Study shows Minnesotans happy with telehealth – but barrier exist – such as no broadband

The Minnesota Department of Health reports…

A new study produced by the Minnesota Department of Health (MDH) highlights the potential for telehealth to make care more accessible while providing similar levels of service to traditional, in-person ways of delivering care. Telehealth is the use of electronic or telecommunications technology to access health care remotely. …

The preliminary report’s findings, which focus on Minnesotans with private health insurance coverage, show that the use of telehealth increased significantly during the COVID-19 pandemic. Data also showed that most patients receiving telehealth services were satisfied with their experience. Overall, about 80% of Minnesotans surveyed by MDH during the study period were satisfied with the telehealth services they received, regardless of whether it was a video or audio visit. In addition, the study found telehealth has the potential to increase access to health care by removing barriers like transportation and the need to arrange child care.

There’s a special nod to increased mental health access…

Telehealth’s impact has been particularly strong in expanding access to mental and behavioral health providers. During the first half of 2021, about 60% of all mental and behavioral health services were delivered through telehealth. This finding is especially important for improving access to care for residents of Greater Minnesota, where telehealth has the potential to fill provider coverage gaps that make attaining care especially challenging.

But access to telehealth is not equitable…

The report does note several equity issues to consider with telehealth. For instance, some providers reported challenges in ensuring adequate support for patients whose first language is not English. In addition, while patient satisfaction with telehealth was positive overall, it was somewhat lower for Black, Indigenous and people of color (BIPOC) Minnesotans. Communities that face disproportionate inequities in digital access and affordability, or comfort in using digital technology, face barriers to telehealth access. Still, telehealth provides opportunities to address disparities compared to in-person care, particularly the potential for connecting culturally or linguistically “matched” provider and client pairs without the barrier of physical distance.

MN high school tech education is the worst

The Minneapolis Star Tribune reports

In the next 10 years, Minnesota businesses will have to fill 81,000 tech jobs, including 45,000 in the next five years, vacancies mostly from retirements and job changes to other states, according to the Minnesota Technology Association (MTA). In that same span, there will be an additional 6,500 IT jobs.

Minnesota projects to produce only 6,600 new tech workers by 2032, not nearly enough to address all the positions.

Technology is a profitable career choice…

As of 2022, there are roughly 110,000 tech employees in the state. That figure ranks 18th among the 50 states, according the Computing Technology Industry Association. A year ago, Minnesota ranked 12th in net tech employment.

Experts forecast the state’s unemployment rate for tech occupations to stay at 1.1% through 2027. Software developers and analysts are the most sought after workers in Minnesota with more than 7,000 positions advertised each month, though employers fill only 1 in 4 of those positions each month.

In Minnesota, the annual median tech wage is $94,715, 106% higher than the state’s median wage. Depriving students, especially those living in underrepresented communities, from high salaries can be a detriment to the state’s economy, experts said.

Schools are not helping…

Minnesota ranks last in the U.S. in the percentage of high schools offering computer science coursework with only 21% doing so. Of those schools, 12% are in urban areas, according to MTA. The national average of states whose schools offer computer science courses is 53%.

Meanwhile in Iowa, 71% of high schools offer a computer science course, and in Wisconsin, it’s 66%. North Dakota recently signed into law a bill that makes taking at least one computer science or cybersecurity course a requirement for graduation.

MN is number 2 for widest availability of Gig access

TVTech reports

A new study by finds North Dakota tops the list of states with the widest availability of fixed broadband providing download speeds of at least 1,000 megabits per second.

The conclusion is based on FCC data showing that gigabit speed internet is available to 60.58% of residential locations in the state – the highest percentage in the nation, the study found.

The study analyzed FCC data on broadband and mobile internet speeds and availability in each state.

Minnesota has the second highest availability of gigabit broadband speeds with coverage for 60.41% of residential locations, found.


Public libraries make public computers feel like your own with Personal User Privacy and Security – PUPS

Telecompetitor reports on new sresearch from the University of Kansas Institute for Policy & Social Research on the state of computer use in libraries. The idea that people get access to computers, skills and broadband from the library isn’t new – although it is still valuable. But Telecompetitor picked up on something that is new – the Personal User Privacy and Security…

The University of Kansas developed and is testing, in the libraries, a system called PUPS (Personal User Privacy and Security). PUPS is “a USB-based virtual computing environment… designed to afford public computer users increased customizability, session state per­sistence, and security as compared to the restricted use settings of most library PCs.”

In other words, while library computers are generally locked down and don’t allow for customization, PUPS gives its users the feeling of a personal computer, including the ability to download software and retain their unique user settings. They found that PUPS is most useful to users with digital access but was less useful for users struggling in the second area: digital literacy.

Having worked in libraries, I’ve seen there is a spectrum of skills that walk through the door and there always has been. There are the kids or travelers who are power users. Back in the day, they wanted the DOS prompt to get to their email. As technical as I am, they are often much more so or at least experts in some segment of use. There are folks who may need help remembering how to get to their Gmail. There are folks who, especially since prevalence of smartphones and tablets, aren’t comfortable with the mouse. PUPS targets the first and second group of folks.

There are so many reasons PUPS is a boon. It’s easier to use a computer when it looks like they way you are used to seeing it. (Just think about using a friend’s computer or phone for a minute. It’s disorienting.) Second your digital stuff is always with you. You don’t have to worry about something happening to the computer at the library or having to access “the cloud” every time you want to work on something. Finally, you can open up your files in various locations. So if you move to another part of town, you can still access your midterm report.

PUPS can help users who are digitally astute, but lacking access to a device or broadband, feel more autonomous and more digitally connected.

Growing old rural has become new metro and that difference matters

While a rose by any other name will still smell sweet, a community once called rural,  as Daily Yonder points out,  paints a bleak picture of what we’re calling rural areas…

Later this year, some of the nation’s most economically successful “rural” counties will be reclassified as metropolitan, moving their populations and economic output from nonmetropolitan to metropolitan with the stroke of a pen.

That’s because 2023 is the year the federal Office of Management and Budget will create a major revision for its list of Metropolitan Statistical Areas based on data from the 2020 Census.

Because of how Metropolitan Statistical Areas are defined – using a combination of population figures and commuting patterns – the reclassification is likely to move some of the fastest growing and economically productive rural counties into the metropolitan category.

This gives a falsely bleak impression of rural America, according to scholars Daniel T. Lichter and Kenneth M. Johnson. The researchers from Cornell and the University of New Hampshire respectively, call this phenomenon “the paradox of rural population decline.”

Surveys show broadband is mostly working and mostly important

Telecompetitor reports

Two things are clear in an internet satisfaction report commissioned by Amdocs and conducted by researchers at Dynata: Broadband generally is working well and many see it as a necessity.

The survey found that 89% of respondents said they have reliable access and that the number of homes with more than nine connected devices has almost doubled since 2021. Only 13% of homes with annual incomes of less than $50,000 per year – which the graphic refers to as “low-income” —have more than nine connected devices. Forty-one percent of households with incomes of more than $150,000 have more than nine.

The survey found that almost half—49%–of consumers said that they are happy with their home Internet, while occasionally having issues. Forty percent said they never have an issue and 11% said they struggle with connectivity.

Broadband access is necessary but not sufficient to expand use in some urban area

Earlier today I wrote about how rural Minnesota was missing out on telehealth benefits because of lack of broadband. And now here to report that they aren’t the only ones. Recent research indicates there are pockets in urban areas that are also underserved – based on racial/ethnic and income disparities…

As an emerging social determinant, broadband access impacts health across the life course, affecting students’ ability to learn and adults’ ability to find and retain jobs. Resolving lack of broadband access remains an urban priority. City policymakers can harness recent infrastructure funding opportunities to reduce broadband access disparities.

The article recognizes that access is better in urban areas than rural and suggests that help is on the way…

In the 2021 infrastructure bill, $65 billion dollars were allocated to build broadband infrastructure in unserved and underserved areas, a step that should help to ameliorate infrastructure barriers to broadband connection.

Unfortunately, $65 billion may not get everyone covered but this article is focused on other reasons folks don’t have broadband at home…

Broadband gaps in cities are largely influenced by lack of affordability, disparities in digital literacy, and difficulties accessing broadband among populations with lower educational attainment and language barriers.5,14 Previous research has also found evidence of profit-based discrimination in service delivery contributing to racial and geographic disparities in broadband access.9 These factors suggest that infrastructure improvements alone may not be sufficient to eliminate disparities in broadband access for urban households.

Here are some of their conclusions, worth consideration for rural and urban areas looking to create a digital equity plan for their community. Access is necessary but not always sufficient to expanding broadband use…

Four key findings emerged from our analysis of broadband access in US cities. First, in 2021, about a quarter of households in the 905 largest US cities did not have broadband access at home. Second, households in low-income neighborhoods were less likely to have broadband access compared with households in high-income neighborhoods. Third, predominantly minority neighborhoods had lower broadband access compared to White and no majority neighborhoods, regardless of income level. Our findings confirm patterns previously published by the PEW Research Center and others using smaller surveys or a more limited geographic focus.5,9,21 Fourth, although broadband access increased only modestly between 2017 and 2021, we documented that improvements were larger in low-income and minority-predominant neighborhoods and had the effect of modestly reducing racial/ethnic and income broadband access disparities. To the best of our knowledge, this is the first article to comprehensively examine broadband access of city neighborhoods at national level.

Telehealth not as prevalent in rural MN – due to broadband issues

The Post Bulletin reports

Between 2019 and 2022, MDH found that telehealth use among most categories of health care providers grew. Among Minnesota’s physicians, for example, 64% report using telehealth at least some of the time in 2022, compared to 32% in 2019. Mental health providers saw the biggest jump in telehealth use, with 80% of those providers using telehealth some of the time versus 21% in 2019.

But that uptick isn’t evenly distributed between rural and urban patients. Per MDH’s 2021 Minnesota Health Access Survey, rural Minnesotans were less likely to use video or telephone visits than urban residents.

“It’s really hard to characterize the penetration of telehealth, but by almost every measure … people in urban areas used more telehealth during the pandemic and continue to this day to use more telehealth than folks who live in rural areas,” said Jonathan Neufeld, director of the Great Plains Telehealth Resource and Assistance Center, based at the University of Minnesota.


The answer, according to Neufeld, is nuanced. A mix of post-pandemic preferences, internet access and provider availability all come into play when a patient decides whether or not to see their doctor from their living room — or if that option is available at all.

Broadband is a big issue…

MDH’s Minnesota Health Access Survey found that almost 20% of rural Minnesotans don’t have access to internet reliable enough for a video visit. This lack of internet access is an acute issue for rural medical providers. At Gundersen St. Elizabeth’s Hospital in Wabasha, clinical social worker Mindy Wise sees it firsthand.

“It’d be great if everybody had internet access at fair and reasonable costs, especially for the senior group,” Wise said. “The budget can be a difficult thing for some people.”

Providers ran into similar problems at Zumbro Valley Health Center. Heather Geerts, ZVHC director of clinical services, said even if patients have a cell phone, limited data can make a telehealth visit less desirable.

Census and NTIA unveil new broadband map – slick but only tracking to 25/3

The Census reports on their slick new broadband map

The U.S. Census Bureau, in partnership with the National Telecommunications and Information Administration (NTIA), today announced the launch of the ACCESS BROADBAND Dashboard. …

The dashboard includes a series of maps showing different broadband access measures, as well as economic characteristics that research suggests could be influenced by increased access to broadband. Maps display statistics on employment, small business establishments, wages and income, poverty, home values, population change and migration, educational attainment, and gross domestic product (GDP).

You can zoom into get data at the county level and the data will be updated annually. Here are items tracked:

  • Households with a broadband subscription:
  • Population with access to broadband services of at least 25/3 Mbps:
  • Employed:
  • Labor force participation:
  • Unemployed:
  • Annual change in employment:
  • Workers self-employed:
  • Workers that work from home:
  • Weekly wage:
  • Median household income:
  • Poverty (SAIPE):
  • Poverty (ACS):
  • Establishment entry rate:
  • Annual change in establishments with less than 20 employees:
  • Annual change in establishments with less than 500 employees:
  • Annual change in Real Gross Domestic Product (GDP):
  • Median home value:
  • Annual change in population:
  • Net migration rate (per 1,000 population):
  • Population with a bachelor’s degree or higher:
  • High school-aged population not enrolled, not a graduate:

It’s great to see the subscription rate. It’s frustrating to not see access to broadband at speeds of 100/20 or higher.

Ramsey County residents talk about their broadband experience

SDK Communications, the consultants creating the Connectivity Blueprint, report…

Connectivity Blueprint is creating a roadmap to digital equity that centers the experiences of people in our community. The initiative is led by Ramsey County and the City of Saint Paul, in partnership with a dedicated steering committee of organizations and community partners working across sectors.

They have held meetings and surveyed local residents and have captured some of the feedback from residents especially about the difficulties using technology during the pandemic…

Update in Minnesota enrollment in ACP (Affordable Connectivity Program)

USC Anneberg has taken a closer look at the results of the first year of access to ACP (Affordable Connectivity Program)…

The Affordable Connectivity Program (ACP) is the most ambitious federal initiative put into place to bridge the broadband connectivity gap for low-income Americans. The ACP launched in January 2022, serving almost 10 million households that were transitioned from the Emergency Broadband Benefit program (EBB). By the end of 2022 it had enrolled another 5.4 million households for a total of about 15.4 million subscribers in December 2022. Using data from the ACS 2021 1-year estimates, our estimation is that about 55.3 million households are eligible for ACP[1].

According to the USAC website, Minnesota has 179,362 households signed up for ACP. Last time I checked (Nov 2022) only 87,113 households had signed up.)

Here is how we compare to the rest of the country (lighter the color the lighter the subscription rates to ACP)…

And here is what it looks like in Minnesota, (again lighter the color the lighter the subscription rates to ACP)….

Does it look like your county is leaving help in the table? SF (San Francisco) Tech Council has some tools to help.

The business end of digital skills: everybody wins – households can gain $1,363 to $2,879 per year

The National Skills Coalition took a look at the impact of digital skills training on workers, the word force and businesses…

The findings in this analysis are unequivocal:

There is overwhelming demand for digital skills in the labor market, with 92 percent of all job ads requiring definitely digital or likely digital2 skills. This demand is robust across all industries, and small businesses are just as likely as their larger peers to seek workers with technology skills.

Yet many workers have not had sufficient opportunity to build such skills; earlier research found that nearly one-third of U.S. workers do not have foundational digital skills, and workers of color fall disproportionately into this category due to structural inequities.3

Equipping workers with necessary skills requires action by both private employers and public policy[1]makers. Notably, public investments in workforce development and education are especially vital given the unevenness of private investments and the prevalence of digital skill demands among smaller businesses, which depend on publicly funded work[1]force and education partners to upskill employees.

Closing the digital skill divide has major payoffs for businesses. Prior research has shown that workers value upskilling opportunities and prefer working for employers who offer clear, well-defined path[1]ways to advancement.4 Because turnover has heavy costs for businesses – with estimates ranging from $25,000 for workers who leave within the first year to over $78,000 for workers who leave after five years,5 averting or delaying turnover by ensuring that workers have upskilling opportunities can be economically significant.

Public investments in closing the digital skill divide can also generate economic benefits for individual workers and the broader economy. People who qualify for jobs that require even one digital skill can earn an average of 23 percent more than those working in jobs requiring no digital skills — an increase of $8,000 per year for an individual worker.6 These increased earnings could result in more state and federal tax revenue generated by each worker. Depending on the household size and composition, this could range from $1,363 to $2,879 per year.7

State of Digital Inequity: we need to understand and remember it to build equity

Connect Humanity published the State of Digital Inequity: Civil Society Perspectives on Barriers to Progress in our Digitizing World, a global look at barriers that prevent people from fully participating in the world that most of us take for granted. I always love a report like this but I was wondering if there was a place for it in blog given the global scope and well, it’s kind of librarian-nerdy. Then I went to the Capitol where Senator Kunesch asked a good question about digital equity with communities of color. (The quick answer is that Minnesota is working on a digital equity plan – and you can help!) And last week several Representatives asked questions that indicated they were so far away from folks who are unserved that they didn’t know what to ask.

And then I saw the banner at the right and I remembered that most of the world takes technology for granted. It’s a tool that we have and use because we have broadband, a device (or two) and the skills to use it. Then there’s another part of the world who doesn’t have access and because of it, they can’t even speak up about the need. They can’t send emails or TikToks to get the attention they need. To close the gap, we have to remember it and understand it. The report is full of good info and statistics but here are their key findings:

  • Infrastructure & Access: Inadequate or unavailable internet access affects everyone, but the people CSOs serve are more likely to be impacted by a lack of connectivity due to poor infrastructure and issues with their internet providers.
  • Policy: While CSOs view access to both information and the internet as basic rights, many CSOs feel their governments do not have policies that support this.
  • Content: When it comes to the resources that motivate people to use the internet, email and chat services are by far the most important to CSOs and the people they serve. It is important that these services are available in local languages, which, the survey shows, they mostly are.
  • Affordability: The high cost of both devices and internet access remains a significant barrier for both CSOs and the people they serve and prevents them from participating meaning-fully in our digital world.
  • Digital Skills: Though CSOs agree that digital skills are important, a lack of training on how to use the internet and digital devices is a major issue for both CSOs and the people they serve. Few feel their employees are well trained on the devices and software they use

MN Broadband Task Force Report 2022: State should invest in broadband!

The Minnesota Broadband Task Force Report 2022 is out. The chair of the Task Force Teddy Bekele presented it to the MN House Agriculture Finance and Policy committee meeting today (Jan 17, 2023).

They have recommended annual funding for the Border to Border grants through 2026 to meet the speed goals of 100 Mbps down and 20 up. According to the chart (show below) the cost to the State would be $273,784,250 per biennial (for two years, which is the legislative cycle) if the grant match continues to be 50 percent. That number increases to $569,773,625 with a 75 percent match.

They have also recommended that the cap per award be lifted from $5 million to $8 million to allow for larger projects and cover the increasing cost to reach the households that are hardest to reach.

The other recommendations include:

  • Mapping
  • Affordability
  • Adoption Goals
  • Usage and Navigation

Details are included in the report.

Why is computer ownership less in rural areas? How can it improve?

Digitunity is a national organization working to close technology gaps. They recently published a report (Rural Communities & Digital Device Ownership: Barriers & Opportunities) on device ownership in rural areas. They looked at three important factors that speak to the need and hampered solution to low computer ownership:

  • Current ownership and rural demographics that do not match up with computer ownership
  • Fewer options for getting refurbished computers or discount devices (even due to ACP)
  • Fewer organizations offering help connect users to computers

The challenge for households?

If universal computer ownership is the goal, this “status quo” means rural communities face an uphill battle. There are a larger percentage of households to reach and a larger number of miles to cover to reach them.

The challenge for business support?

Rural locations typically have fewer options for supplying devices than more urban areas. Local businesses are often an important source of previously used computers. They feature heavily in donation efforts for many device drives (Federal Reserve Bank of Kansas City, 2021).

The challenge for nonprofit/community support?

Technology-focused nonprofit spending is especially low in rural locations, with $40 spent by an urban nonprofit for each $1 spent by a rural nonprofit (Neuhoff & Dunckelman, 2011). Other studies found that organizational capacity is lacking in rural nonprofits (Walters, 2020). Part of this may be due to significantly more square miles being covered per organization (Neuhoff & Dunckelman, 2011).


  1. Build on What You Have

Rural areas tend to have a higher percentage of lower-income and elderly individuals, and less robust nonprofits and libraries to engage with them. However, other support

networks also exist in rural America, such as religious organizations, book or quilting clubs, or farm cooperatives that often work with these exact demographics.

  1. Develop Rural-Urban Linkages

Distance to urban areas with device refurbishers or computer repair businesses is

another rural disadvantage. However, once a relationship is established, opportunities

exist for mutual benefit (Mayer et al., 2016).