Nelson Communications gets NTCA award for digital outreach programming for seniors

Broadband Communities reports on Nelson Communications, a vendor that has worked with BBCs (Blandin Broadband Communities) in the past…

Telecommunications provider Nelson Communications Cooperative announced that they have been awarded the NTCA Smart Rural Community Collaboration Challenge Grant to connect remote seniors, using remote monitoring and socialization technology GrandCare Systems.

This grant is part of NTCA – The Rural Broadband Association’s (NTCA) initiative to highlight and support efforts that make rural communities vibrant places to live and do business. The grant promotes broadband-enabled solutions for communities and supports collaborative efforts in economic development, education, energy, health care, and public safety.

Providing Broadband Enabled Elder Care Services

Nelson Communications Cooperative, located in Durand, Wisconsin, plans to use GrandCare technology to provide broadband-enabled elder care services to seniors in rural Wisconsin. GrandCare is a large touchscreen system designed to help seniors easily stay connected with their families. It also provides telehealth, activity monitoring, and many socialization features.

“Nelson Communications is proud of our longstanding commitment to our customers and the communities we serve,” said Christy Berger, general manager of Nelson Communications Cooperative (DBA Ntec). “We also recognize that our broadband is a powerful tool for positive change and improving quality of life. In partnership with GrandCare and WSTA, we hope to demonstrate the role broadband can play to connect lonely and socially isolated senior citizens.”

Nelson Communications will leverage their connectivity and GrandCare’s communication, remote health, and activity monitoring to help engage, connect and empower seniors living in rural and remote communities.

Willmar telemedicine program keeps heart patients closer to home – so nice in a snowstorm!

The West Central Tribune reports…

Once upon a time, DuWayne Underthun and his wife, Betty, would have been making many snowy trips from their rural Willmar home to the CentraCare Heart and Vascular Center in St. Cloud for his congestive heart failure.

Instead, he now receives most of his care much closer to home through a newly launched heart failure telemedicine program at Rice Memorial Hospital.

An appointment last week, the day after a snowstorm pummeled the region and brought most travel to a standstill, reinforced the value to the Underthuns of local access to quality care.

“We would not have been able to make it to St. Cloud because of the weather,” said DuWayne Underthun, 78. “This is much more convenient.”

How does it work?

The telemedicine visits with clinical specialists at CentraCare Heart and Vascular Center bring a layer of advanced care that wouldn’t otherwise be locally available.

A patient in Willmar and a clinician in St. Cloud can see and speak to each other via the two-way connection. From St. Cloud, a mini-camera can be manipulated to get a close-up look at the patient’s ankles to check for swelling. Heart and lung sounds through a stethoscope in Willmar are transmitted to St. Cloud where the clinician can hear them through headphones.

Three months after his diagnosis, Underthun is doing well. He quickly grew comfortable being on camera, and he and Betty appreciate the access to skilled clinicians both in their hometown and in St. Cloud.

“They know what they’re doing. I’m thankful for that,” he said.

Willmar is the first satellite to offer the service. It’s hoped that more sites will be added to broaden the outreach that CentraCare Heart and Vascular Center can provide.

Telehealth helps people stay in rural areas – policy makes is affordable

Business North talks about the scarcity of traditional healthcare access hurting rural communities in Minnesota…

The disparity of home health workers and personal care attendants is an ever-widening gap with no clear solutions in sight, and that is something Teri Fritsma Mogen, a Minnesota Department of Health senior workforce analyst, noted should be a major concern for the trickle-down effect it will have.

“If you don’t have enough home health workers to allow people to age in place, older folks will have to move to nursing homes or assisted living and that just moves the workforce shortage to another area,” she said.

Rural northeastern Minnesota has the highest need for specific mental health providers in the entire state, specifically alcohol and drug counselors and licensed mental health therapists, according to Fritsma Mogen.

“Including Duluth for alcohol and drug counselors the region has the second highest ratio in the state, and if you take Duluth out of that equation the ration is through the roof with 8,000 people to every one drug and alcohol counselor with the average in the metro roughly 2,000 to one,” Fritsma Mogen said.

Including Duluth and beyond, there is one psychiatrist for every 20,000 residents, far short of the statewide average of 11,000 residents to one psychiatrist.

And the impact of telehealth, especially since policy has helped offset costs of telehealth…

In 2015 the Minnesota legislature passed the Telemedicine Act, increasing the list of professionals eligible to bill for telemedicine practices, including physicians, nurse midwives, clinical nurse specialists, dentists and psychologists. The Telemedicine Act took effect at the beginning of 2016, with some provisions not fully operational until 2017.

Louise Anderson, director of the Carlton-Cook-Lake-St. Louis Community Health Board said the use of telemedicine to meet client needs is expanding significantly.

“Meeting remotely with clients is especially important in rural areas of the region where mental health providers are less accessible,” Anderson said.

She noted video conferencing technology is also serving to fill a crucial gap for public health nurses. Providing Direct Observed Therapy (DOT) via video conferencing to monitor patients taking oral medication for treatment of tuberculosis has fulfilled some need efficiently.

“One example of this in our region was public health staff time and travel savings of 2.5 hours per day by using (video) conferencing with a patient who lived in a remote area of the county,” Anderson said.

Carlton County Public Health and Human Services director Dave Lee has been an advocate of using the Health Insurance Portability and Accountability Act (HIPPA) compliant video conferencing technology called “Vidyo” in Northeast Minnesota.

In the Region 3 Adult Mental Health Initiative Area several counties are represented: St. Louis, Lake, Cook, Carlton and Koochiching, which comprises 23 percent of the state’s land and contains only 6 percent of the population. That geographical area also happens to represent an area where health challenges such as depression outstrip any other major health concerns two to one.

“All the data points to mental health being the number one chronic health condition in that part of Minnesota and the benefits of using telehealth tools to redirect resources quickly are huge,” Lee said.

Despite working on expanding video conferencing for mental health treatment over the last six years, Lee is frustrated with how slow the system has been to take hold. The technology exists, but he said attitudes are slow to change and minor legal and technical obstacles can take a long time to overcome.

Minnesota ranks top state to raise a family

This news was too good not to share. WalletHub was just named Minnesota the best place to raise a family. No surprise to me with three girls! To be fair they don’t mention broadband or internet but reading through their categories, it was easy for me to see the impact broadband would have on each:

Family Fun – OK we only ranked 13. I have a family blog that alone should rank us higher than that. (To be fair, we were more obviously fun when the girls were little.) But especially when the girls were little, broadband helped us find fun. I scanned local calendars for fun things on a regular basis – from Winter Carnivals to art openings to pumpkin carvings. You name it, if we had an afternoon off, we could find fun. Also we used the internet to see things we’d never go see. Question about the Sphinx? We’ll look it up. For some families, gaming may be an issue or feature – and Paul Bunyan has shown us how fun and profitable that can be with their annual Gaming Contest. Not for us – but it has been a ticket into finding unusual activities.

Health & Safety – Access to remote healthcare – be it doctor emails or actual video visits has been a game changer, especially as a parent. And I’m a parent in a city. I can’t imagine the time savings not bundling up kids for every sneeze when the doctor is 10 miles away. Also portals make it easy to manage regular visits and payments. Telehealth use increased seven-fold in Minnesota between 2010-2015, and use continues to grow. But it also helps with healthier lifestyles. Many of us use devices (fitbits and others) to maintain healthy habits. And of course using the internet for quick fixes for getting out splinters or getting gum out of hair is a day saver too.

Education and Child Care – My kids have used broadband for assignments starting almost in kindergarten. In Kindergarten we used it to extend learning. But by second grade one was using Khan Academy for extra math support. They have all created and uploaded videos for class assignments. All have been required to access, complete and turn in assignments online. The youngest has created (on her own) online quizlets to help her with mock trial. Broadband is all but required for basic education but it is key for extending a student’s reach beyond formal education. (Last year, Blandin hosted a webinar on broadband and the homework gap.)

Affordability – Studies show that homes with broadband see an annual economic benefit between $1,850 and $10,500. And home buyers will pay seven percent more for a home with gigabit service; people wouldn’t pay that if they didn’t think there was a return on investment in education, healthcare or fun for their families.

Laws and Policies Affecting Broadband Access in Minnesota

The Network for Public Health recently posted a report on State Laws and Policies Affecting Broadband Access in Eight Northern Region States – including Minnesota.

Here is what they say specifically about Minnesota. Because tables don’t always transfer well here, I’ve manipulated the format a little but not the content…

Minnesota

Broadband Definition

  • “Broadband” or “broadband service” means any service providing advanced telecommunications capability and Internet access with transmission speeds that, at a minimum, meet the Federal Communications Commission definition for broadband. MINN. STAT. § 116J.39

State Leadership Body/Initiative

  • The Office of Broadband Development
    The Office of Broadband Development is established to serve as the central broadband planning body for the state and shall remain in existence until the commissioner of the Minnesota Department of Employment and Economic Development certifies that the state has met the broadband goals established in MINN. STAT. § 237.012. MINN. STAT. § 116J.39
  • State Statutory Goals
    It is a state goal that all Minnesota businesses and homes have access to highspeed broadband by 2022, among other goals. MINN. STAT. § 237.012

Statutory Funding
Border-to-Border Broadband Fund

  • Administration. The border-to-border broadband fund is administered by the Department of Employment and Economic Development. MINN. STAT. § 116J.396
  • Eligible Expenditures. Grants may be awarded under this section to fund the acquisition and installation of middle-mile and last-mile infrastructure that support broadband service scalable to speeds of at least 100 megabits per second download and 100 megabits per second upload. MINN. STAT. § 116J.395
  • Eligible Applicants. Eligible applications for grants include: (1) an incorporated business or a partnership; (2) a political subdivision; (3) an Indian tribe; (4) a Minnesota nonprofit organization; (5) a Minnesota cooperative association; and (6) a Minnesota limited liability corporation. MINN. STAT. § 116J.395

Preemptive/Restrictive Laws Regarding Municipal Broadband

Procedural Barriers

  • A municipality seeking to construct a new exchange where an exchange already exists shall not be authorized to do so unless 65 percent of those voting thereon vote in favor of the undertaking. MINN. STAT. § 237.19
  • The council of a municipality shall have the power to improve, construct, extend, and maintain facilities for Internet access and other communications purposes, if the council finds that: (i) the facilities are necessary to make available Internet access or other communications services that are not and will not be available through other providers or the private market in the reasonably foreseeable future; and (ii) the service to be provided by the facilities will not compete with service provided by private entities. MINN. STAT. § 429.021

Other

“Dig Once” Efforts

  • The Office of Broadband Development shall, in collaboration with the Department of Transportation and private entities, encourage and coordinate “dig once” efforts for the planning, relocation, installation, or improvement of broadband conduit within the right-of-way in conjunction with any current or planned construction, including, but not limited to, trunk highways and bridges. MINN. STAT. § 116J.391

Fiber Collaboration Database

  • The purpose of the fiber collaboration database is to provide broadband providers with advance notice of upcoming Department of Transportation construction projects so that they may notify the department of their interest in installing broadband infrastructure within the right-of-way during construction in order to minimize installation costs. MINN. STAT. § 161.462

Creation of Broadband Deployment Maps

  • The Office of Broadband Development shall oversee the creation of state and county maps showing the availability of broadband service at various upload and download speeds throughout Minnesota. MINN. STAT. § 116J.397

I see that they have the 2022 state speed goals but have missed the 2026, which are 100 Mbps down and 20 up.

The report also provides some easy ways to compare us with our neighbors; we’re not number one.

Also they frame broadband from a healthcare perspective, which is helpful in making the case that broadband is a solution to other problems – not a problem in and of itself…

Lack of broadband access at home can serve to exacerbate disparities in other social determinants of health, such as by limiting educational and employment opportunities. Lack of broadband access can limit online educational opportunities for students living in rural and underserved areas. With online curricula and resources being increasingly part of the educational experience, this puts many rural students at a significant disadvantage. Lack of broadband access can also limit employment opportunities. It may be difficult to draw businesses to communities lacking broadband access, and job-seekers also face logistical challenges in looking for work or applying for jobs online.

Connectivity also plays an important role in healthcare. In addition to accessing clinical services online via telemedicine, individuals can learn about health topics online, access their electronic health records, and learn about programs and opportunities to improve their health. Individuals without broadband access at home may not be able to take full advantage of these opportunities for remote care and health promotion.

 

Telehealth increases sevenfold in MN between 2010 and 2015

Minneapolis Star Tribune reports…

The popularity of telemedicine has soared among Minnesotans in the past decade, with urban dwellers seeking the convenience of routine care online and rural residents videochatting with distant doctors for everything from prescription refills to psychiatric sessions to cancer consults.

A first-of-its-kind report used a Minnesota database of health insurance claims and found that the number of telemedicine visits increased sevenfold from 2010 to 2015. The study is part of a special edition of the influential journal Health Affairs that assesses the national impact of telemedicine — a broad term to describe billable patient care that isn’t provided face to face, including online queries and videoconferencing.

There is a difference in how telehealth is happening in rural and urban areas…

Most of the increase was in virtual visits by privately insured patients in metro areas, who used online portals such as VirtuWell to receive routine care for sore throats and skin rashes.

Such visits accounted for only 20 percent of the 11,113 telemedicine visits in Minnesota in 2010, but 60 percent of the 86,238 visits in 2015.

Patients in rural areas used telemedicine more to connect with doctors in other communities — either to avoid long drives for routine checkups or to get second opinions from specialists, the data showed.

Duluth-based Essentia Health has videoconferencing in every one of its clinics in northern Minnesota. Patients in International Falls, for example, can connect remotely with doctors in seven different specialties, including psychiatry and cardiology.

And there’s room for growth…

Telemedicine accounts for less than 1 percent of all patient care visits, but the local study suggests continued growth. Abraham noted that her research did not assess the effectiveness of virtual vs. in-person visits, just the numbers of them.

Why are adults using health care devices?

Just a fun look at how people are using connected health devices from Internet Innovation Alliance…

It doesn’t actually say how many (or what percentage of) adults use a device for heath reasons but I think we could conservatively say a third do. I wore a Fitbit for years and I have to say for myself it did get me thinking about how to sneak in extra steps. So now I walk outside whenever I have a conference call. I’m getting exercise and I’m not distracted with my email. When I’m in a waiting room, I tend to pace. I park at the back of the lot.

It’s a little way that being online can make life a little better – for those who have access.