How Telehealth and TAPs Drive Broadband Adoption

There are some policymakers, politicians and media pundits who can’t understand why low-income people who don’t have a certain technology will turn down the technology, even when it’s free. But one thing low-income folks learn, often from a young age, is that “free” comes with a cost.

There are at least a dozen reasons why broadband subscriptions go begging for takers among the unserved and underserved populations. But let’s look at this from another angle: What can make people enthusiastic about broadband?

What if a community, using the creation orientation, views broadband as the means to build or invent things that didn’t exist before? For example, a home delivery system for family mental health. Or maybe the community creates a variety of broadband-driven mental health resources within the seven populations targeted by funding from the National Telecommunications and Information Administration: rural communities, the urban poor, those for whom English is a second language, veterans, seniors, disabled residents and the incarcerated.

As director of the National Institute of Mental Health (NIMH), Joshua A. Gordon, M.D., Ph.D., wrote in 2020, “Disparities in mental health are significant and easily documented. Deaths by suicide, for example, are much more common in American Indians and Alaska Natives compared to the general population. The rate of deaths by suicide is also higher in rural areas. Another example: Black and Hispanic children may be diagnosed with autism at a later age compared to white children.”

TAKE ME TO THE PILOT

Essential Families is a 501c3 nonprofit that provides virtual parental education and mental health-care services. They conducted a telehealth pilot in one of the poorest communities in Kansas City, Mo., with stellar results. The organization plotted an eight-step plan:

Step 1: Start by developing a database of residents who could potentially use telehealth and broadband.

Steps 2 and 3: Essential Families’ chief of digital marketing, Kenneth Yancy, explained the next step in the process, a combination of marketing and developing strategic partnerships: “We had to go directly to the people to educate them about FCC’s Affordable Connectivity Program (ACP) as part of our neighbor outreach. Our partnership program included organizations such as the school district and child-care providers, who were part of the needs analysis process.”

Step 4: When residents registered for the pilot and completed their forms, Essential Families gave them free laptops. The incentive motivated residents to provide data that can be difficult for government agencies to collect.

Step 5: Each participant was assigned a digital navigator who walked the family through the processes leading to telehealth services, including enrolling with ACP and training for the video streaming platform, computer and Internet.

Step 6: Participants went through a minimum of 15 virtual parental education sessions and six mental health-care sessions with a licensed therapist or counselor.

Step 7: Each participant had an extensive follow-up session with the digital navigator.

Step 8: Essential Families wrote an evaluation of the pilot that was helped significantly by both electronic and manual tools that execute various real-time assessments, impacts and cost/benefits analysis. Without those tools, pilot programs can lose many of the seemingly unimportant details that are actually vital to the analysis.
Sixty-nine families from the community participated in the pilot. Digital navigators met with and supported each family. The navigators enrolled families in ACP, did computer training, then set them up and trained them on a HIPAA-compliant multilingual video streaming platform. It took up to three months before participants actually began receiving the mental health services.

“When the families come to receive their laptop, that's in person,” said Terri English-Yancy, founder and CEO of Essential Families. “From then on, they will interact virtually as much as possible. We want the family to get comfortable using our platform for computer training, ordering resources, virtual parental education and of course the mental health services.”

THERE'S A TAP FOR THAT

Everyone can agree that using telehealth at home to address mental health care is beneficial. But imagine the creative possibilities if someone breaks down telehealth to its essential elements: a computing device, four walls, Internet and telehealth access, and often (but not always) a health-care professional.

The Northwest Regional Telehealth Resource Center (NRTRC) and the Utah Education and Telehealth Network (UETN) noted the rapid growth of telehealth due to COVID-19, but knew not everyone who needed it had Internet access or computing devices. The agencies created and publicized the Find Telehealth app so that residents in the Northwest region were aware of public community facilities offering dedicated telehealth access points (TAPs).

Started during the COVID-19 pandemic, TAPs are self-contained spaces open to the general public that are furnished with an Internet connection, a computing device equipped with a camera, speaker and microphone, and a dedicated private room or kiosk. TAPs do not provide medical services, just access to the Internet and a device to connect to a telehealth appointment. There is no charge for that access at this time.

TAPs currently are mapped in the NRTRC states (Alaska, Washington, Oregon, Montana, Idaho, Wyoming and Utah). There are 11 additional regional and two national independently operated telehealth resource centers, five of which have their own mapping application in beta test. These centers provide consultation, resources, news and services such as the TAPs at no cost to the general public.

NRTRC and UETN offer “Navigating the Telehealth Neighborhood, A Guide to Telehealth for Digital Navigators,” an online training for digital navigators and others assisting individuals participating in a telehealth visit, or those employed at TAPs. It's easy for TAPs and facilities operating as TAPs in all 50 states to register their information online.

“The general principle of TAPs fits well with a specific initiative that addresses middle mile and anchor institution priorities, what we're calling Connectivity Hubs,” said Andrew Butcher, president of the Maine Connectivity Authority. “A perfect example is a library system that will be upgrading a facility for telehealth utilization, device lending and infrastructure upgrades.” More details need to be known about TAPs, but it seems logical to integrate the public library system with TAP maps.

“It's interesting to me because I can see TAPs becoming a part of an ecosystem, and we all recognize that telehealth is a priority,” said Brandon Carson, executive director of the Pennsylvania Broadband Development Authority. “We’re investing into a deployment to improve access in an area and we’re looking to future-proof these networks as well. We are developing our programming to account for new innovations like these TAPs.”