Federal Communications Commission (FCC) members, senators, mobile carriers, and private sector leaders think 5G could solve the rural broadband problem and improve healthcare for rural Americans because 5G has the capacity to maximize internet speed and responsiveness and advance a new healthcare trend: telehealth.
Despite 5G’s capabilities — touted by many experts as the bringer of a digital revolution that will enable autonomous vehicles, widespread Internet of Things (IoT) adoption and remotely controlled industrial machinery — broadband infrastructure is so complicated that it may not be able to substantially advance telehealth efforts anytime soon.
Telehealth encompasses a wide range of services including doctors video-calling patients, patients sending doctors photos of injuries or ailments for prompt diagnosis, and even doctors going over X-Ray and MRI images with patients via video communication platforms like CaptureProof.
For rural patients, telehealth services can make a huge difference in their quality of life. Instead of driving a long way to visit a physical doctor’s office, remote and rural patients can converse with doctors on their laptop or smartphone.
Just a few weeks ago, FCC commissioner Brendan Carr launched a $100 million Connected Care Program with Sen. Roger Wicker (R-MS) to evaluate how telehealth programs might benefit low-income Americans, especially veterans and those living in rural areas.
At a presentation hosted by the Hudson Institute Tuesday morning, Carr said the FCC wants to support telehealth initiatives and believes expanding 5G to empower telehealth initiatives is an opportunity for the FCC to “step in and help.”
Michael Romano, senior vice president of industry affairs and business development for the NTCA-Rural Broadband Association, described several telehealth pilot projects at a panel hosted by Health IT Now on Tuesday.
One in McKee, Kentucky allows veterans to access a Virtual Living Room/VALOR portal through the local Jackson County Library, “which provides free access for veterans to Veterans Administration telehealth.”
Sitka CEO Kelly Mellard described to panel attendees how her company Sitka can “compress the cycle of care” for getting MRI results from days or weeks to hours via video and real-time imaging communication services.
“What we think is really important — and 5G can do — is deliver the asynchronous care,” Mellard said. “It improves patient literacy and progresses the care cycle.”
But telehealth services — especially ones involving MRI images — inherently require a lot of bandwidth to handle video and images. In rural areas, this is a significant challenge, as much of the broadband infrastructure in rural America is copper wiring, which struggles to handle sharp increases in downloads by Americans increasingly watching more Netflix and cat videos.
To get an idea for how much video Americans are consuming via the internet, Cisco estimates that by 2020, internet provider (IP) video traffic will account for 82 percent of all internet traffic, according to a research paper by broadband engineering and consulting company Vantage Point Solutions.
In theory, 5G could dramatically increase data transfer speeds and substantially improve connectivity (according to Qualcomm tests), but Vantage Point Solutions pointed out in its paper that “actual throughput capacity for wireless users is often only 15 percent of the peak data connection rate — although the peak rate is the speed that providers promote.”
But telehealth advocates are convinced 5G can augment telehealth services for rural Americans.
“These lightning fast speeds are critical to telehealth because when you’re downloading images as a doctor (because you need clear, quickly-uploaded images) to make a correct diagnosis because lives are on the line,” said Health IT Now CEO Joel White at the panel on Tuesday. “We want to optimize that care.”
Lawmakers are already working to accelerate 5G adoption. Last month, senators John Thune (R-SD) and Brian Schatz (D-HI) introduced the STREAMLINE Small Cell Deployment Act (S. 3157) which would accelerate the widespread adoption of the “small cells” necessary for 5G connectivity.
Small cells — which Romano said are about the size of a pizza box — can be attached on cell towers to provide a 5G wireless connection.
But 5G also needs deep fiber networks in order to reach its potential, and therein lies the rub.
According to Deloitte, 5G requires “greater network densification” in order to provide the maximized internet speed and responsiveness touted by mobile carriers.
“Despite the demand and economic imperative for fiber deployment, access networks in the United States lack the fiber density to support the bandwidth advancements necessary to improve the pace of innovation and economic growth,” a Deloitte article reads. “Without more deep fiber, carriers will be unable to support the projected 4x increase in mobile data traffic between 2016 and 2021.”
But many rural areas still don’t have fiber optic cables to provide internet access, which means they may be unable to receive 5G access without an increase in infrastructure investment.
While mobile carriers like AT&T, T-Mobile, and Verizon may be able to dip into the broadband market with 5G in more densely populated, urban areas stocked with expansive fiber networks and cell towers, serving rural communities will take longer.
Still, companies will be making investments in these areas, and initiatives from internet service providers (ISPs) like Charter Communications, are working to overhaul current broadband infrastructure.
“5G and fiber are complementary pistons in this engine,” Romano said. “You need densification. This is going to require a lot more investment by firms like Verizon and ours. We’re going to need to make sure the fiber is there.”
