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class="fusion-breadcrumb-link"><span >Home</span></a></span><span class="fusion-breadcrumb-sep">/</span><span class="fusion-breadcrumb-item"><span class="breadcrumb-leaf">Broadband Access</span></span></div> </div> </div> </div> </div> </div> <main id="main" class="clearfix "> <div class="fusion-row" style=""> <section id="content" style="width: 100%;"> <div id="post-7438" class="post-7438 page type-page status-publish hentry"> <span class="entry-title rich-snippet-hidden">Broadband Access</span><span class="vcard rich-snippet-hidden"><span class="fn"><a href="https://connectwithcare.org/author/connectwithcare/" title="Posts by Alliance for Connected Care" rel="author">Alliance for Connected Care</a></span></span><span class="updated rich-snippet-hidden">2023-11-28T15:59:55-04:00</span> <div class="post-content"> <div class="fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling" style="background-color: #ffffff;background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:#eae9e9;border-style:solid;" ><div class="fusion-builder-row fusion-row fusion-flex-align-items-flex-start" style="max-width:1248px;margin-left: calc(-4% / 2 );margin-right: calc(-4% / 2 );"><div class="fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column"><div class="fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column" style="background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;"><div class="fusion-text fusion-text-1"><p><strong>Broadband Access</strong></p> <p>The Alliance for Connected Care advocates for greater access to telehealth and remote patient monitoring, and a core component of that is access to the connectivity capabilities needed to access care. Access to broadband is key to ensuring telehealth serves those with the most need. Many telehealth tools <a href="https://hitinfrastructure.com/news/lack-of-broadband-access-can-hinder-rural-telehealth-programs">include</a> require video streaming and the real time exchange of data and patient information. Most importantly, broadband services used for telehealth must be reliable, so that important patient care needs are not disrupted. With the greatest gap in health care access being in rural areas, telehealth serves as a primary tool in access necessary health care.</p> <p>The Federal Communication Commission maintains a <a href="https://www.fcc.gov/consumers/guides/broadband-speed-guide">Broadband Speed Guide</a>, in which it outlines requirements for high-definition video conferencing as a minimum of 6 Mbps download speeds. Furthermore, video telemedicine requires a minimum download speed of 25 MB/s and a minimum upload speed of 3 MB/s. Depending on the number of devices simultaneously streaming content, latency, and other factors, higher download and upload speeds may be needed.</p> <p>The Office of the National Coordinator of Health IT (ONC) outlined minimum broadband needs for health care (as of 2019):</p> <ul> <li>A minimum of four megabits per second (Mbps) is recommended for a single physician to provide remote monitoring services.</li> <li>A minimum of 10 Mbps is recommended for a small practice, nursing home, or rural health clinic to provide real time video consultations.</li> <li>A minimum of 25 Mbps is recommended for a larger physician practice.</li> <li>A minimum of 100 Mbps is recommended for a hospital.</li> </ul> <p>Major telehealth platforms have optimized their systems to function with relatively low bandwidth needs. A selection of recommendations includes:</p> <ul> <li><a href="https://go.amwell.com/network-requirements/amwell-home/#:~:text=For%20the%20best%20experience%20when%20using%20Amwell%20Home%20on%20the,s%20upload%2Fdownload%20is%20recommended.">Amwell</a> recommends a minimum bandwidth of 3 MBPS for both upload and download.</li> <li><a href="https://blog.curogram.com/telehealth-tech-requirements#:~:text=Before%20a%20telehealth%20consultation%2C%20it,video%20lags%20during%20the%20consultation.">Curogram</a> recommends a minimum of 10 Mbps for download speed and 5 Mbps for upload speed.</li> <li><a href="https://whereby.helpscoutdocs.com/article/425-network-requirements">Whereby</a> recommends at least 2.0 Mbps outbound (upload) and 2.5 Mbps inbound (download).</li> <li><a href="https://evisit.com/what-are-the-basic-technical-requirements-for-telehealth">eVisit</a> recommends internet speeds should be at least 15Mbps download and 5Mbps upload.</li> <li><a href="https://help.doxy.me/en/articles/95860-minimum-system-requirements">Doxy</a> recommends bandwidth speeds above 15-20 Mbps</li> </ul> <p>This being said, faster and more stable connections are always preferred to ensure high-quality video and consistent remote monitoring. Its also important to note that telehealth is rarely the only use for a broadband connection, which often must support a wide range of services at once.</p> <p>Several more recent studies and recommendations build on this foundation:</p> <ul> <li>A <a href="https://www.sciencedirect.com/science/article/pii/B9780443159800000016#s0015">2023 study</a> published in Academic press found that synchronous audiovisual virtual visits require at least 8 Mbps download speed but <strong>recommend at least 25 Mbps</strong>.</li> <li>As of <a href="https://www.ncdhhs.gov/improving-internet-and-device-functioning-telehealth-visits/open">December 2022</a>, the North Carolina Division of Services for the Deaf and Hard of Hearing requires <strong>1.5 MBPS</strong> for both upload and download to run a video call.</li> <li>The <a href="https://hs.utah.gov/telehealth">Utah Department of Human Services</a> requires a minimum of 10 MBPS, but <strong>recommends 25 MBPS</strong>.</li> </ul> <p>Additionally, studies suggest that broadband availability is associated with better access to telehealth/remote care. For example:</p> <ul> <li>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076155/#:~:text=Among%20the%203107%20counties%2C%20those,broadband%20availability%20(quintile%201).">2023 study</a> published by the Journal of Telemedicine and Telecare found that among 3107 counties, those with the greatest broadband availability had 47% higher telehealth utilization compared to counties with the least broadband availability. The study concluded that decreased telehealth utilization in rural areas highlight the importance of broadband access for healthcare access and the need to continue investing in broadband infrastructure to promote equitable healthcare access across populations.</li> <li>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10356688/">2023 study</a> published in the Journal of General Internal Medicine found that patients with optimal versus inadequate broadband availability had more video-based and fewer in-person MH visits after pandemic onset, suggesting broadband availability is an important determinant of access-to-care during public health emergencies requiring remote care.</li> <li>A <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577674/">2022 study</a> published in JAMA Network Open found that patients with optimal versus inadequate broadband availability had more video-based and fewer in-person MH visits after pandemic onset, suggesting broadband availability is an important determinant of access-to-care during public health emergencies requiring remote care.</li> <li>In a <a href="https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06746-0">2021 BMC study</a>, researchers observed that patients in a rural western Tennessee health system residing in a zip code where there is 80 to 100% broadband access compared to 0 to 20% were more likely in the year following March 13th, 2020 to have completed only telemedicine visits and less likely to have only completed in-person visits.</li> <li>In a <a href="https://storymaps.arcgis.com/stories/2c9ba320417d41d09f6a17b63343ea17">2022 study</a> on West Texas, only 57 percent of rural hospitals had at least one provider of fixed broadband delivering service at 100 Mbps or greater downstream speed, leaving 43 percent without broadband at this downstream speed.</li> </ul> </div><div class="fusion-separator fusion-full-width-sep" style="align-self: center;margin-left: auto;margin-right: 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