1997 Partnerships for Networked Consumer Health Information Conference

1997 Partnerships for Networked Consumer Health Information

Letter from HHS Secreatary Donna Shalala to FCC Chairman Reed Hundt

The Honorable Reed E. Hundt
Chairman
Federal Communications Commission
1919 M Street, N.W., Room 814
Washington, D.C. 20554

Dear Chairman Hundt:
The U.S. Department of Health and Human Services (HHS) is pleased that the 1996 Telecommunications Act recognizes the potential of advanced telecommunications to improve the health of Americans. We are all proud of the many advances in our health system in recent decades: innovations in preventing, diagnosing, and treating disease are keeping Americans healthier, longer. Telehealth applications can help us strengthen many of the activities that make this progress possible.

Health care providers can be linked to each other, to health facilities, and to valuable sources of medical information to do their work better. They can get continuing education from distant institutions. They can also be linked to patients in their homes in order to monitor their progress.

Our public health departments can track emerging diseases and share vital information with health professionals and officials around the world and target public education campaigns to prevent behaviors that are risks to health.

Individuals can be linked via the Internet to their doctors, to interactive health education programs, and to the vast global database of health information that was previously reserved for professionals. They can be connected to others who share their health concerns. This can help them take an active responsibility for their own health and medical care.

I am enclosing a document, entitled "Value of Telecommunications Services for Health Priorities," that gives examples of these benefits.

Unfortunately, these benefits are not shared equally. People living in underserved areas, primarily rural, often carry the double disadvantage of heavier health burdens and less access to advanced telecommunications. Using the Universal Service Fund to address the telecommunications cost disparities between urban and rural areas could help improve both health care delivery and the health status of these Americans.

HHS believes it is especially important to support Internet access at local calling rates for rural health care providers. We also urge the FCC to allow providers to choose telecommunications services up to the 1.544 Mbps ceiling for any health-related application the provider determines to be necessary. HHS also believes that the elimination of distance charges is vital to help make advanced services affordable.

It is important not to focus too narrowly on "telemedicine" applications, which refer to medical care and especially consultative services by subspecialists. We would like to see explicit recognition of other public health services that support health care. These services are described in an enclosed documents entitled "The Role of Public Health in Prevention and Medical Care" and "Making a Powerful Connection: The Health of the Public and the National Information Infrastructure." To help avoid ambiguity, we suggest that the FCC adopt the broader term "telehealth," which encompasses telemedicine and other health-related applications.

Our specific recommendations on these and other issues are given in greater detail in the enclosed document entitled "HHS Response to FCC Public Notice on Universal Service." The telecommunications cost data that we have been able to gather are also enclosed. Any further data will be sent as an amendment to this response during the Reply Comment period.

Under a very tight timetable, the FCC has accomplished a great deal. We look forward to working with you to improve the health status of all Americans through the implementation of the 1996 Telecommunications Act and future legislation. I am sending a similar letter to all FCC Commissioners.

Sincerely,


(signed)
Donna E. Shalala