Leroy Jones, Jr. is the creator of Talking Technology with Leroy Jones, Jr.

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mHealth: Moving Telehealth Forward

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For anyone who follows health care, this week's Congressional hearing on the Internet had disappointing news.  As FCC Commissioner Ajit Pai testified with evident exasperation halfway through the 3-hour hearing, "The FCC has impeded the IP transition, making it harder for carriers to leave behind the fading copper networks of yesterday and focus on building next generation networks."


The health care implications of this problem are huge.  "Internet Protocol" is a revolutionary system for transferring data. Exactly two years ago, FCC Chairman Tom Wheeler called America's transition to this technology the "fourth network revolution."  He enthusiastically talked about the "innovation, investment, ideas, and ingenuity" that IP would create and "spillover effects [that would] transform society...."


Nowhere will the spread of IP do more good than with healthcare.  IP systems will allow the next generation of health care monitoring and treatment.  The technology will facilitate medical specialists' abilities to give real-time advice in operating rooms a thousand miles away. It will give new hope and access to those who can't leave home.


But now this progress is delayed and so is the mass adoption of the amazing healthcare benefits that IP makes possible.  Why?  Because the FCC inexplicably seems to be turning its back on the smart regulatory policies created by President Clinton. Those policies, which helped drive so much progress and investment in the Internet, are one of President Clinton's great legacies.


Instead, as the hearing made clear, the FCC now seems focused on regulating tomorrow's Internet with rules from the early twentieth century.  As Congress heard, these rules are confusing and legally questionable. The matter is now in front of a federal court, which will hear the case next month but probably not rule until well into 2016. 


This is puzzling, dismaying and incredibly disappointing.  We are delaying some of the greatest advances in health care history while Federal lawyers try to figure out how to apply an 80-year-old telephone law to a world in which a surgeon could be offering real-time help on a complex operation taking place in a different state.


The problems with this situation are so evident and so severe that Congress must step in.  The last time Congress passed a communications law was in 1996, when Internet access for most people involved a 56 kbps connection over a phone line.


There should be no more delays to either health care or the IP transition.  Congress, you need to take action.



mHealth: Detroit

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Last week's two-day FCC telehealth event in Detroit was a testament to the Internet's empowering ability to deliver health care. Start with this eye-opening statistic from the Detroit Medical Center and Wayne State University: A mobile pediatric crisis team with access to an on-call psychiatrist equipped with telemedicine capacity reduced the emergency visit hospitalization rate from 82% to 20%.


Other sessions focused on digital inclusion, advances in online health care and using the Internet to spur health care entrepreneurship.  Doctors presented documentation of an Inpatient Diversion Program that used telemedicine to reduce unnecessary hospitalization and save Michigan's Medicaid program nearly $8 million in one year.


In short, the event offered the latest evidence of the Internet's potential for direct personal health care empowerment.


For federal policymakers, this bears directly on the FCC's misguided effort to begin regulating existing high-speed broadband services instead of promoting better forms of access. That effort has already sparked a noticeable pull-back in investment and deployment of new broadband services, which undercuts telemedicine's growth.


This issue is especially noteworthy since many of society's most vulnerable, including seniors, the physically disabled and those unable to afford their own transportation, have become dependent on telemedicine advances.


For federal policymakers, the common denominator linking Detroit's results and the ability of communities nationwide to adopt similar programs lies in the rapid deployment of broadband service. Few people understand this better than Jamal Simmons, who moderated a session last week on how broadband has become a "social determinant" of health.


For Jamal, tele-healthcare offers the chance for millions of people to finally gain the affordable health care access they need.  But the FCC's decision to regulate the Internet slows down our progress to this desired end.


Earlier this year, he explained this issue perfectly when he called on Congress to take action on Internet deployment.


Noting that the FCC's expensive "utility-style regulations... would increase costs on low- and middle-income people," Simmons urged Congress to protect Internet users in a way that doesn't add billions in new taxes and fees on our monthly service bills.


Jamal is right.  The Internet is far too important to allow the FCC to tie it down with expensive rules that we have to pay for.  No one benefits from that, least of all those who rely on Internet-based solutions in healthcare.


The FCC was wrong to overturn rules begun during the Clinton Administration that have served us well.  This week's events in Detroit should give further impetus to Congress to step in and pass a bipartisan solution.



mHealth: Privacy & Security Rules

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The issues of of both Privacy & Security will always be of great importance to mHealth community.

Check out this interesting article on the regulatory questions being asked about the expanding technology.:

mHealth: Ten Cool Apps for Seniors

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mHealth: Why Health Care Access Needs a Lifeline

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A remarkable demographic change is happening among elderly Americans.  It's a trend that the U.S. Census Bureau recently called, "a gray revolution in living arrangements" and the implications for health care access are huge.

There are now almost 27 million households headed by someone 65 and older, a 24% increase over the past decade, according to Census. For women over 75, living alone has overtaken staying with relatives as the most common living scenario.

As a result, the need for dramatic improvements in health care delivery, especially in rural America, is becoming a crucial national issue. As The Journal put it, "Aging in place is proving difficult in places where the population is growing older, supportive services are scarce, houses are in disrepair and younger people who can assist have moved away."

The seniors profiled in that article - many living alone in rural areas - show the need for expanded telehealth and mHealthpractices. Telehealth and mHealth are vital to expanding access to diagnoses and monitoring services that would otherwise only be available after a long car ride.

But while Federal and State officials increasingly recognize the importance of telehealth and mHealth, the inevitable question is - how can we make this happen? Larry Irving, co-chair of the Internet Innovation Alliance, has an excellent idea: expand the federal Lifeline Program to include broadband Internet service.

Irving, who has been writing for decades about the need to expand broadband Internet service, envisions a scenario in which consumers in need receive direct subsidies to purchase broadband. This, in turn, stimulates competition for broadband deployment.  Administration of the new program would rest with an appropriate Federal agency. 

Perhaps the most important aspect of Irving's insightful idea is that Federal benefits will go directly to those most in need. As Irving correctly notes, the tens of millions of Americans still not connected to broadband "tend to be older, poorer, sicker or live in rural communities."  

The Lifeline program today is focused solely on telephone service.  To be sure, phone service remains vital. Yet in today's society, phone service without broadband is incomplete - like a car whose tires are almost, but not quite, flat. Modernizing the Federal Lifeline program would address this problem efficiently and effectively.

American society is changing and so are our health care needs.  Modernizing the Federal Lifeline program is an important step forward to address those needs.



mHealth Apps: Privacy Gap?

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mHealth: EHR Connect

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mHealth Personal

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This summer, The New York Times offered a front-page view of the future of medical care. It was a vision of better health care access, more convenience and the potential for large cost savings.  "The same forces that have made instant messaging and video calls part of daily life," said The Times, "Are now shaking up basic medical care."


The rise of online health care access is one of the most important social benefits of the decade.  Approximately100,000 mHealth apps are now available to help patients monitor their health and connect with their doctors more easily. 


After watching my mother endure years of serious chronic medical conditions and then serving as the primary caregiver of my father, I am especially appreciative that health care providers are increasingly utilizing broadband as an effective way to deliver healthcare services and improve quality of life for their patients.


That's why the recent news about an unexpected plunge in broadband investment is so worrisome.  For only the second time since 2003, investment in U.S. Internet services declined in comparison with the previous year.  In every other year, broadband investment has moved higher, generating faster Internet service and economic benefits like better health care.


Worse, that other decline, which took place in 2009, could be explained by the Great Recession. But not this one, as our growing economy should, by all rights, mean higher investment.


While many things may have contributed to this bad news, there shouldn't be much doubt on the main culprit: last February's decision by the Federal Communications Commission (FCC) to begin micromanaging the Internet with Title II regulations from the 1930s.


That FCC action was as unprecedented as it was unnecessary.  The constant upgrades fueled by demand for HD video had created an Internet that was unprecedented in its openness.


Unfortunately, this recent news is only the latest sobering development following the FCC's Title II action.  Last May, FCC Commissioner Ajit Pai, who opposed the Title II overreach, released a list of several mostly rural communities in the South and West that lost opportunities for better Internet service because of the higher costs and legal uncertainty caused by the FCC's action.


The FCC took the Internet in the wrong direction this year when it voted to treat our sprawling, rapidly evolving service like a public utility.  The implications for social benefits are significant - nowhere more than with improved health care.


Loss of investment means less deployment of faster services that are necessary to expanding access to the latest in mHealth.  If the FCC won't reverse course, then it's up to Congress to set a better course.



mHealth or Wellness?

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mHealth: Technology & Health Behaviors

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