MN Broadband County profiles including comparative map and PDFs

The snow is coming to most of us in Minnesota today. Good news though – I have something fun for you to check out online. Remember the 2019 County Broadband Profiles I did September? Blandin Foundation took that information and made is prettier and more accessible and each profile is now available in a PDF format, making it easier to print out and share with the Minnesota Broadband County Profiles.

I love the map because it does a nice job showing of which areas are on track to meet 2026 broadband speed goals (in green) and which ones aren’t (in red). The intention is that local communities and policymakers can use this information to access local and statewide need. Maybe it’s something you can share with your community and/or policymakers. They’re probably sitting at a desk watching for snow today too.

Beyond telemedicine – there’s demand and some solutions for tele-caring

I just finished reading a report on how rural areas can be slower to adopt broadband because the population can be older, have less education and lower incomes. My grandpa used to say – first you gotta wanna – as in, you can learn anything but first you gotta wanna.

That framed my read of the next report by the Rural Health Information Hub on Informal Caregiving and Technology in Rural America. In short, the report talks about how using technology can make your life easier if you are a caregiver – especially if you are an unpaid caregiver with a full time job and maybe some kids. In other words, if you’re caring for a parent or other loved one.

They point out three ways that technology can help:

  • “An ‘Intelligent Family Care Assistant’ to help with day-to-day caregiving by helping to coordinate the family’s tasks in the context of the family’s other activities.”
  • “‘Wearable technologies’ — devices worn on or placed in the body, with sensors and/or human interfaces — to help monitor a person’s health and overall condition.”
  • “Technologies that provide better connections between family caregivers and health professionals, enabling them to work more effectively as a team in providing care.”

I suspect most readers will grasp the advantages of those tools without help. And if you want another great use of technology, you can look back on my article on Virtual Realty in Cannon Falls.)

There are several hiccups in the deployment. Lack of broadband is one – but imagine using these tele-caring applications to reach a demographic that was slow to get broadband before. We’re building demand.

Lack of skill is another. I’ve done digital literacy training for decades. Learning to use a computer for the first time when you’re older is hard. It’s an entirely next experience – it would be like me trying to use a sewing machine or oven! Also you don’t hear or see as well as certain ages and learning gets slower. BUT the incentive is high to stay in your own home to make life easier for you kids or other loved ones caring for you. We’re building demand and increasing local skills.

There are some policy constraints too. The report outlines the NACRHHS Recommendations on Supportive Services and Caregiving:

  1. “The Committee recommends the Secretary create a comprehensive resource on the aging and long-term services and supports available to older adults in rural areas.”
  2. “The Committee recommends the Secretary continue to expand flexibility in Medicare telehealth billing and provide a comprehensive resource of telehealth offerings in rural areas.”
  3. “The Committee recommends the Secretary ensure the promotion and encouragement of age-friendly concepts within rural health grant programs.”
  4. “The Committee recommends the Secretary explore the entry of Medicare Advantage Dual-Eligible Special Needs Plans into rural areas, identify potential barriers, and work with states to adopt policies that encourage or expand the reach of these plans to rural beneficiaries.”

There’s work to be done but tele-caring is a reward that most families would (or will eventually) appreciate. The report does a nice job with statistics and a few stories.

 

Supply and demand for broadband in rural areas and what can help make the business case work: Gov Report

Congressional Research Service recently published a report (Demand for Broadband in Rural Areas: Implications for Universal Access) that looks at the challenges of expanding or upgrading broadband in rural areas. The report includes lots of good number and research but at a really high level there are some of their points:

  • Rural areas are expensive to serve (because distance and lower population density make networks expensive) and the cost to deploy may surpass expected return on investment (ROI).
  • Rural areas tend to populations that are older, less educated and earn less money – each characteristic makes them less likely to be broadband (or generally tech) users. So even when there is broadband the adoption rates are lower.
  • Even in areas where the adoption is high and deployment costs are lower (so town centers) the potential for ROI is lower than in an urban setting.

These ideas aren’t new – but they are well documented in the report. The next section of the report looks at what the Federal government is doing to offset these challenges. I’m going to try to outline the options they mention. Most are funds that go to the provider, I’ve tried to note where that’s not the case:

  • Rural Utilities Service Programs
    • the Rural Broadband Access Loan and Loan Guarantee Program
    • Community Connect Grant Program
    • ReConnect Program
  • Universal Service Fund Programs
    • High Cost program (has morphed in the Connect America Fund although this report doesn’t go into that)
    • Lifeline program (funds offset cost to end users)
    • Schools and Libraries program and Rural Health Care program (schools, libraries and healthcare facilities apply directly)

There’s a quick and interesting discussion of FCC’s broadband definition. Key here is using legacy infrastructure to help define future needs. It’s practical but is it like asking your barber if you need a haircut?…

The 25/3 Mbps threshold is meaningful in both technical and policy terms, because the legacy copper-based connections utilized by some broadband providers would likely require significant upgrades in order to meet higher thresholds

The rest of the report looks at what Congress can do moving forward to make best use of resources:

  • Oversight or Legislation Addressing the Lifeline Program
  • Research on How the Costs of Broadband-Enabled Services Affect Rural Broadband Demand
  • Broadband-Focused Education and Outreach Grants
  • Incentivizing Adoption via the Terms of Federal Infrastructure Buildout Programs
  • Oversight of FCC Section 706 Process

Cooperatives excel at rural broadband – how can we help?

The Institute for Local Self Reliance (ILRS) has updated their report on the growing role of cooperatives bringing better broadband to rural areas – including a map of showing where cooperatives provider fiber service…

You can see that cooperatives are really making a difference in the Midwest. In fact, here are the top five states with cooperative fiber coverage…

ISLR and others have made the case for cooperative providers before. The very quick high level look is that cooperatives’ stakeholders are their customers so they are at least as interested in providing them with service and improving the community as making a profit. And they are more patient with return on investment than many for-profit providers.

The report does highlight some recommendations to better support cooperatives – here’s an abridged version…

Federal and state governments must recognize that cooperatives are one of the best tools for ubiquitous, rural, high-speed Internet access.

  1. Design funding programs with cooperatives in mind.

  2. Encourage cooperatives by removing barriers and encouraging partnerships.

  3. If you live in a rural area, talk to your neighbors, co-op manager, and board members about the potential for Internet networks. Successful cooperative projects are community-led projects. About 70 percent of electric cooperatives have less than 10 percent average turnout for their board member elections.

  4. Make it clear that rural connectivity is about more than entertainment. Farmers, programmers, and entrepreneurs all need high-speed Internet access. Rural connectivity also supports needed research.

Mayo Clinic implements telehealth approach for neonatologists

Healthcare IT News reports, starting with the stats…

The new technology connects on the first attempt 96% of the time, compared with 73% for the previous telemedicine carts; with enhanced monitoring and support, tele-neonatology availability is 99%.

They began looking at telehealth approaches for neonatologists in 6 years ago. Here’s how it works…

In October 2016, Mayo Clinic’s tele-neonatology program transitioned from a wired telemedicine cart with hardware CODEC to a proactively monitored, fully supported wireless telemedicine product from vendor InTouch Health.

Care teams in the community hospitals activate tele-neonatology when there is a high-risk delivery or a newborn that requires advanced resuscitation. Providers at the community hospital place the wireless telemedicine device at the newborn’s bedside and call Mayo’s Admission and Transfer Center to request a tele-neonatology consult.

A Mayo Clinic neonatologist then establishes a synchronous, audio/video connection with the care team via the telemedicine device in the room. If the newborn requires transfer to Mayo Clinic’s neonatal intensive care unit (NICU), the neonatologist can dispatch the transport team to retrieve the patient as part of the tele-neonatology workflow.

They compared two solutions; the article details the results. They also posted some lessons learned…

“The focus of Mayo Clinic’s tele-neonatology program has always been the needs of our neonatal patients, whether they are located in Mayo Clinic Rochester or elsewhere in our region,” Fang said. “By leading with patient care and identifying unmet needs of patients or care teams, organizations can design telemedicine programs that are impactful, effective and highly utilized.”

When developing a tele-neonatology program, the multi-specialty team must consider many factors including service activation and workflow, staff education and training, team building and communication – and the telemedicine technology itself, she advised.

“Our recently published study (McCauley et al, Telemed and e-Health, 2019) focuses on one of these domains, the telemedicine technology,” she said. “We demonstrated that the ITH Lite improved audio quality and ability to connect on first attempt when compared with a wired telemedicine cart. Organizations should consider the reliability of connection, audio/video quality, and fit within the care environment when selecting a technology for their tele-neonatology program.”

In addition, proactive monitoring is broader than hardware and network monitoring, she cautioned. In this study, incidents were not only identified by vendor monitoring of the devices but also during care team and physician training, tele-neonatology simulation sessions, and physician on-call preparation activities.

“When developing a tele-neonatology program,” Fang concluded, “organizations should consider comprehensive support models for incident management and tracking.”

Broadband Imperative III Driving Connectivity, Access and Student Success – Recommendations and MN Take

State Educational Technology Directors Association (SETDA) just released the a report on broadband access and education, Broadband Imperative III Driving Connectivity, Access and Student Success. Minnesota is a featured case study,

A look at State support…

From a state level, agencies such as the Department of Employment and Economic Development (DEED) and the Minnesota Department of Education (MDE) provide funding through grant opportunities and aid programs to help communities, schools, and public libraries achieve high speed broadband access. The Minnesota Office of Enterprise Technology (MnIT) provides a backbone network (leased, not state owned) throughout the state to deliver connectivity to cities, counties, public schools and libraries in various areas of Minnesota.

State Funding…

Minnesota provides state funding directly to the district for external broadband connections and directly to the regional networks. Through regional partnerships, the median cost of broadband (per mbps) in Minnesota schools has dropped 84% from $15 in 2015 to $2.35 in 2018. While cost has decreased, the amount of bandwidth necessary for students to participate in digital learning has increased. In the same period of time, the median bandwidth speeds available on a per student basis has increased almost four fold from 226kbps to 890kbps. Minnesota currently provides limited state funding for connectivity on buses and previously provided one-time grants that could be used to obtain hotspot devices for students to use off campus. Minnesota does not provide funding for internal wireless connections.

Regional support…

Minnesota provides education broadband connectivity through 19 regional networks. … Most school districts rely on the federal E-rate program to afford high speed broadband, so they use the corresponding competitive bid process either independently to choose a regional network or the regional network completes a competitive bid process through E-rate for the regional broadband network as a wide area network for all members. The networks are coordinated by a cooperative or nonprofit education agency that provides services to the K-12 education system. Minnesota estimates that 50% – 74% of districts participate in a regional network.

They highlight programs and projects such as Southwest West Central Service Cooperative (SWWC)’s recent upgrade from a microwave network to fiber. They also look at remote music classes through MacPhail Center for Music and of course they mention redesigned Minnesota snow days. And they talk about off campus access…

In Minnesota, other state agencies, libraries, community-based groups and the state broadband commission work together to coordinate efforts to support student access to off campus connectivity. The state is promoting strategies, both formally and informally, for access to affordable out-of-school broadband for students, especially in low-income and rural areas through legislated funding; promotion of discount/ free options; community partnerships; connecting anchor institutions; and Wi-Fi on buses. Off campus access strategies are driven by availability and affordability in rural areas; minimum broadband standards, such as speed, safety and security, as well as limited service options for consumers. Specifically, through efforts by the Governor’s Task Force on Broadband and the Office of Broadband development, statutory goals were put in place calling for all homes and businesses to have access to broadband service of at least 25 Mbps download and 3 Mbps upload by 2022 and that by 2026 all homes and businesses would have access to broadband service of at least 100 Mbps download and 20Mbps upload from at least one provider. To help incentivize the deployment of broadband in rural areas, the state funded grant programs and projects that offer new or upgraded broadband service to unserved and underserved areas of the state. Grant programs have totaled $85.6 million to date and $500,000 was awarded to provide schools with mobile hotspots available to students without adequate broadband access at home. The grant programs were administered by the Office of Broadband Development and funding for the programs has been consistently supported by the Governor’s Task Force on Broadband. Grants have also been awarded to provide schools with mobile hotspots for students without adequate broadband access at home.

And future plans…

Minnesota’s regional broadband networks will continue to seek cost-effective broadband solutions for all Minnesota school districts by leveraging state and federal funding initiatives and local partnerships with an eye toward always providing the bandwidth that districts need to fully participate in digital learning and utilize digital resources. Additionally, the regional networks will continue to expand enterprise level services designed to share resources that are expensive for smaller, often rural, districts to afford on their own. Services that will improve network and data security, provide access to online resources, bring educational opportunities directly to the schools and improve administrative procedures within districts.

The report also include a series of recommendations…

Technology and Pedagogical Approaches

Districts and schools are in different stages when considering access to and the utilization of digital tools. The integration of technology for learning is a unique journey that each school or district may embark upon differently. Leaders must focus on academic goals and leverage technology to support student learning experiences in preparation for college and/or careers in the digital age.

Digital Access and Equity

Addressing digital equity for all students continues to be a challenge and stakeholders must ensure that we consider equitable student access to broadband and devices both on and off campus. Every child, regardless of background, race or economic status deserves equitable access to personalized, student-centered learning experiences to prepare for life and work in the global economy.

Planning Infrastructure for the Future

Schools and districts should strategically plan for reliable, high speed networks to support sustained, seamless access to the internet for the implementation of administrative tools, the Internet of things and teaching and learning activities, without disruption. Districts should consider the recommended peak utilization bandwidth capacity goals and WAN implementation considerations as a guide and then plan according to their current and future needs as they move to teaching and learning environments that mimic the corporate structure.

Building Networks for the Future

In order to create sustainable, robust and reliable networks, administrators and technology leaders must look at the level of digital learning implementation and the administrative and security services relying on the network. Additionally, education organizations must implement the most effective security practices to protect their communities.

Policies and Funding Federal: The federal government should continue to expand federal funding options to support:

(a) state, regional and district broadband networks,
(b) districts and schools increasing bandwidth capacity to and throughout each campus, (c) communities in providing access points at anchor institutions, such as libraries and community centers. State: As schools increase digital learning opportunities, states need to demonstrate leadership to support high-speed broadband connectivity by leveraging policies, networks and purchasing options to support increased broadband access in schools.

Broadband for America’s Future: A Vision for the 2020s outlines a policy plan for local, state and national audiences

The Benton Institute for Broadband & Society released a new report; last week I looked at mentions of Minnesota today I thought I’d look more broadly at the report. They define three main benefits better broadband can deliver…

  • Growing the American Economy. High-Performance Broadband transforms industries that are basic to everyday life, positively impacting agriculture, education, healthcare, energy, and more.
  • Empowering Workers. High-Performance Broadband advances skills training to boost individual opportunity, helping to overcome income inequality and economic frustration.
  • Strengthening Communities. High-Performance Broadband spurs economic growth and jobs. It can enable civic participation. It can improve the health, education. and learning of community members.

Then they look at a four-prong approach to making that happen. Here’s an outline of topics in the report based on the four segments:

Advancing Broadband Deployment

  • Map Broadband Oases and Deserts
  • Deploy High-Performance Broadband
  • Reach Unserved Areas (and Reject the Claim of “Overbuilding”)
  • Deploy High-Performance Broadband on Tribal Lands
  • Employ Reverse Auctions to Stretch Federal Dollars
  • Establish Eligibility for Reverse-Auction Participation
  • Establish Requirements for Funded Deployment
  • Increase the Effectiveness of Federal Efforts
  • Support State Strategies Targeted for Specific State Circumstances and Needs

Promoting Broadband Competition

  • Promote Broadband Competition at the Local Level
  • Enact Stronger Federal Policies to Spur Broadband Competition
  • Execute Additional Pro-Competition Recommendations in Other Parts of This Report

Ensuring Affordability and Adoption

  • Create an Affordability Agenda
  • Support Digital Skills
  • Incorporate Digital Skills Training in Regional Economic-Growth Strategies

Supporting Community Anchor Institutions

  • Governments should establish connectivity goals fit for the rising demands of the next decade, including periodically re-examining the current goals set by the FCC for federally funded connectivity to schools and libraries and establishing connectivity goals for other community anchor institutions.
  • Governments should support and promote competition to drive better broadband at lower prices for community anchor institutions.
  • The administration of broadband programs supporting community anchor institutions must be transparent, rely on competitive outcomes, and provide reasoned (and thus reviewable) analysis for administrative decisions.
  • Federal and state programs should empower community members—particularly K-12 students—to access community anchor institution broadband and crucial applications ubiquitously.
  • Governmental support for High-Performance Broadband deployment to community anchor institutions should leverage those networks to spur competition and greater connectivity for nearby residents.
  • Spectrum policy should allow community anchor institutions to be full or even favored participants in shared and tiered access.
  • State and local governments should facilitate comprehensive broadband strategies, including encouraging the creation and growth of state research and education networks and bringing institutions together to learn from one another.

The report is filled with persuasive stats and stories. In fact, if you were looking to build awareness of broadband, you could do worse that Tweet a stat a day from this report!