In December, the FCC voted to repeal its net neutrality rules, which would essentially give service providers the green light to start charging for differentiated Internet speed access. While efforts to block this are underway in Congress, and states are taking legal actions, healthcare providers have good reason to be concerned.
In defense of the move, FCC Chairman Ajit Pai said in December that by “replacing an outright ban with a robust transparency requirement and FTC-led consumer protection, we will enable these services to come into being and help seniors.”
Naturally, the healthcare community is wary of remarks like these. The biggest concern is that a tiered system in which Internet traffic could be prioritized would set back rural communities who can’t afford to invest in the fastest networks.
While we don’t yet know how things could shake out, it’s important to consider what changes in net neutrality might mean to the healthcare industry — not only to telehealth and technology providers, but to healthcare organizations and patients, too.
What’s at Stake
The technology community is no stranger to regulation, and developers have always found a way to adapt to circumstances. Still, by understanding what’s at stake, we are better prepared for any outcome.
Modern-day telehealth is centered on a video-based experience, which in and of itself sets it apart from other digital healthcare systems and technologies. Video is highly sensitive to bandwidth and speed, so it costs a lot of money to run the highest-quality video over a network. Thanks to net neutrality, Internet Service Providers like Verizon and AT&T can’t slow down the flow of data packets as they travel from the first data hop to subsequent hops along a route.
If net neutrality goes kaput, an operator will be allowed to prioritize traffic and charge premium rates for organizations to receive the same services they take for granted today. It’s the virtual equivalent of going to the post office and having to pay for priority mail, instead of regular mail, to deliver a product intact.
Thinking about this on a larger scale, if service providers begin to prioritize certain types of traffic like a video consultation, the costs trickle down quickly. A large, urban health system might just feel a pinch, but has the budgets to compensate — while a rural hospital would feel a huge punch in the gut.
Considering that cost savings are a key driver of telehealth’s growth, this is a big deal. Telehealth has proven itself a game changer in expanding access to all kinds of healthcare for patients and access to specialists for financially strapped, small rural hospitals and physician practices. If these rural organizations have to pay a fortune just to maintain their bandwidth loads, their ability to grow and scale programs like telestroke, tele-behavioral health, or other specialties will suffer.
In addition, I am concerned about the threat on innovation. The Amazons, Facebooks and Googles of today were all small start-ups with fantastic ideas at one point. These ideas leveraged the Internet and disrupted industries because on the Internet, there wasn’t a toll or premium price charged for their new ideas. If that was the case, we might still be stuck with AOL as our search engine, or Sears as our only real online marketplace. I believe net neutrality has lowered the barriers to entry for Internet-based technologies and this has driven the rapid innovation of the last two decades.
On the flip side, there are couple of potential positives. For one, ISPs have argued that doing away with net neutrality will help them expand and deliver telehealth to a greater number of customers. Another, less-discussed silver lining to a post-net neutrality world is innovation by necessity.
Anytime there are roadblocks with emerging technologies, scientists, engineers and creative thinkers push harder for innovation. We have so many talented information technology leaders working on optimizing the telehealth experience — when push comes to shove, they’d likely seize the opportunity to figure out how to conduct video consultations with dramatically less bandwidth. Consider the 1990s, in the early days of dial-up, how quickly the IT community pushed innovation until the Internet was free of ISPs’ “walled gardens.”
Is it not conceivable we could experience a similar technological revolution with telehealth?
Moving Forward Under New Rules
The fearful can take heart that we’re still in hypothetical territory as the fight to keep net neutrality rules intact continues.
Today, healthcare leaders should take this time — in the weeks before rules potentially change for real — to talk to their vendor partners about how they plan to move forward in a post-net neutrality world. Is a vendor partner committed to investing in the best possible video experience, and pushing for the highest quality possible? Is a vendor partner pushing for innovation, and trying to find new ways to create value for its healthcare organization partners? Is the vendor taking part in conversations in Washington, D.C., with policy makers?
Answers to these questions can say a lot about a vendor’s character and priorities.
In the meantime, it’s important to remember that challenges will always arise, in and out of the physician’s office or hospital board room. So long as healthcare organizations are committed to providing high-quality, value-centered care to their patients, we will rise above the noise and regulatory changes and help make the world a better place.