Fixed wireless
internet can help
close the gap
for telehealth
in rural areas

With the pandemic continuing, some people have continued to be reluctant to visit their healthcare provider in person, which helped increase the popularity of telehealth in the U.S. A recent Department of Health and Human Services (HHS) survey found nearly 1 in 4 respondents used telehealth services between April and October 2021. Meanwhile, a Bipartisan Policy Center survey reported 90% of telehealth patients were satisfied with the quality of care, and 80% were likely to use it again in the future.

The use of telehealth in rural areas has long been seen as a way to address some of the systemic challenges relating to delivering healthcare to hard to reach populations. According to the Georgetown University Health Policy Institute, adults in rural areas are:

• Likely to have access to fewer healthcare providers
• Less likely to be tested for chronic conditions
• Likely to pay slightly more for healthcare and pay a larger percentage of healthcare costs out-of-pocket

Telehealth in rural areas can help with these challenges but needs reliable broadband internet services with enough capacity for both the healthcare facilities and the patients. The "digital divide" is still a challenge for businesses in rural America—a group that is less likely than their suburban counterparts to have home broadband. The Federal Communications Commission (FCC) found 22.3% of rural residents have only minimal broadband services (compared to 1.5% of residents in urban areas), making it difficult in many instances to provide telehealth much beyond a basic phone call. One solution, fixed wireless internet, stands out as potentially helping to close this gap in areas where it is available.

Fixed wireless is a step toward enabling expanded use of the internet for healthcare facilities and services. This is because fixed wireless internet connects one business location (such as a clinic) to high-speed internet using radio waves between two fixed points. The point-to-point signal travels from the nearest cell phone tower directly to a business grade router at your business location, which in turn connects your devices.

With services expanding (Verizon's fixed wireless access over LTE to rural areas is now available in 189 markets in 48 states), fixed wireless is well positioned to further support the use of telemedicine and telehealth in rural areas.

Rural residents are aware of the benefits of using the internet for healthcare facilities and services. According to the Bipartisan Policy Center, 12% of rural Americans indicated they would have delayed seeking care without a telehealth option, and 14% said they would not have sought care at all. However, that same survey also found 35% of rural residents reported technical issues, such as access to reliable cable broadband, as an obstacle to making the most of telehealth services.

The HHS survey found rates of video-enabled telehealth service usage were lower among historically underserved populations, with "lack of broadband access" and "social isolation" among the reasons cited in the report. Tests by researchers from Pennsylvania State University found median speeds in most areas did not meet the FCC's criteria to qualify as broadband. Additionally, what internet services that were available in rural areas performed worse than similar services in urban areas. This problem is further exacerbated when considering the FCC's minimum broadband requirement has met criticism from the Government Accountability Office and lawmakers for being far too low.

Poor broadband capacity can have serious implications for the reduced offerings of telehealth in rural areas such as video consultations, checkups, remote patient monitoring, follow-up discussions and sometimes even reviews of lab work. It also means residents who do seek care are forced to visit locations in person—an infection and public health risk in the middle of the ongoing COVID-19 pandemic. Limiting exposure risk has been foundational to national, state and local government responses to the public health emergency. Researchers have also noted that lack of high-quality broadband can even cut people off from access to patient portals or the online systems used to schedule vaccination appointments.