Yesterday I spoke with Karen Welle, who was gracious enough to talk to me on the day after Christmas about the Greater Minnesota Telehealth Broadband Initiative.
Our conversation left me feeling very positive about the future of telelhealth in Minnesota and reminded me about the good, the bad, and the ugly of receiving federal funds.
A quick background:
In November (2007), the FCC dedicated more than $417 million for the construction of 69 statewide or regional broadband telehealth networks in 42 states and three U.S. territories under the Rural Health Care Pilot Program (RHCPP).
In Minnesota, the Greater Minnesota Telehealth Broadband Initiative was submitted by an alliance of the Minnesota Telehealth Network, Medi-sota Network, North Region Health Alliance, SISU Medical Systems and Minnesota Association of Community Mental Health Programs, New Connections. Their plan was to build upon an established vision of a strong integrated rural telehealth care delivery system supported by a telecommunications infrastructure that will ultimately allow any patient in any community in Minnesota and bordering states to connect to any provider in Minnesota and beyond. The goal is to promote technical standards and operational best practices to reduce costs, boost performance, and improve user-friendliness of telehealth application.
Initially, the MN Telehealth Initiative requested $3 million over one year to formalize an organizational strategy; specifically to identify barriers, work with legislation, and create partnerships to create a statewide telehealth initiative. After 8 months of deliberating, the FCC offered $5.6 million over 3 years (or $1.6 million a year). However, this isn’t cash that they can use for just anything. The money can only be used to reimburse telecommunications providers for technology planning and services.
Good New / Bad News
Receiving the money was not entirely a reason for celebration. As anyone who has received federal funding knows – the money isn’t free. There is a lot of required reporting. And as I stated above – this money is earmarked for something very specific – and doesn’t include administrative support to coordinate, compile or present the necessary reporting.
Actually no money is earmarked for administrative support, which makes me nervous for sustainability. You can’t keep a program running with no coordination. It’s important that the administrator or driver of the program come from the health care industry but unless that is a funded position, it becomes a backburner project for some poor overworked hospital administrator. (Some states’ university medical centers are driving the projects. It’s hard to say whether that approach would work here or not.)
The focus of funding is the technology – not application of technology. So the money buys broadband but not training or development of applications to use the broadband. It’s that build it and they will come mentality, which hasn’t been particularly effective with Internet projects in the past.
Finally, one of the initial goals of the program was to build partnerships – as the initiative is set up now, the partners are required to match funds. That puts many of the smaller health care providers out of the running. They simply cannot afford to pony up money for infrastructure at this point.
Building for the Future
So why in the heck am I positive about telehealth in Minnesota? I think the people involved in Initiative are smart and are realistic about what is possible with and without the FCC money. Karen mentioned – and I think it’s clear from the application (which believe it or not is kind of fun to read – well the narrative is anyways) that the group had a vision to work together before the funding was made available.
They have taken time to create a rough roadmap of where they want to go and are trying to stay on it. The FCC money, to continue on the road analogy, was/is like an opportunity to get cheap gas except that you have to take a detour to get it and it’s tough to tell whether or not it will work out to be cheaper once the mileage is calculated. So, they forge ahead with their road map and keep an eye on the speedometer.
The ultimate goals are:
To great a statewide network – so that the hospital in Hallock, MN can reach Johns Hopkins via broadband.
To carve out continued funding.
To reach more hospitals.
The more immediate goals are to assess existing infrastructure, to aggregate technology requests, and to create network facilities to build the scaffolding for the statewide network.
Fascinating post, Ann! I’m increasingly realizing the need for more scrutiny of government efforts to get more broadband out there and get people using it more.
That’s not to say efforts like the FCC’s $400 million aren’t well-intentioned, it just seems like sometimes they’re a little shortsighted, and in being so end up not allocating the resources available to them in a way that can maximize the return on investment.
I wrote up some thoughts in response to your post that can be found here: http://www.app-rising.com/gdblog/2007/12/questions_raised_about_efficac.html
The gist of these is that perhaps instead of forcing matching funds to be spent on networks, perhaps they could instead be refocused on the adoption and use of these networks.
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