hairdressers, or churches are places to go for appointments when people don’t have Internet accounts, laptops or their smart phone is data-capped out.
“The Find Telehealth app located at our webssite is a tool that helps people find TAPs if they need them, and the app will help these established TAPs become better utilized by their communities,” said Jaleen Johnson, program manager for the Northwest Regional Telehealth Resource Center and the Utah Education and Telehealth Network. “TAPs are scalable at many different levels. These typical locations you’ve described would have the basic necessities for a TAP, though some across the region have added features.”
Nicki Perisho, program director for NRTRC, continued, “Currently TAPs are live, but we have been marketing it as only being available in the Northwest Region (Alaska, Washington, Oregon, Montana, Idaho, Wyoming, Utah). Not all the regional TRC’s have the same telehealth mapping functionality. There is another mapping project being utilized by five of the other TRCs that is still in beta testing.”
Location data can be entered by NRTRC, individuals that run the TAPs and individuals independently finding TAPs after NRTRC verifies it. TAPs do not provide medical services, just access to the Internet and a device to connect to a telehealth appointment. There is no charge for that access at this time.
TAPs, strategically speaking
TAPs have a wonderful potential to impact telehealth deployments, especially if communities maximize TAPs’ public health value with a plan, some thought and a little kick-ass marketing strategy.
Every state is working feverishly to produce statewide broadband plans as well as digital inclusion plans by in Fall. Then true craziness begins as local broadband teams start jockeying for millions of federal and state dollars. Public health official and stakeholders need to leverage these planning activities with health needs assessment to determine where TAPs can play.
Poor people are in a crisis of poor health!
Right off the bat there’s a market need for TAPs because 25 percent of U.S. homes do not have internet access, often due to affordability issues. A little research will uncover that those who can’t afford broadband have trouble keeping food on the table, they don’t have insurance or regular doctors, and they have a higher propensity to be chronically sick or unhealthy. Consider broadband and telehealth the double-edged sword of digital health.
Health Affairs, a leading journal of health policy, wrote recently that “Poor adults are five times as likely as those with incomes above 400 percent of the federal poverty level to report being in poor or fair health. Low-income Americans have higher rates of heart disease, diabetes, stroke, and other chronic conditions, compared to higher-income Americans.” TAPs can or should be a part of every digital equity plan.
TAPs are ideal for trusted spaces
In Cleveland, two Urban Kutz barbershops have been screening customers’ blood pressures for 12 years. Owner Waverly Willis said, “I find at least 90 percent of my customers have high blood pressure, and many don’t know about the dangers of hypertension.” Other than the church, there’s not a more trusted place for TAPs to find sanctuary than the barbershop or hairdresser for African Americans.
And speaking of the church, quite a few churches of every domination worked overtime tackling COVID-19 prevention and detection. Often there were lines at the door and down the street for COVID testing and vaccinations. Thematically and logically, churches where you go to heal the sick or better yet, prevent illness and sicknesses in the first place. Move from church TAPs to telehealth in the home.
“The general principle of TAPs fits well with a specific initiative that addresses middle mile and anchor institution priorities, what we’re calling Connectivity Hubs,” said Andrew Butcher, president of the Maine Connectivity Authority. “A perfect example is a library system that will be upgrading a facility for telehealth utilization, device lending and infrastructure upgrades.” It seems logical to integrate public library systems with TAPs.
TAPs are good for the telehealth ecosystem
Digital equity needs an ecosystem that includes telehealth, and TAPs can be part of the picture. Wireless ISP Vistabeam launched their Empowerment Center in Torrington, Wyoming to foster digital inclusion among residents. The Center has a fulltime digital navigator, telehealth tools and capabilities, and remote doctor visits. Community facilities such as the Center can be added to the TAP map.
“It’s interesting to me because I can see TAPs becoming a part of an ecosystem since we recognize that telehealth is a priority,” said Brandon Carson, Executive Director of the Pennsylvania Broadband Development Authority. “We’re investing into a deployment to improve access in areas and we’re looking to future proof of these networks as well. We are developing our programming to account for new innovations like these TAPs.”
Jason Welch, Infiniti Mobile President, said, “By expanding the ecosystem beyond broadband and telehealth providers to also include healthcare organizations themselves, there’s a unique opportunity to educate as well as treat patients.” TAPs, besides giving individuals access to telehealth, can also be health education centers.
It’s time to work plans for TAPs into the fabric of digital inclusion and broadband infrastructure plans. Start your planning with the National Consortium of Telehealth Resource Centers and pick the TRC for your particular state. These centers provide consultation, resources and news at no cost.
Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. 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.
Expert Opinion
Craig Settles: The Role of Telehealth in States’ Broadband Plans
Communities need a strong human element for telehealth to succeed, so digital navigators are key to the team.

Telehealth visits were estimated to account for fewer than 1 percent of all outpatient visits before 2020. Then COVID hit. Telehealth use was off the chain!
U.S. Census Bureau Household Pulse Survey data revealed 22% of the U.S. population used telehealth services in 2022. As the 60s ad said, “You’ve come a long way, baby!” Much of the general public is now familiar with the basic virtual doctor visit.
But are state and local broadband teams on board with using telehealth to drive broadband adoption? Here are three pilot programs that address urban social determinants of health (Chattanooga Tenn.), family mental health delivery (Kansas City, Missouri), and a developing digital equity ecosystem that includes telehealth (Torrington, Wyomin). These pilots offer valuable lessons in driving ACP enrollments.
Much of digital health requires broadband infrastructure and computing devices. “When one looks at healthcare and technologies in the App Store today, there are over 400,000 healthcare-related apps, not to mention content items available on the Web” said Equiva CEO and Co-Founder Nir Altman.
Accepting that telehealth is one logical path to broadband adoption, pilot projects are one method for verify the impact on broadband adoption.
Chattanooga pushes the envelope – again
Chattanooga and their urban broadband network are a booming success story, and they are moving to the next level by distributing 1,000 free telehealth accounts in a pilot to impact the social determinants of health one of most economically blighted area in the city.
“Our pilot project is bringing a variety of resources to a beautiful but under-resourced neighborhood called Orchard Knob,” said Deb Socia, president and CEO of the Enterprise Center, a nonprofit that works at the intersection of technology and inequality. “The neighborhood has high levels of diabetes, stroke, heart disease, asthma. We’re providing home Internet access, digital skills training, and devices.” Some homes are getting energy upgrades and smart thermostats.”
Many Orchard Knob residents work but not at jobs that offer medical insurance, and they earn too much to qualify for the state’s health programs. It will be difficult for residents to mitigate the negative effects of the without telehealth.
The city-owned electric power board, EPB, is critical to success. EPB was part of planning from the beginning, they contributed funding, they will power the telehealth accounts, and EPB is building out free WiFi in public spaces.
The Enterprise Center received a Tennessee Valley Authority award, and their healthcare partner is the Parkridge Medical System.
Eight steps to the pilot
Essential Families is a 501(c)3 nonprofit that conducted a telehealth pilot in one of the poorest communities in Kansas City, MO with stellar results. They delivered mental healthcare for families and also virtual parent education that enhanced parenting skills.
Their pilot has eight steps, starting with:
Step 1. Developing a database of residents who could potentially use telehealth and broadband. 69 homes participated in the pilot.
Steps 2 and 3. Their Chief of Digital Marketing, Kenneth Yancy, said, “We had to go directly to the people to educate them about FCC’s Affordable Connectivity Program (ACP). Our partners such as the school district and childcare providers were part of the needs analysis process.”
Step 4 When residents registered for the pilot and completed their forms, Essential Families gave them free laptops. The incentive motivated residents to provide data that is difficult for government agencies to collect.
Step 5. Each participant was assigned a digital navigator who walked the family through the processes leading to telehealth services, including enrolling with ACP and training for the video streaming platform, computer, and Internet.
Step 6. A minimum of 15 virtual parental education sessions and six mental healthcare services.
Step 7. An extensive follow up by the additional navigator.
Step 8 The pilot evaluation report that is helped significantly by the electronic and manual tools that execute various real-time assessments, impacts, and cost/benefits analysis.
Rural telehealth
Wireless ISP Vistabeam launched their first Empowerment Center in Torrington, Wyoming. The Center offers ACP enrollment help, digital skills training, video conferencing, and Microsoft delivers digital skill programs.

Matt Larson, owner of Vistabeam
“A fulltime digital navigator is on-site, and we are working with a telehealth company to pilot a home test suite that includes an oximeter, blood pressure monitor, and blood testing,” says Matt Larson, owner of Vistabeam. “The device will be part of the Center’s telehealth capabilities, along with remote doctor visits.”
Rural communities need a strong human element for telehealth to succeed, so digital navigators are key elements of the team. The Center draws people in by emphasizing familiarity, knowledge, no pressure, and exploration.
Larson believes digital equity is just one component of a giant ecosystem of social services to help take care of people. However, there can be a lack of coordination between many of these resources. Effectively coordinating these resources is the way to get maximum collective impact from the ecosystem. The Center staff connects people with complementary social services and other resources.
The quality of broadband infrastructure is key to telehealth success – it cannot fail customers! “The soul of a broadband deployment is in that relationship between an ISP and the customer,” says Larson.
Piloting innovation
Communities need to understand that telehealth is not connections just between doctors and patients. “It’s not up to the patient alone, but also loved ones and care providers in a collaboration that occurs in the care process,” said Altman. “There are many supports groups such as the Cancer Support Community that supports hundreds of thousands of patients and loved ones.”
The broadband infrastructure supporting telehealth should pilot test these many-to-many connections and resources to be sure they are supported. Pilots should include tools that enables patients, urban and rural activists, and communities to do their own healthcare needs assessment as well.
Jason Welch, Infiniti Mobile president said, “By expanding the ecosystem beyond broadband and telehealth providers to include healthcare organizations themselves, there’s a unique opportunity to educate the patient. ‘Here’s your device and software, and here’s how you maximize the value of their use.’”
If a city’s telehealth pilot is driven by the creation orientation, a community builds or invents things that didn’t exist before. With the creation orientation, you reduce tunnel vision because you’re always pushing the envelope of innovation.
Craig Settles conducts needs analyses, planning, and grant assessments with community stakeholders who want broadband networks and telehealth to improve economic development, healthcare, education and local government. 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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