1997 Partnerships for Networked Consumer Health Information Conference

Summaries of Plenary Sessions and Breakout Sessions

Plenary Sessions and Response Panel: Implications of The 1996 Telecommunications Act

Tuesday, April 15
2:30 - 3:30 PM

Plenary Speaker: The Honorable Reed Hundt, Chairman, Federal Communications Commission

Moderator: Jo Ivey Boufford, MD, Acting Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, DC

Respondent: Gregory Lawler, Chairman, FCC Advisory Committee

Respondent: Jay Sanders, MD, President and CEO, Global Telemedicine Group

Respondent: Gwen Edwards, Vice President, Health Care Market Group, Pacific Bell

Respondent: Kevin Patrick, MD, MS, Editor-in-Chief, American Journal of Preventive Medicine, Graduate School of Public Health, San Diego State University

Statement of the Subject

The 1996 Telecommunications Act is designed to deregulate the dynamic communications sector, permitting competition across previously separate subsectors such as cable TV, wireless communications, and local and long-distance telephone industries. The intention was to provide the consumer with better telecommunications at lower costs, while stimulating the development of new technologies and the enhancement of the national information infrastructure. In addition, the act's Universal Service sections provide subsidies for telecommunications services for schools, libraries, and rural health care providers (including public health departments). Public and non-profit providers of health care to rural populations are to have access to telecommunications services necessary for the provision of health care services at rates comparable to those offered in urban areas. The Federal Communications Commission is now drafting regulations to implement the act. It received input in October from an Advisory Committee on Telecommunications and Health Care [http://www.fcc.gov/Reports/telemed3.txt] and public comment was received over the winter. The FCC's decisions are due May 8, 1997.

Key Issues

The FCC is required to determine which telecommunications services are eligible for Universal Service funding support. The FCC's Advisory Committee recommended that health care providers decide for themselves which services are "necessary for the provision of health care services." They suggested that eligible health care providers be entitled to any services of bandwidth up to or including 1.54 Mbps at rates comparable to those in urban areas. This level of bandwidth would support voice, data, and video applications used in physician-to-physician and physician-to-patient consultations, continuing medical education programs, access to medical information on the Internet, rural emergency department support, and specialty consultative services. The FCC must also decide how to determine rates that are "comparable" to those in urban areas and whether or not to support toll-free access to Internet Service Providers and infrastructure buildout.

Roles, Responsibilities, and Priorities

Government: draft and implement regulations that support an appropriate level of health-related functionality, including peer-to-peer and provider-patient communication; explore additional legislation to address issues not covered in 1996 act, such as improving service to disadvantaged urban areas.

Telecommunications companies: provide covered services to eligible health care providers according to FCC regulations; extend infrastructure to support advanced services; facilitate partnerships among health, education, local government, and other sectors to enhance telecommunications service to a given region.

Telemedicine providers: participate in FCC policy-making process.

Health care providers, including local health departments: participate in FCC policy-making process; become educated about potential telecommunications applications; conduct needs assessments to determine optimum uses for specific purposes; acquire training and infrastructure to sustain health-related telecommunications; explore partnerships with other sectors within a given community (e.g., education, local government).

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