Reach Rural and Underserved Residents
coverage for many Americans under the
2010 Affordable Care Act, coupled with
explosive advances in telecommunica-
tions technology, is greatly expanding the
potential delivery of medical services by
U.S. medical centers and Federally Quali-
fied Health Centers (FQHCs) to regions
otherwise underserved or unable to access
medical care in the United States.
Despite the establishment of Medicare
and Medicaid in July 1965, the free clinic
movement in 1967, and the creation of
FQHCs in 1975, the nation continues
to experience existing and anticipated
provider shortages in large pockets of rural
and isolated areas in Alaska, throughout
Appalachia, across the West, the South,
and in Guam, the Northern Mariana
Islands and other unincorporated territories
of the U.S.
Recognizing that technology can greatly
assist the expansion of access to health
care, the U.S. government has stepped
up efforts to fund innovative programs by
providing financing in the form of grants
and cooperative agreements to assist
purchase equipment to link centers of
medical excellence to those regions where
such expertise is needed the most.
Agriculture (USDA)
government regulation requires a
telecommunications link to an end-
user through the use of equipment that
electronically links medical professionals
at separate sites in order to exchange
health care information in audio, video,
graphic, or other format for the purpose of
providing improved health care services
(7 C.F.R. § 1703.102).
Telemedicine is a high priority for the
USDA based on the unique history of the
agency: in the 1930's, the Rural Electrifica-
tion Administration (REA) funded electric
cooperatives to bring electricity to rural
communities. In 1949, the REA received
authority to finance telephone service in
recognition of its importance to the health
and well-being of rural communities.
Starting in 1995, all telecommunications
to be broadband-capable.
Today, the USDA's Rural Utilities
Service annually provides Distance
Learning and Telemedicine (DLT)
competitive grants from $50,000 to
$500,000 to hospitals and other medical
providers to enable them to purchase
audio/video equipment and related
technologies to provide medical advice
to rural communities. The grants, which
cover a three-year project period, are
intended to benefit multiple "end-user"
sites in different rural areas. The end-
users, which often consist of local clinics
and community health centers in very
rural areas, use the funds to purchase
telemedicine equipment to link their less
populous towns and villages to urban
medical centers. The urban medical
centers serve as "hubs," from which
specialists and other providers of medical
expertise advise rural end-users on
medical care. The use of telemedicine
is drastically reducing consultation and
travel costs for patients who, otherwise,
would be required to travel hundreds and
whose practice focuses primarily on health care policy, federal
funding and government relations important to hospitals,
community health centers and related non-profit organizations.
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