Tlast winter, one of us, Alister, was speaking to the daughter of an elderly patient at a community health center in Boston. Her mother had recently been admitted to a local hospital for pneumonia, and doctors believed she was a perfect candidate for an innovative “home hospital” program, leveraging remote care using internet-enabled devices, video conferencing, and personal home visits so the patient can receive care in the comfort of her own home.
But the plan fell apart. Although she was medically fit and had a caring daughter who was ready to help her, something critical was missing: she didn’t have a stable internet connection at home. Instead of returning home, she stayed in hospital.
As this moment shows, healthcare and internet access are now inseparable. Those who do not have reliable access to the internet face significant barriers to accessing telehealth services, patient portals, video conferencing, and other health care technologies that are now available. vital in modern medicine. This digital divide perpetuates health inequalities and reinforces existing inequalities.
To address this issue, bridging the gap between internet access and have-nots is critical. But a program that is making great progress could run out of funds within the next year.
In the United States, the Bipartisan Infrastructure Act established the Affordable Connectivity Program (ACP) in 2021 to tackle the digital divide, which disproportionately affects older, rural and ethnic minority communities. With a $14.2 billion was allocated, the ACP aims to subsidize high-speed internet access for low-income Americans. Eligible families can up to $30 per month (or $75 per month for families on tribal lands) as a subsidy for any internet service plan provided by participating companies. In addition, certain families qualify for a one-off $100 subsidy for desktop, laptop, or tablet. To be eligible for the ACP, families must be registered in separate programs in the past year, such as Medicaid, the Supplemental Nutrition Assistance Program, or WIC. The ACP played a critical role in subsidizing high-speed internet access for low-income Americans. Organizations like Health Link (where we work), Charlotte Digitaland EducationSuperhighway actively working to raise awareness of the program and encourage registration. Currently, more than 16 million households are registered in the ACP, and many more are expected to join in the coming months.
But the program is set to expire once the allocated funds are exhausted, which is expected occur by mid-2024. If that happens, it could hinder progress in closing the digital divide and hinder access to essential services, including healthcare. Telehealth services are especially important for marginalized communities, such as people of color and patients with chronic illnesses. A significant proportion of telehealth visits in 2021 — 44% to be exact — they related to chronic conditions, which more prevalent in low income areas. Research has shown that telehealth services can be used reduce mortality rates and hospital stays among low-income patients.
It’s not just patients who are facing internet barriers. This lack of access is of particular concern to “double burden counties,” where home broadband rates are low, and mortality rates for diseases like cancer are high. The Covid-19 pandemic has further accelerated the use of telehealth services, with telehealth visits skyrocketing 80% in regions greatly affected by the virus. In 2020, 46% of consumers reported by using telehealth services, a significant increase from 11% in 2019.
To ensure that marginalized communities have access to telehealth services, it is essential to extend the ACP beyond the expected end date of mid-2024.
Congress must enact and pass legislation that guarantees funding for the ACP and requires broadband providers to offer affordable and reliable internet access to low-income families. That legislative approach would ensure funding for the ACC and establish a long-term legal framework, ensuring the programme’s sustainability and effectiveness. By enshrining the ACP’s mission in law, it could become a permanent feature of the US health care system. In addition, this legislative approach could encourage telecommunications companies to invest in broadband infrastructure in rural and low-income areas, expanding access to reliable and affordable internet for healthcare purposes.
The recent allocation of $42 billion under the Broadband Equity Access and Deployment (BEAD) Program has significant implications for the ACP and its internet investment efforts, as the two programs work together to address the digital divide. While the ACP received $14 billion as a short-term solution to increase internet access in low-income and rural communities, the BEAD program, with its a significant investment of $42 billion, which focuses on long-term improvement of national internet infrastructure. Overseen by the FCC and NTIA, these joint programs represent a comprehensive approach to closing the digital divide and ensuring equal access to internet services for all Americans.
But BEAD alone is not enough.
Expanding ACC and improving broadband access for all is critical to achieving — and keeping — equal access to essential health care services.
He is an M.D. and Ph.D. in chemistry is Sammer Marzouk. student at Northwestern Feinberg School of Medicine’s Medical Scientist Training Program. Alister Martin is an ER physician and assistant professor at Harvard Medical School and a former senior adviser in the Biden administration. Alessandro Hammond is a student at Harvard University and a researcher in oncology and hematology at Children’s Hospital in Boston.