Survey Says: Telehealth + Community Broadband = Local Economic Success

Benton Foundation

Monday, August 19, 2019

Digital Beat

Survey Says: Telehealth + Community Broadband = Local Economic Success

Craig Settles

The International Economic Development Council (IEDC) and I teamed up to survey the association’s members. The 2019 survey analysis report addresses: 1) the state of broadband, 2) broadband’s impact on local economies, 3) broadband-driven education and healthcare, and 4) community broadband money matters.

In the last few years, broadband-driven education and healthcare (now telehealth) have an increased mindshare among broadband proponents and builders. When Danville Virginia's public utility built their broadband network (nDanville), their main driver was how to use the network to help combat the town’s 19% unemployment rate. 

“The healthcare argument was always understood, but it wasn’t one of the drivers of the network at the time,” states Dr. Frank Maddux, co-founder of Gamewood, Inc, an ISP that joined nDanville. “People didn’t understand how important the network would become and what healthcare applications there would be. They see it now.”

Telehealth is becoming a greater part of the broadband planning picture. Even though telehealth is hampered in many areas because of poor broadband, especially in rural America, there are a lot of innovative apps waiting to break free of those limitations.

In addition to impacting the local economy, facilitating telehealth on the infrastructure can have a significant impact on the economics of the network itself. “The municipalities and co-ops can offer higher-value, over-the-top services to care providers and patients, thus expanding their ARPU[average revenue per user], and make their bids for grant dollars more attractive,” says Mark Noble, Senior Vice President of Business Development for Telehealth vender ViTel Net. “You can impress the committees evaluating grant application by offering turnkey healthcare service delivery capabilities as opposed to ‘just plumbing’ for broadband.”

What the economic development pros think about telehealth

Forty-two percent of this year’s survey participants and 43% in 2014 said telehealth “is a major economic development issue for us.” However, 42% also said telehealth is “mainly an indirect economic impact,” whereas 28% had the same answer last year. In 2019 only 16% can’t see telehealth impacting their local economy.

Two-thirds of respondents in 2014 felt their broadband conditions were not great for producing healthcare-related outcomes that could help communities attract and retain both individuals and businesses. Furthermore, there were higher percentages of respondents who said broadband was insufficient for producing positive telehealth outcomes than for business or education outcomes.

I want to point out that, unlike broadband-driven education, many people have not experienced a lot of telehealth. What's popular these days are services in which a random doctor is assigned to you, you take care of some manageable illness or injury, and you may never speak to that doctor again.

For the survey, I gave the economic development folks a minor primer on telehealth, described several healthcare outcomes that may have economic benefits for the community, and asked them to rate the likelihood of an economic impact for their community. Here are the more popular outcomes based on respondents’ reactions.

Reduce unnecessary visits to the ER. “The average cost of an ER visit is $1,200 and comes with an average wait time of four hours or longer,” stated a 2015 BlueCross BlueShield of North Carolina newsletter. “A recent study indicated that treating many of these ER non-emergencies at urgent care or retail clinics could save $4.4 billion.” Possibly big savings for the community and government.

Twenty-four percent of recipients felt that this particular outcome would have a significant direct impact on their communities. Where there's a high level of uninsured people plus a high percentage of individuals with chronic diseases, this can have an even greater impact on the local economy. A higher percentage (35%) felt it was worth testing to see if the assumptions panned out.

Drawing doctors, medical professionals to our community. There are not enough specialists in certain healthcare professions, especially working in rural and low-income urban communities. The economic viability of certain communities depends heavily on the presence of healthcare professionals. Twenty-six percent of survey respondents feel this would have a definite impact on the local economy, and 36% are willing to test the assumption.

While it is true that people like telehealth because it reduces travel time to and from the doctor’s office,  it’s still high comfort having doctors in the neighborhood, and telehealth becomes another “tool” in the doctor's satchel. Twenty-four percent of survey participants feel this outcome will have a measurable impact on the community, and 36% felt comfortable testing the long-term results.

More mental healthcare services stay local. “There are 65 million Americans that have diagnosable mental health illness but we have less than half of the psychiatric providers needed to meet that demand,” says Encounter Telehealth CEO Jennifer Amis. According to a Scientific American blog, depression in America costs society $210 billion annually. For every dollar spent treating depression, $4.70 is spent treating related illnesses and $1.90 is spent for lost work productivity and suicide.

Based on interviews with people in the telehealth profession, the ability to directly impact economic development may be harder to gauge because telehealth guarantees anonymity, which is ideal for many patients. Nevertheless, 24% of respondents expect a direct impact, and 33% want to see what local research reveals.

Clearly, there has been a lot of publicity, public interest, and resources devoted to telehealth in the last few years. This survey reveals that economic development professionals see the potential economic value of telehealth.

“The role of broadband in healthcare and telehealth cannot be ignored. The medical community needs to be part of the research into broadband and the broadband planning itself,” says Gene Scott, General Manager of Wilson’s (NC) Greenlight public network. “There’s Duke about an hour and a half away from us, there’s East Carolina University and Chapel Hill, UNC is less than an hour away.” If the state legislature could get out of its own way, the possibilities of tying those medical resources with broadband could transform healthcare in the state. 

There's a good deal of valuable data here. This report should generate a lot of questions to be asked and answered in your community.

International Economic Development Council (IEDC) partner, ETI Software sponsored the report.

Craig Settles assists cities and co-ops with business planning for broadband and telehealth. He can be reached at:

Benton, a non-profit, operating foundation, believes that communication policy - rooted in the values of access, equity, and diversity - has the power to deliver new opportunities and strengthen communities to bridge our divides. Our goal is to bring open, affordable, high-capacity broadband to all people in the U.S. to ensure a thriving democracy.

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