MN Broadband Task Force July 2017 – telehealth saves money and lives

Yesterday the MN Broadband Task Force met at the new Essentia Hospital in Sandstone. It’s a beautiful location with a fiber connection symmetrical 100 Mbps connection. And they’re making good use of that connection saving money and making lives better.

I have video of most of the meeting. We learned a lot about telehealth – but there were a few details that stuck out for me.

  • More people in rural areas come to health care facilities with a stroke. Treatment has traditionally been slower for them. Every 15 minutes a patient with a stroke goes untreated the situation becomes more dire. Telestroke technology (and promotion of it) cuts that time and helps people get better.
  • Hospitals don’t just share images faster with faster broadband – they share more, giving a fuller view of any problem.
  • There aren’t enough healthcare professionals – especially specialists – to go around in rural areas. Telehealth provides an opportunity for one specialist to serve many facilities.
  • Communities in rural areas without broadband are envious of communities with cooperatives because they feel they would get better service. Communities are worried that broadband expansions paid for with CAF 2 (federal) funding will leave some communities with worse infrastructure for longer periods. They are especially worried about upload speeds. (CAF 2 funding only requires a provide to expand/upgrade to 10/1 service. And really 4/1 service is some areas.)
  • Minnesota does not allow for bonding for technology (software or hardware) but perhaps there’s an opening to discuss bonding for broadband.

PPTs:

Continue reading

Rural Minnesota needs broadband – what will help?

The Minneapolis Star Tribune today features a big story on the need for better broadband in much of rural Minnesota. They opened with a story about a business that recently moved from Minnesota to Wisconsin for better broadband…

“It never dawned on me that it would be such a detriment to my business,” Jelinski said of inadequate broadband access. “There’s no reason for it.”

A recent switch to a DSL connection helped, but Jelinski worried about her business’ future. The family moved to De Pere, Wis., last week — after Jelinski confirmed that it has great broadband access.

Some predictions on future federal support for broadband

“The outlook [for rural broadband improvements] is not positive” under Trump, said Milda Hedblom, a lawyer, broadband advocate and digital studies professor at Augsburg College in Minneapolis.

Hedblom said she’s worried that the president, a former businessman, will naturally favor big private companies over municipalities and local collaborations. That could mean he’ll steer federal broadband funds to big providers that are averse to expensive rural projects, she said, since the return on investment isn’t as quick or as large

Some details on federal funding..

Trump’s budget, released May 23, proposes $1 billion in cuts from U.S. Department of Agriculture rural development spending — including some funding for broadband infrastructure. Instead, he wants $160 million in new rural economic infrastructure grants that would include broadband money — along with many other projects. Half the money would be set aside for Appalachia; broadband’s share was not specified.

Trump also plans a $1 trillion infrastructure package— which he is expected to detail on Monday — and his budget lists broadband among priorities that include “surface transportation, airports, waterways, ports, drinking and waste water.” It added that “federal funding for infrastructure is not the solution,” however, and promised to “fix underlying incentives, procedures and policies.” Exactly what that means is unclear.

Some advice…

Some rural broadband advocates say the infrastructure initiative could be the best bet for future federal grants.

“Our message to communities is get ready. Those with civic infrastructure [in place] to respond to opportunities … are going to be in the best position to benefit,” said Bernadine Joselyn, public policy and engagement director for the Grand Rapids, Minn.-based Blandin Foundation.

And some new approaches…

Uncertainty about government funds has prompted new approaches to leveraging grants and raising awareness:

• Member-owned rural electric cooperatives are installing broadband to fill voids left by mainstream providers.

About 100 of the nation’s 900 co-ops “are involved in some way,” said Martha Duggan, who handles regulatory issues for the National Rural Electric Cooperative Association. “We’re very local … and very focused on economic development.” She hopes funding will be included in Trump’s infrastructure plan and the 2018 farm bill.

• The Minnesota Farmers Union called broadband “an essential utility” in an April report to state officials. Gary Wertish, the group’s president, said it’s time for a broad national initiative. “The state can’t do it on its own,” he said.

“We’re trying to compete in a global economy and if we don’t have access to broadband, we’re left behind again,” Wertish said.

• Communities are pooling resources and clout. Six southwestern Minnesota counties (Chippewa, Lincoln, Lyon, Murray, Pipestone and Yellow Medicine) are working with the Southwest Regional Development Commission and in May received a $123,800 Blandin Foundation grant to study ways to fill broadband gaps.

VA wants Telemedicine authority to improve health care for rural veterans

IT World reports…

Officials from the VA recently made their way to Capitol Hill to appeal for legislation that would grant the agency greater flexibility in providing remote health services to the military community. In particular, the VA is putting a “special emphasis” on improving the delivery of health services for veterans in rural and “underserved” areas, according to Dr. Kevin Galpin, executive director of telehealth services at the Veterans Health Administration.

They are looking for a solution that could open a door to similar solutions where policy is hindering technology use…

Galpin’s primary request is relatively straightforward. He is asking Congress to expressly affirm that VA providers are authorized to deliver telehealth services across state lines and to patients in their homes.

“This authority will remove barriers that currently exist between a national VA clinical expert and a veteran that needs their service,” he said.

They have had success with telemedicine and want to continue to grow…

The VA has three broad categories of telehealth services, comprised of clinical telehealth, home telehealth, and “store and forward” services, where a device captures an image and relays it along to be examined by a specialist at a later time.

The VA offers telehealth services in more than 50 clinical specialties. The VA reports that more than 307,000 veterans received care through a clinical telehealth encounter last year, and, at present, more than 87,000 are using home telehealth services.

In an interesting tangent, the Minnesota House is looking at the definition of telemedicine

HF1314/ SF1353*, sponsored by Rep. Matt Dean (R-Dellwood) and Sen. Julie Rosen (R-Vernon Center), would cover professional standards both regarding practice and conduct and services that can be provided via telemedicine including assessment, diagnosis, treatment, education and care management.

The bill would also clarify that “telemedicine” refers to real-time, two-way interactive audio, visual and audio-visual communications — like secure video conferencing, said Rep. Nick Zerwas (R-Elk River).

A telephone conversation, email or fax between licensed health care providers would not count as telemedicine consultation or service.

The Minnesota definition seems more limiting that the federal as I’m not sure where the VA’s idea of home telehealth and store and forward fit into the local version of telehealth as video conference. And it will be interesting to see how such differences get ironed out especially since one of the things the VA is requesting is authorization to deliver telehealth service across state lines.

MN Broadband Task Force April 2017: Making the business case for broadband

The Task Force heard from folks in the field who slice and dice the numbers to help people understand what it will take to deploy broadband in rural areas. They heard from Mark Mrla of Finley Engineering about his work on broadband feasibility studies. When ordered by a rural community, many feasibility studies in Minnesota have become like a work plan. Communities use it to approach providers (directly or through and RFP) and many have then gone on to seek (and get) state broadband funding. ComQuest spoke about their broadband modeling tool that helps communities and providers build scenarios for business case development. They can alter variables to predict outcomes. Dusty Johnson from Vantage Point talked about the economic impact of the rural broadband industry on rural and urban areas.

They also heard from Minnesota economic developers (Cheryal Hills, Executive Director, Region 5 Development Commission, Sheila Haverkamp, Executive Director, Brainerd Lakes Area Economic Development Corporation and Kristi Westbrock, COO, Consolidated Telecommunications Co.). Kristi works with the local CTC but their surveys on the impact of their network indicates that she’s an economic developer too.

They also got a legislative update.

It was an interesting discussion. Continue reading

Akamai Q4 (2016) broadband report is out – MN ranks 25-29 depending on the category

The latest Akamai Report is out Q4 (2016). They measure worldwide broadband adoption and speeds. Turns out Minnesota is pretty middle of the pack. Really Minnesota doesn’t even rank well enough to make the report (they only list “top 10) but the folks at Akamai are kind enough to send me our stats.

I’ve included below charts from the report – followed by Minnesota stats…

Average connection speed:

We rank #26 with an average connection speed of 16.2 Mbps – that’s a slight increase over Q3 (1.5 percent) but a nice increase from 2015 (8.5 percent).

Average peak connection speed:

We rank #27 with an average peak connection speed of 76.3 Mbps – that’s an increase over Q3 (3.5 percent) but a very nice increase from 2015 (24 percent).

4 Mbps broadband adoption:

We rank 29 with 88 percent having access. That’s an increase of 1.1 percent from Q3 and 5.1 percent from 2015.

10 Mbps broadband adoption:

We rank 26 with 60 percent having access. That’s an increase of 6.5 percent from Q3 and 16 percent from 2015.

15 Mbps broadband adoption:

We rank 25 with 39 percent having access. That’s an increase of 5.2 percent from Q3 and 20 percent from 2015.

25 Mbps broadband adoption:

We rank 26 with 14 percent having access. That’s an decrease of .1 percent from Q3 and an increase of 17 percent from 2015.

There’s a slight dip in growth in the 25 Mbps category. We weren’t the only state to see a decrease there and the decrease is slight (.1 percent) so that isn’t too concerning. What is concerning is the stronghold we have on middle of the pack standing!

It is disheartening to rank #27 for peak connection speed with 76.3 Mbps. It’s not great to be #27 – but again more concerning is that while the average peak for the state is 76.3 Mbps 12 percent of the state doesn’t have access to 4 Mbps. That’s quite a digital divide.

Turn snow days into e-learning day? Good idea once everyone has broadband and a computer!

I’m a little slow about posting this suggested bill  – (SF 1241 & HF 1421) to turn snow days into e-learning days. The St Cloud Times gave a nice description…

Minnesota lawmakers are considering legislation that could spell the end for snow days.

A House committee Thursday will discuss a bill that could replace up to five snow days each year with “e-learning days.” Students would get on a laptop or tablet at home and follow along with online lessons on school days that would otherwise have been canceled.

Like a snow day, parents would be alerted to the at-home learning day at least two hours before the start of school and teachers would be available throughout the day to answer students’ questions.

Minnesota lawmakers are considering legislation that could spell the end for snow days.

A House committee Thursday will discuss a bill that could replace up to five snow days each year with “e-learning days.” Students would get on a laptop or tablet at home and follow along with online lessons on school days that would otherwise have been canceled.

Like a snow day, parents would be alerted to the at-home learning day at least two hours before the start of school and teachers would be available throughout the day to answer students’ questions.

Looks like the bill has been referred to another committee (Education Innovation Policy in the House and E-12 Policy in the Senate). I know Red Wing has been successful with this push. It would help keep kids on track and minimize the nightmare of planning for snow days. I have three kids in three schools and each handles differently snow days and making up for or using snow days at the end of the year. It’s a little bit of a parental nightmare – worse for the schools I imagine. But I don’t think this conversation (never mind conversion) can happen until every student in the state has access to adequate broadband and a computer or device to use it.

Although cards on the table – I grew up in Minnesota. I remember the pure joy of waking up to snow, listening to WCCO and cheering when my school was called off. And even when it was/is my kids school that’s called off, there’s still a little residual joy in the house.

Winona County Broadband Profile: 81 percent access to 25/3 and 100/20 and grants to help upgrade

In 2014, winona90 percent of Winona County had access to broadband. (Broadband was defined with lower speeds back then.) Today 82 percent of the county has access to broadband speeds of 25/3 (Mbps down/up) and 81 percent has access to the 2026 speed goals of 100/20.

Winona is doing well and they got a recent Border to Border broadband grant to help them do even better…

the county will get $416,000 to continue broadband expansion into areas of Wilson, Homer, Richmond, Pleasant Hill and Wiscoy townships.

The total project cost is estimated to be $868,000, with a match by HBC covering the rest.

The project is expected to reach 111 households, 112 unserved businesses, and two community institutions currently unserved or underserved.

Winona County administrator Ken Fritz said the county would like to continue using the programs if the state continues providing grants.

They had received funding in the past as well…

Last year the county was awarded $314,500 to a project to expand broadband into the Witoka and Wilson areas, with HBC covering the rest of the near $1 million project cost. That project started in spring 2016 and affected an estimated 256 households, 117 businesses, 90 farms, nine commercial and industrial businesses, 18 home-based businesses, a school and other public institutions.

In 2015 the county also received $247,000 for broadband expansion in Elba and Norton townships, including Whitewater State Park. The overall project is estimated to cost nearly $775,000. That project will provide improved internet to an estimated 135 households, 70 businesses, Whitewater State Park, Whitewater Wildlife Management Area, Crystal Springs Fish Hatchery, a school and other public institutions.

Winona has been an involved community. They were a Minnesota Intelligent Rural Community (Blandin MIRC) community where among other projects they worked with Project FINE to provide digital inclusion training in multiple languages. Last summer (2016), Senator Franken’s team held listening session in the area to discuss broadband.

Winona County is also in line to receive $245,212 in CAF 2 funding to upgrade 475 locations. CAF 2 recipients are only required to upgrade to 10/1 access. Many may choose to upgrade to better speeds but there are no requirements.

Numbers:

The Office of Broadband Development released data on broadband covered in fall of 2016, based on information gathered in July 2016. Here’s how they ranked:

  • Percentage served with 25/3 or better: 82.13
  • Percentage served with 100/20 or better: 81.17

ranking-roseau-to-yellow-medicine

Mississippi State University Extension have come up with a ranking system to gauge the digital divide index (DDI) by county. (The lower the number the better – the state average is 40.66.) Here’s how they ranked:

DDI score of 41.93 out of 100.

More info:

I plan to profile each county in Minnesota – tracking broadband access, digital divide and annotated links to news of what’s happening with broadband in the county. I’m keeping it high level because there are 87 counties!