Does healthcare really need broadband?

This week I attended and presented at the Communication Alliance’s Broadband and Beyond conference in Sydney. It was a actually a hard decision, as at the same time over in Orlando Florida the 50th annual HIMSS conference was being held, and I was originally going to attend that. But I believe that it is really important to keep the message around technology enabled healthcare strong in Australia, so there I was.

For those of you not based in Australia, the government has committed some $40 Billion to provide a fibre to the premises network to the majority of Australia, with a very fast wireless and satellite alternative for the rest. In this case the majority is 93%, and if you have any experience of Australian geography, you will realise this is a big deal. The rollout is being done by NBN Co Limited, an entity formed by the government to do so. You can read more about them on their web site.

The Broadband and Beyond conference had a number of speakers from various sectors, but what was interesting, especially on the first day was the number of times healthcare popped up. My old friend Professor Michael Georgeff spoke about the CDM Net project he has been running, which has used broadband connected healthcare workers to improve the compliance of people with chronic disease to evidence based care plans. Ian Opperman from CSIRO showed how broadband was used to connect hospitals separated by distance and adverse geography to share resources such as specialists, and I spoke of the work we have been doing in home telehealth with elderly people with chronic disease and the various other inflictions of age.

So the question arose, do we really need a 100Mb connection in everyone’s homes to deliver healthcare. There are some very cool examples of health applications being delivered on peoples I Phones, which uses relatively low bandwidth wireless signals, so why are the NBN folk and many of us in the industry so insistent that the NBN is necessary to deliver the healthcare services of the future?

The problem is that in healthcare we have always innovated to make do with what we have. When all we had was phone lines we used phone based health monitoring services to deliver care. It wasn’t optimal, actually some of the research suggests it wasn’t even effective, but it was all we had at our disposal, so we made do with it. With some tweaking and compromise we made it work for some people, and then used that as an example of how we can deliver services more cost effectively. Sure it was cheaper than sending a nurse out to the patient’s homes. It was more convenient than getting the patient to go the healthcare worker, but it was a compromise. When we started getting some better connectivity, usually some very basic type of data connection, we added to the service. We put in some rudimentary data collection tools, some direct from devices, others where we asked patients to key in their blood sugar readings or other data. We had some very rudimentary educational content we could push down, mainly text. Yes it was a bit better than the phone system, especially when we decided to use Interactive Voice Response (IVR) on the phone to try and make it more efficient. Seriously has anyone had any luck with those systems getting basic customer service yet alone healthcare?

Today we have some better connectivity, and some very cool stuff is happening in healthcare. The CSIRO example of remote consultation between emergency departments The ability to not only monitor vital signs but also see a patient in their own homes via video conferencing. Once you take away the need to compromise on bandwidth you enable healthcare workers to find better ways of connecting with their patients in a way that makes life better for patients and also for themselves.

Healthcare is all about communications, and human communication is a high bandwidth low latency activity. The only way we can deliver the same quality of service as we are accustomed to in face to face healthcare is through a network that is high bandwidth and low latency. To me that sounds like what the NBN wants to deliver to all Australians. Can we deliver healthcare without it, possibly, but many people will have to put up with significant cost and inconvenience to do so, because we will have to compromise the quality of our service to do so. However, if we have access to high bandwidth, low latency, always on and reliable connectivity, then I believe we can deliver much of the healthcare we deliver today in expensive carbon consuming buildings directly into people’s homes at a time that suits them.

The idea that getting healthcare no longer needs to be a hassle is very intriguing. Imagine what would happen if people accessed healthcare when they needed it rather than have to make decisions about whether it is too much trouble for them, their family and their caregivers to try and get access to the same service? Just maybe they will get healthcare earlier, rather than wait for things to go wrong. Maybe they will be able to play a more active role in their own healthcare, because we haven’t waited till the pain is too great, or the tumour too big, or the artery too blocked. If by utilising the connectivity inherent in those tiny glass fibres we may be able to shift healthcare from a reactive service to a proactive service.

So my answer to the question of whether healthcare needs broadband is that we can struggle on with our current way of doing things without it, as long as we are willing to accept that as a result many people will miss out on the skills and value of our healthcare workforce, because they are in the wrong place. Or we can change the system, connect it via broadband, change the way we work and deliver more services to more people in the comfort of their own home or community. It really depends on whether we believe investing in good infrastructure to enable us to provide a better service is a good idea. I say yes, but if you are happy with the way things are now don’t complain when you or a loved one are told you have to wait.


4 Responses to “Does healthcare really need broadband?”

  1. Greg Mundy Says:

    Great blog. I think that the reliability of fibre-based broadband, which you mention, is extremely important. People won’t use a service that drops out, lags, or can’t be relied on and I’m talking about physicians and patients. I’m talking about myself and videoconferencing for that matter!
    We do a lot of things well but separately in our care system (health and aged care), linking them up will work a lot better with reliable, high-speed broadband

  2. Chris ryan Says:

    Very nicely put George I am asked this a lot right now and this adds a useful perspective

  3. David du Plessis Says:

    Great blog George. Why do we always place limiting questions on health care and technology? The question should not be “do we need a 100mbs connection to deliver health care in the home?” The question should be “how do we deliver more effective health care in the home with a 100mbs connection?” Technology and application will only ever be developed to meet the available resources. If we never build the resrouces then we stunt and potentially prevent the development of new technology before it ever starts. Imagine if Intel said, well we can build a faster processor, but do we really need anything faster than a 486? Perhaps the questions should in reality be “If we don’t implement a 100mbs connection to the home, what opportunities for health care will we never develop?”

  4. Fr. Nicholas Stavropoulos Says:

    With a 100MB connection, the answers and uses with reveal themselves. Lets provide the canvas first and not be too concerned about what to paint on it. Healthcare will only improve because of it.

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