Booking Passage to Better Health Care

By Joshua Seidemann, Vice President of Policy, NTCA–The Rural Broadband Association 

March 15, 2018 

Shipping containers are in the news these days as alternatives to traditional home construction. Containers are also emerging as emergency health stations and alternatives to traditional health clinics. I doubt I will ever see one in my childhood neighborhood, which protects quite fiercely its early 20th century appearance. But, their use speaks to the creative approaches to solving critical health care needs.

The Wall Street Journal recently published a supplement on health care that featured "The Future of Hospitals," an article that describes trends toward decreasing hospital admissions and finding ways to treat more people on an out-patient basis. These alternative approaches to medical care are taking hold not only in in rural areas, but in urban areas, as well. For example, Mount Sinai Hospital in New York City offers a "hospital at home" program. Patients can be evaluated in the emergency department, sent home in an ambulance with an IV, and then followed regularly via home visits for up to 30 days. The program serves several goals: it avoids costly, yet unnecessary, hospital admissions; it avoids hospital infections (one in 25 hospital patients fight infections they contracted at . . . the hospital); and it enables low-risk patients to heal in the familiar space of their home.

The role of broadband in this new philosophy, especially in rural areas, is highlighted in an article featured in the Daily Yonder. The self-contained clinics, produced by AMD Global Telemedicine and Jenysis Health Care Solutions, are housed in steel shipping containers and feature water, solar panels, satellite connectivity, and ports for wired broadband connections. They can be deployed for emergencies or supplemented with components to address chronic conditions, pediatric care, or other needs. The units can serve as a home-base for long-distance telemedicine consultations, as well.

Both articles point to an evolving view of medical care that addresses both increasing health care costs and recognition that there is a middle ground between a hospital admission and "take two aspirin and call me in the morning." The Journal notes that the need for hospitals, whether in rural or urban areas, will never disappear. Trauma, acute illnesses, and surgeries all require the full capabilities of a comprehensive medical facility. The question is whether such a facility needs 300-400 beds.

The home of my childhood pediatrician. Telemedicine meant we called him on the phone, and he then walked eight houses up the block to our house with his black bag.

Transitioning to these new models will take time. The medical community is understandably reluctant to make wholesale changes to general protocols that have existed for centuries. Individual hospital systems and communities will need to assess their needs and determine what models best meet their needs. And, patients will need to be accustomed to new practices, as well.

But, if the trends and forecasts are accurate, then as-good if not better care may well be obtained more comfortably and at a lower cost. And shipping containers, even if not for my old backyard, might become a better investment.