This article first appeared at Healthcare Dive on January 29, 2015.
As the Federal Communications Commission prepares to consider tighter rules guaranteeing net neutrality, the issue of healthcare’s place in the debate is coming to the forefront. While the idea of preserving “free speech” on the Internet—mandating that Internet providers treat all traffic equally—sounds like a no-brainer, the outcome of the debate has the potential to impact the ability of hospitals to utilize technologies dependent on online and mobile networks, with implications for both access and HIPAA.
UPDATE: On February 26, the Federal Communications Commission ruled 3-2 in favor of net neutrality.
The status quo
One of the most vocal speakers on the topic of net neutrality is Rob McCray, president and CEO of the Wireless-Life Sciences Alliance. The group recently teamed up with the mHealth Regulatory Coalition and the Health IT Now Coalition to send a letter to the FCC asking them to reject the more stringent neutrality rules under consideration.
McCray urges caution about making any changes at this time because he says “connected health,” which utilizes technology to provide more options in healthcare delivery, is in a good place.
He points toward technologies such as AirStrip, which allows data from monitoring devices in hospitals to be transmitted to doctors’ mobile devices.
“Things are going really well right now,” McCray tells Healthcare Dive. “I think we are building products and tech-enabled services that have the opportunity to really make healthcare better and improve patient and consumer control over their own health and healthcare, and I don’t want to do anything that interferes with that.”
McCray says connected health is rapidly moving forward thanks to momentum in investment and the fast-moving communications sector, and that any changes to regulations could affect the balance. “The current industry standards have worked remarkably,” he says.
Can healthcare compete with entertainment?
On the other hand, McCray says the industry should look down the road and gauge how to avoid the potential problems that come with net neutrality, with the most important being congestion.
“What happens to an ambulance in traffic on a busy street or highway?” McCray asks. Of course, society takes it for granted that the ambulance should be able to supersede regular vehicles for reasons of life and safety—and that otherwise, public roads are generally equal-access as opposed to pay-based.
“I think the world we want to get to is one where we continue to make this entire connected health platform better, faster, cheaper, more accessible to more people—but recognize that if it comes to a head-to-head competition against the latest movie or massive interactive game, healthcare can’t compete financially,” McCray says.
Another expert who doesn’t want to see entertainment handled in the same manner as healthcare data is Ritch Blasi, president of MediaRitch LLC and a consultant in the mobile and wireless industry and the verticals impacted by it.
“The issue becomes whether mobile service is of high enough quality to truly enable mHealth services, products and applications,” Blasi tells Healthcare Dive. “Healthcare is a matter of life and death and the people using the mobile networks have to be treated to a higher standard or level of quality.”
Blasi believes that a one-size-fits-all approach of eliminating any form of priority doesn’t work when mobile services are at the mercy of available spectrum or licensed airwaves, and can’t be apportioned to meets specific needs (such as those in healthcare).
The risk to providers and patients
Taking the opposite perspective is Prof. Jonathan Askin, Founder/Director, Brooklyn Law Incubator & Policy Clinic, and Innovation Catalyst, Center for Urban Business Entrepreneurship Brooklyn Law School.
Askin worries that there are inherent risks in allowing Internet access providers any opportunity to discriminate among users, to probe into what content is being moved, or to deny access or charge more because the service is life or death or of extreme value to the user. He also raises concerns that patients’ confidential and sensitive information would be subject to intrusion.
“From a hospital’s perspective, as well as from a patient’s or doctor’s perspective, it is essential that no gatekeeper be allowed to determine what the user might be able to do with the Internet experience,” Askin tells Healthcare Dive.
“The best scenario is one in which the Internet access provider does what only it can do—provide access to the Internet and then get out of the way so that the hospital and the doctor may do what they do best—provide quality medical services, unconstrained by an intervening gatekeeper seeking to maximize revenue without other regard for its users,” Askin said.
The FCC is expected to review the proposed new rules to guarantee net neutrality in February.