One of my strongest passions is related to my interest in the buildout of our nation’s broadband infrastructure. I am particularly interested in achieving a broadband network infrastructure in the state of Alabama. In this blog post, I will detail the need for a network infrastructure in Alabama, and how it has the capabilities to impact health care and economies in rural areas.
Models to Follow
I first became aware of how the broadband initiative was evolving when I attended the Nobel Summit in Stockholm, Sweden in 2002. At the summit I met with the mayor of Stockholm and their network team, and I was amazed at how well connected the city had become. Education buildings, health care facilities, emergency management stations, libraries, theaters, and pharmacies were all connected to the network and to almost every building in the city. This was especially impressive because the city is built on many islands. Telehealth and telemedicine were commonplace for this nation. European countries have long been engaged in the development of their infrastructure, but the United States has lagged behind in part due to the way in which our telecommunications and transportation industries are segmented.
In the U.S., infrastructure stands as the critical issue when cities attempt to attract and sustain economic growth and development. Infrastructure can also be a major consideration when striving to develop better health care services. Both the West and East Coasts have been noted for their strong network infrastructure, specifically the regional optical networks, as noted by the development of the Corporation for Education Network (CENIC) and Pacific Wave in California, Oregon, and Washington, Florida Lambda Rail (FLR) in Florida, and the Atlantic Wave on the East Coast.
The University of Alabama System Regional Optical Network (UAS RON) represents the first major step toward a statewide network in Alabama. This project was designed to meet demands of rural health care initiatives and also to provide a stimulus for the development of a research corridor. Alabama’s network infrastructure requires a significant build-out and retrofit to meet the growing demands of a technology-centric culture.
There has been increasing pressure to make quality health care more accessible through usable technology. To achieve effective health care reform, nationally, as well as in rural areas, all entities involved must systematically redesign their own infrastructure to assure the highest quality of care, avoid duplication of effort and trim costs. Lack of access to health care professionals, as well as lack of knowledge regarding how this access can be provided through telemedicine, have hindered Alabama’s ability to provide ubiquitous health care to its residents.
The Patient-Centered Medical Home (PCMH) is a model of care articulated by principles that embrace the aspirations of the Institute of Medicine (IOM). This model is closely aligned with the capabilities of patient-centered health care at a distance through the practice of medicine by physicians, physician assistants, nurses, therapists, pharmacists, and specialists. In this model, all entities collaborate for patient consultation either within the confines of the same location or at a distance.
Rural health care is highly dependent upon the ability of the PCMH team to provide health care services to the population that resides in many underdeveloped areas of Alabama. Broadband is required to provide this service to residents in rural communities.
Rural and Economic Impact
Rural well-being is especially critical to Alabama. Approximately 60% of Alabama’s population resides in rural areas, while less than 20% of the state’s physicians’ practice in these areas. In fact, 38% of Alabamians reside in federally designated “professional primary health care shortage” areas. This discrepancy is just one of many rural health care issues facing Alabama; however, collaborative research is providing much needed insights into Alabama’s rural health care issues that may someday provide all Alabamians better access to quality health care. To meet the challenge of the health initiative, several groups have aligned in partnership. The 14 public universities in Alabama, the State of Alabama and Alabama Power have formed a strategic partnership that will focus on the elevation of public health as well as safety, education, and defense for the citizens of Alabama.
Expanding the use of emerging technologies can provide an answer to several necessary requirements for improving quality while removing barriers. Through such technology, rural health care facilities can offer patients an expanded continuum of care at a lower cost. Local patients who receive such convenient and specialized care at their local health care facility will be more likely to enhance the facility’s financial viability by returning to that facility for other health care needs. The use of emerging health care technologies can also aid in decreasing the tremendous pressure that rural facilities face in trying to provide subspecialty care for its local patients. Broadband provides the solution.
To enact a solution, we must map a set of fiber-optic cable rings to provide a more accessible backbone for connection points. The map below is concept-only and doesn’t represent a complete plan. It is intended to illustrate the concept of regional rings, and how they might bring connection points closer to the communities and facilities where they are needed. The figure does show the existing UA System-owned Regional Optical Network that would certainly be an integral component of a general state network backbone.
This is an exciting initiative, one that will place Alabama in a position to enhance its economic potential through its ability to provide health care, education, and other critical services to all of its citizens. Multiple planning sessions have been held to move this initiative forward, especially in light of the U.S. infrastructure development plan. I look forward to providing updates as this project moves forward.