Blandin Webinar Archive Dec 14: Emerging trends in Minnesota Tele-Health

Thanks to those who joined. It was a great session…

The Online Health Care Experience

Listen and learn what is happening in three of Minnesota’s leading health care networks around the trend towards tele-health.  Care leaders from Essentia, Altru and Allina will discuss the importance of home tele-health care for the delivery of health care to rural communities and residents.  Learn about the importance of tele-health services to the vitality of rural health care providers.  Increase your understanding about the connection between good rural broadband and rural health care. Invite your own local health care providers to join us for this webinar.

More handouts from Allina Health


Free Blandin Webinar Dec 14: Emerging trends in Minnesota Tele-Health

Please join the session and spread the word…

The Online Health Care Experience
Thursday, December 14 from 3-4 pm
Register Online

Listen and learn what is happening in three of Minnesota’s leading health care networks around the trend towards tele-health.  Care leaders from Essentia, Altru and Allina will discuss the importance of home tele-health care for the delivery of health care to rural communities and residents.  Learn about the importance of tele-health services to the vitality of rural health care providers.  Increase your understanding about the connection between good rural broadband and rural health care. Invite your own local health care providers to join us for this webinar.

Literature review on the impact of broadband

When you need numbers to make your case I know where you can go! To the new report from Purdue University (by Roberto Gallardo, Brian Whitacre and Alison Grant) – Research & Policy Insights: Broadband’s Impact A Brief Literature Review. It looks at research related to broadband specifically on the following topics:

  • Economic Development
  • Migration & Civic Engagement
  • Education
  • Telework
  • Telehealth
  • Smart Cities, Big Data, & Artificial Intelligence
  • Agriculture

Again, it’s a great reference tool to help give you quality answers to help make the case for better broadband. It’s also inspiring to read. I wanted to share just a portion they wrote about rural broadband…

Focusing on rural areas is important since they are lagging behind urban areas when it comes to broadband deployment and use (Perrin, 2017; Good, 2017). Furthermore, rural places need digital connectivity in order to compensate for their remoteness (Salemink, Strijker, & Bosworth, 2015). Studies that have given specific attention to rural areas have noted a positive relationship between rural broadband access and adoption and greater economic growth (Stenberg, et al., 2009), attraction of new firms (Kim & Orazem, 2017), higher household incomes (Whitacre, Gallardo, & Stover, 2014), small business growth (Shideler & Badasyan, 2012), increase in annual sales and value added (Canzian, Poy, & Schuller, 2015), and growth in annual payroll and number of business establishments (Kandilov & Renkow, 2010). In addition, a recent article explored the effects of USDA broadband loan programs on agriculture and found a positive impact on farm sales, expenditures, and profits among rural counties adjacent to metropolitan counties (Kandilov, Kandilov, Liu, & Renkow, 2017).

Additional studies have estimated the economic impact of rural broadband or lack thereof. The Hudson Institute estimated that broadband companies contributed $2.4 billion in 2015, supporting over 65,000 jobs and $100 billion in e-commerce (Kuttner, 2016). Another report conducted by Ohio State University attempted to estimate the economic benefits associated with increasing broadband access and adoption in Ohio. Using two research articles that estimated broadband consumer surplus ($1,850 per household per year was used in practice), they concluded that reaching full broadband coverage and adoption among currently unserved Ohio households would result in $2 billion in economic benefits over the next 15 years (Rembert, Feng, & Partridge , 2017). Following a similar methodology, another study found that assuming full access of 25/3 Megabytes per second (Mbps) fixed broadband in the United States and a 20 percent adoption would result in $43.8 billion in economic benefits over 15 years (Gallardo & Rembert, 2017).

Important to note is that distinguishing between broadband access/availability and adoption is critical. Even if broadband is available, subscribing or using it (adoption) is not a given. In fact, Internet know-how or utilization is not randomly distributed among the population. For example, a study among young (college-age) Internet users found that parental education, gender, and race/ethnicity impacted the level of web-use skills (Hargittai, 2010). Furthermore, the relationship between entrepreneurs and creative class workers found that broadband adoption actually had a negative relationship with creative class type of workers in rural communities, while higher broadband availability is associated with a higher level of entrepreneurs (Conley & Whitacre, 2016). Another study found that increases in broadband adoption were more significantly related to changes in median household income and percentage of nonfarm proprietors than broadband availability (Whitacre, Gallardo, & Strover, 2014). Thus, it is important to distinguish between the impact of broadband access/availability and adoption/utilization since the digital divide consists of both (Gallardo, 2016).

Broadband can be a solution to rural healthcare issues

Efficient Gov recently ran an article by Craig Settles that talks about how to spin broadband as a solution to lower healthcare costs. I love the idea; I think we need to focus on broadband as a solution. Quit looking at the costs to install and start looking at the potential cost savings and earning of being able to access broadband amenities (such as telehealth) everywhere…

Telehealth offers substantial benefits for those receiving healthcare, so a well-done needs analysis could help your local government translate the need for institutional broadband as well as individual access to high speed service.

As community-owned networks go online, “Some find more interest among stakeholders for using broadband for telehealth, and its subset telemedicine, than for economic development,” John Windhausen, executive director of the Schools, Health & Libraries Broadband (SHLB) Coalition, shared with me. “There can be several reasons, starting with the fact that almost everybody is affected by healthcare,” he said.

In the U.S., the telehealth market is driven by the rising healthcare costs, upcoming regulatory policies, rising prevalence of chronic diseases, shortage of physicians and increasing funding for telehealth. It is estimated 90 percent of all self-insured businesses will have some form of telehealth in the workplace because it has a provable ROI.

People may not know a gigabit from of giraffe, but they will pay for and/or support projects that enables an elderly parent to stay safely in her home, or workers with two or three jobs to get regular healthcare treatments or check ups. They want the benefits a particular technology delivers, and care less about the technology itself.

There is a segment of the population who are not low-income enough to qualify for Medicaid, they don’t earn enough to afford health insurance and their employers don’t provide it,” Eric Bacon, president of AMD Global Telemedicine, said. “So they go to the ER, which is more costly for local government.”

Telemedicine can cover many medical disciplines, including mental health, stroke, dermatology, women’s health and physical rehabilitation. Just about every person — from newborns to seniors — may find that telemedicine influences their lives at some time. Healthcare stakeholders can quantify for municipal broadband planning teams how telehealth makes sense and saves dollars.

How can broadband help with the opioid crisis?

Yesterday at the Border to Border MN Broadband conference, Broadband Task Force member Maureen Ideker said her goal was to find a way for broadband to help with the opioid crisis. Maureen is a nurse and has been involved with telehealth for a long time; I remember when she spoke to the original Task Force as an expert in 2009. Thinking that broadband could prevent opioid addiction seemed like a big,  but fantastic, ask.

Then I remembered just the day before Chuck Olsen (Visual) talked about how virtual reality (VR) was more effective with pain management than morphine. In a test 10 years ago, they used VR to distract a veteran while he was being treated for burns. VR reduced his pain by 50 percent; morphine will only reduce pain by 30 percent.

You can see how it works below

Perusing the literature, it sounds like the health care profession has been using VR for acute pain for a while and it looks like more work is being done to help with chronic pain too. Keeping patients away from opioids is clearly a big step to solving the problem.

Pain Pathways Magazine noted…

While Dr. Gromala acknowledges that opioids have their place, she also believes that any tool she can offer patients to better manage their pain that isn’t an opioid is important. Since the late 1990s, some studies have shown that VR reduced the need for opioids in patients who had acute pain and who used VR during very painful procedures.

“If we can achieve the same results for chronic pain, that would be a game changer,“ she states.

And the doctors approve…

The medical community has been surprisingly positive about VR. For acute pain, VR has become commercially available in the last two years or so. It will take a little more time for VR for chronic pain to become accessible, but it’s already in the hands of some pain experts. The technology is still not as stable as Dr. Gromala’s team would like, and it’s incredibly expensive to develop what she refers to as “content.” But VR researchers, pain doctors and other health providers have been forming networks to speed up development and access.

“Based on the response I have when I present my research at medical and especially pain conferences, there’s a lot of enthusiasm for VR. Now we have to do the hard work of figuring out how to integrate VR in health care systems,” states Dr. Gromala.

The key is access to the technology – and for folks in remote areas, especially folks who might be difficult to move, broadband is part of the answer!

Broadband helps remove obstructions to health care in Minnesota

The Post Bulletin recent ran an article on What obstructs health care in Minnesota? They listed problems such as:

  • Record sharing
  • Insurance rates
  • Workforce

They also listed broadband as a possible solution…

Rural providers especially have a difficult time retaining employees, the table agreed.

Possible solutions included lowering standards that prevent people with any criminal records from being hired in any capacity, and instituting a broadband network that could connect rural buildings with higher-tech providers downtown.

I might say more. Broadband is obviously going to help with record sharing. It helps with workforce too. Yes, it can help you connect with other facilities but for rural areas attracting health care workers, but broadband can be a powerful tool to entice trailing spouses and significant others. With broadband those folks ca work anywhere.

Senator Lourey Lack of broadband hurts healthcare in Otter Tail County

The Fergus Falls Daily Journal reports…

District 11 Minnesota Sen. Tony Lourey visited Fergus Falls on Tuesday afternoon to speak with local health care leaders and government officials. The fourth of 10 visits across the state, Sen. Lourey hoped to learn more about dynamic approaches to health care management being employed in rural areas, in an effort to better inform future conversations in the state Senate.

Turns out broadband access is a big barrier in the area…

Broadband internet infrastructure across the region is another concern, according to John Dinsmore, director of community Services for Otter Tail County. Dinsmore explained that the same lakes which make the area so desirable for residents also present a considerable challenge when laying fiber optic cables.

In fact, recent estimates anticipate that the necessary expenses for installation of broadband services across the county would total nearly $170 million.

Still, the improved service coverage would mean enhanced appeal for rural communities looking to attract medical professionals. At present, those considering small-town living may feel isolated.

“You’re not connected — literally,” Dinsmore said.