In an effort to support the medical industry and promote chronic disease care during the COVID-19 pandemic, California Governor Gavin Newsom recently relaxed regulations that prohibited medical providers from using telehealth technology to provide services to patients. This move, aligned with federal efforts to expand telehealth, is restricted by California’s limited broadband network that has left vast swathes of the state without reliable internet.
Telehealth, which is the online communication between patients and their physicians, relies on a steady broadband connection to work correctly. Unfortunately, rural broadband access has been a thorn in the side of the Federal Communications Commission and the United States Department of Agriculture since they began seeking to expand telehealth services nationwide.
California has not been immune to this issue. While urban counties, like Los Angeles and Alameda enjoy broadband coverage rates of 99.7 percent and 99.0 percent respectively, rural counties like Mariposa have coverage rates as low as 10.2 percent. Modoc County, located in the remote Northeast corner of the state, only has 4.8 percent broadband coverage.
Ability to access broadband is a particularly salient issue for rural Californians, who are currently faced with rampant hospital shutdowns and a predicted physician shortage of 18 percent.
By bolstering broadband coverage and telehealth technology, the state could significantly abate the pressure on the deteriorating rural health sector, leading to improved healthcare access for rural areas. If implemented successfully, a patient in Modoc County could speak with a doctor 680 miles away in Los Angeles without having to leave their home, saving time and money.
Rural physicians can similarly benefit from the use of telehealth technologies like remote patient monitoring, which collects vital data on heart rate, blood pressure, weight, and other health indicators that would normally require a patient to visit an in-person clinic. This means that clinical staff wouldn’t have to see as many patients per day, significantly reducing pressure on staff and wait times for patients. For residents of medically underserved communities, this sort of technology could mean the difference between accessing care from their home or traveling a burdensome distance for a regular check-up. For this to work would require broadband infrastructure that doesn’t exist in much of rural California.
While there have been efforts to expand broadband into rural areas, it hasn’t been expedient nor has it been large enough in scope. Last year, the Federal Communications Commission allocated $14 million to expand broadband throughout underserviced parts of California, however, the plans are to take place over the next 10 years and are estimated to reach only 18,000 households. Keep in mind that some estimates suggest that as many as 12 million Californians don’t have access to broadband.
Even before the COVID-19 pandemic, rural healthcare was being stress tested by a lack of medical infrastructure, compounded by disproportionately high rates of obesity, physical inactivity, and food insecurity. The aging population, which required more complex treatment systems, didn’t help either. As we come out of the COVID-19 pandemic, it will be vital to promote healthcare systems that work for rural California. Any such plan will require funding for both telehealth and broadband infrastructure. As we’ve learned, the state’s digital divide is no longer something that we can afford to ignore.
Finn Dobkin works in municipal government, where he specializes in social safety net, behavioral healthcare, and urban planning policy.