82_FR_21869 82 FR 21780 - FCC Seeks Comment and Data on Actions To Accelerate Adoption and Accessibility of Broadband-Enabled Health Care Solutions and Advanced Technologies

82 FR 21780 - FCC Seeks Comment and Data on Actions To Accelerate Adoption and Accessibility of Broadband-Enabled Health Care Solutions and Advanced Technologies

FEDERAL COMMUNICATIONS COMMISSION

Federal Register Volume 82, Issue 89 (May 10, 2017)

Page Range21780-21788
FR Document2017-09309

The Federal Communications Commission (FCC) seeks comment, data, and information on a variety of regulatory, policy, and infrastructure issues related to the emerging broadband-enabled health and care ecosystem. The FCC seeks to ensure that consumers--from major cities to rural and remote areas, Tribal lands, and underserved regions--can access potentially lifesaving health technologies and services, like telehealth and telemedicine, which are enabled by broadband connectivity. The anticipated record will allow the Commission and its Connect2HealthFCC Task Force (Task Force) to gain a broader understanding about the current state of broadband health connectivity. The record will also be used by the Task Force to make future recommendations to the Commission.

Federal Register, Volume 82 Issue 89 (Wednesday, May 10, 2017)
[Federal Register Volume 82, Number 89 (Wednesday, May 10, 2017)]
[Proposed Rules]
[Pages 21780-21788]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2017-09309]


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FEDERAL COMMUNICATIONS COMMISSION

47 CFR 1, 15, 20, and 54

[GN Docket No. 16-46; FCC 17-46]


FCC Seeks Comment and Data on Actions To Accelerate Adoption and 
Accessibility of Broadband-Enabled Health Care Solutions and Advanced 
Technologies

AGENCY: Federal Communications Commission.

ACTION: Request for comments.

-----------------------------------------------------------------------

SUMMARY: The Federal Communications Commission (FCC) seeks comment, 
data, and information on a variety of regulatory, policy, and 
infrastructure issues related to the emerging broadband-enabled health 
and care ecosystem. The FCC seeks to ensure that consumers--from major 
cities to rural and remote areas, Tribal lands, and underserved 
regions--can access potentially lifesaving health technologies and 
services, like telehealth and telemedicine, which are enabled by 
broadband connectivity. The anticipated record will allow the 
Commission and its Connect2HealthFCC Task Force (Task Force) to gain a 
broader understanding about the current state of broadband health 
connectivity. The record will also be used by the Task Force to make 
future recommendations to the Commission.

DATES: Submit comments on or before May 24, 2017, and reply comments on 
or before June 8, 2017.

ADDRESSES: You may submit comments, identified by GN Docket No. 16-46, 
by any of the following methods:
     Electronic Filers: Comments may be filed electronically 
using the Internet by accessing the ECFS: http://apps.fcc.gov/ecfs/ 
(click the ``submit a filing'' tab). Filers should follow the 
instructions provided on the Web site for submitting comments. For ECFS 
filers, in completing the transmittal screen, filers should include 
their full name, U.S. Postal service mailing address, and the 
applicable docket number: GN Docket No. 16-46.
     Paper Filers: Parties who choose to file by paper must 
file an original and one copy of each filing. Filings can be sent by 
hand or messenger delivery, by commercial overnight courier, or by 
first-class or overnight U.S. Postal Service mail. All filings must be 
addressed to the Commission's Secretary, Marlene H. Dortch, Office of 
the Secretary, Federal Communications Commission. All hand-delivered or 
messenger-delivered paper filings for the Commission's Secretary must 
be delivered to FCC Headquarters at 445 12th St. SW., Room TW-A325, 
Washington, DC 20554. All hand deliveries must be held together with 
rubber bands or fasteners. Any envelopes must be disposed of before 
entering the building. The filing hours are 8:00 a.m. to 7:00 p.m. 
Commercial overnight mail (other than U.S. Postal Service Express Mail 
and Priority Mail) must be sent to 9300 East Hampton Drive, Capitol 
Heights, MD 20743. U.S. Postal Service first-class mail, Express Mail, 
and Priority Mail must be addressed to 445 12th Street SW., Washington, 
DC 20554.
    Additional Filing Instruction: To the extent feasible, parties 
should email a copy of their comments to the Task Force's email box, at 
[email protected]. In the email, please insert ``Comments in GN 
Docket No. 16-46'' in the subject line. Copies of all filings will be 
available in GN Docket No. 16-46 through ECFS and are also available 
for public inspection and copying during regular business hours at the 
FCC Reference Information Center, Portals II, 445 12th St. SW., Room 
CY-A257, Washington, DC 20554, telephone (202) 418-0270. Documents will 
be available electronically in ASCII, Microsoft Word, and/or Adobe 
Acrobat.
    People with Disabilities: To request materials in accessible 
formats for people with disabilities (braille, large print, electronic 
files, audio format), send an email to [email protected] or call the 
Consumer and Governmental Affairs Bureau at 202-418-0530 (voice) or 
202-418-0432 (TTY). Contact the FCC to request reasonable 
accommodations for filing comments (accessible format documents, sign 
language interpreters, CART, etc.) by email at: [email protected]; phone: 
202-418-0530 or TTY: 202-418-0432.

FOR FURTHER INFORMATION CONTACT: For further information about this 
Document, please contact Ben Bartolome, Special Counsel, 
Connect2HealthFCC Task Force, at (770) 935-3383, or via email at 
[email protected] (inserting ``Question re GN Docket No. 16-46'' 
in the subject line). Press inquiries should be directed to Katie 
Gorscak, Communications Director, Connect2HealthFCC Task Force, at 
(202)

[[Page 21781]]

418-2156, or via email at [email protected]. For additional 
information about the Connect2HealthFCC Task Force, please visit the 
FCC's broadband health hub at http://www.fcc.gov/health.

SUPPLEMENTARY INFORMATION: This is a summary of the Commission's 
document, FCC 17-46, in GN Docket No. 16-46, released on April 24, 
2017. The full text of this document is available on the Internet at 
the Commission's Web site, at https://www.fcc.gov/document/fcc-seeks-comment-accelerating-broadband-health-tech-availability; and it is also 
accessible from the Connect2HealthFCC Task Force's Web page, at https://www.fcc.gov/health/public-notice. The full text is also available for 
public inspection and copying from 8:00 a.m. to 4:30 p.m. Eastern Time 
(ET) Monday through Thursday or from 8:00 a.m. to 11:30 a.m. on Fridays 
in the FCC Reference Information Center, 445 12th Street SW., Room CY-
A257, Washington, DC 20554 (Telephone: 202-418-0270; TTY: 202-418-
2555).

Overview

    Broadband networks are increasingly important to our national well-
being and everyday lives. As such, we must maximize their availability 
and ensure that all Americans can take advantage of the variety of 
services that broadband enables, including 21st century health care. In 
this Document, the FCC seeks information on how it can help enable the 
adoption and accessibility of broadband-enabled health care solutions, 
especially in rural and other underserved areas of the country. We 
expect to use this information to identify actions that the Commission 
can take to promote this important goal.
    Ensuring that everyone is connected to the people, services, and 
information they need to get well and stay healthy is an important 
challenge facing our nation. Technology innovations in clinical 
practice and care delivery coupled with burgeoning consumer reliance on 
mHealth and health information technology (or healthIT) are 
fundamentally changing the face of health care, and a widespread, 
accessible broadband infrastructure is critical to this ongoing shift. 
Indeed, the future of modern health care appears to be fundamentally 
premised on the widespread availability and accessibility of high-speed 
connectivity. By some estimates, broadband-enabled health information 
technology can help to improve the quality of health care and 
significantly lower health care costs by hundreds of billions of 
dollars in the coming decades. However, the United States remains 
behind some advanced countries in the adoption of such technology.
    As discussed in this Document, the Commission plays an important 
role in improving the quality of health care and enabling health care 
innovation through the universal service program, spectrum licensing, 
and other activities. In order to perform these and other important 
roles in the health technology space, the Commission should continue to 
evaluate the nation's broadband health infrastructure and to understand 
the ongoing technology-based transformation in health care delivery. 
This will better assure that consumers--from major cities to rural and 
remote areas, Tribal lands, and underserved regions--can access 
potentially lifesaving health technologies and services, like 
telehealth and telemedicine. Leading this effort on behalf of the 
agency is its Connect2HealthFCC Task Force. Among other things, the 
Task Force is charged with charting the broadband future of ``health 
and care'' in order to ensure that the agency stays ahead of the health 
technology curve. We use the phrase ``health and care'' deliberately in 
this Document to reflect and include the broad range of participants in 
the emerging broadband health ecosystem, including providers (e.g., 
health systems, community health centers, clinicians, pharmacists, 
nutritionists, allied health professionals); public health and social 
service agencies and organizations; innovators and entrepreneurs; 
academic and research facilities; state and local policymakers; 
patients and their caregivers; as well as consumers who seek support to 
prevent disease and maintain optimum health.
    This Document seeks comment, data, and information on a broad range 
of regulatory, policy, technical, and infrastructure issues related to 
the emerging broadband-enabled health and care ecosystem. Commenters 
should address the agency's authority on all issues raised in this 
Notice. The comment, data, and information requested are intended to 
provide the Commission with a broader understanding and perspective on 
the current state of broadband health technology and other related 
issues; and it will also inform the Task Force's work and 
recommendations.

The Broadband Health Imperative

    Broadband holds promise for enabling health care solutions and 
advanced technologies that can help to meet America's growing health 
care needs. Health care accounts for a significant percentage of the 
U.S. gross domestic product and health care costs are projected to 
increase. Studies confirm that the United States has a serious health 
care supply problem. By some estimates, the country could face a 
shortage of up to 94,700 physicians by 2025, and the forecast is worse 
for rural communities. The healthcare provider shortfall is likely to 
disproportionately affect rural and remote areas which are already 
medically-underserved.
    At the same time, demand for health care services is increasing. 
Today, over 320 million people in the United States could, at any time, 
utilize health care services, with one person added every 12 seconds 
(net), yet we only have approximately 280,000 primary care physicians 
to meet the needs. By the year 2060, the number of people living in the 
United States is projected to increase by 100 million (resulting in a 
total of 425+ million people), further exacerbating the projected 
physician shortage concern. To further complicate matters, over 100 
million Americans are dealing with chronic diseases and conditions 
(e.g., heart disease, stroke, cancer, obesity, diabetes, and 
arthritis); and despite best efforts, health care disparities persist 
across various geographic regions and ethnic groups. While many 
individuals struggle with one chronic illness, older Americans often 
face from two to as many as five chronic diseases at the same time. By 
2030, one out of every five Americans (or 71 million) will be over the 
age of 65, and 20 million will be over the age of 80.
    While broadband is not a complete answer, there are a growing 
number of broadband-enabled solutions that can play an important role 
in improving population health; addressing health needs beyond the 
hospital; expanding access to primary, acute, preventive and specialist 
care, especially for those Americans living in rural and underserved 
areas; providing more cost-effective solutions; improving the quality 
of care; and better engaging consumers in their health. Put simply, 
health care is being transformed by the availability and accessibility 
of broadband-enabled services and technologies and the development of 
life-saving wireless medical devices.
    Indeed, we are already realizing some of the tremendous benefits 
that broadband-enabled health technologies and innovative wireless 
medical devices have to offer: Electronic Health Record (EHR) systems 
can track and transmit vast amounts of patient clinical data. X-rays, 
MRIs, and CAT scans can be transmitted seamlessly to specialists at a 
distant hospital. Telemedicine and

[[Page 21782]]

telehealth programs and services provide opportunities to close access 
to care gaps and facilitate specialized training. Medical providers are 
able to prescribe medications electronically, saving time and money. 
Surgeons are able to perform operations miles away from patients via 
robotics. Self-service health kiosks are becoming increasingly 
available at pharmacies and grocery chains, providing additional access 
points for primary care and disease screenings. Remote patient 
monitoring applications and services are reducing hospital readmissions 
as well as travel and associated expenses for patients. Mobile devices 
like smartphones and personal data assistants are transforming the way 
physicians manage patient care; they are also empowering and engaging 
consumers to take a more active role in managing their own health. 
Implant or body-worn monitoring, therapeutic, and treatment 
technologies include wireless blood glucose monitors and automated 
insulin pumps. ``Ingestibles'' and ``smart pills'' (broadband-enabled 
digital tools that are swallowed by the patient) use wireless 
technology to monitor internal reactions in real-time, dispense 
medication, and provide other granular health data.
    Veterans, in particular, have seen tangible benefits from 
telemedicine. Most notably, critical mental health services are now 
accessible via telemedicine to those veterans living in rural areas or 
abroad. In fiscal year 2014, more than 690,000 military veterans 
accessed the U.S. Department of Veterans Administration's (VA) health 
care network using telemedicine programs, reflecting more than 1.7 
million episodes of care. The Veterans Health Administration notes that 
``[telemedicine] technology is now considered `mission critical' for 
effectively delivering quality healthcare to veterans, particularly for 
those in rural or underserved areas.''
    These are just some of the opportunities that broadband-enabled 
services and health-related communications technologies and devices 
offer, especially for those living in rural and underserved areas, low 
density populations, and Tribal lands; for older Americans; persons 
with disabilities; military veterans; and the economically 
disadvantaged--all of whom have traditionally faced significant health 
and care challenges. We endeavor to foster the development and 
accessibility of these and other emerging communications-based 
technologies throughout the country. The work ahead, however, can only 
be successful if it combines the efforts of all levels of government, 
industry, innovators and entrepreneurs, academia, consumers, and the 
health care community. Accordingly, we seek broad public and private 
stakeholder input and collaboration on the issues discussed below.

Request for Comment and Data

    As part of its charge, the Connect2HealthFCC Task Force is focused 
on the following objectives: (1) Promoting effective policy and 
regulatory solutions that encourage broadband adoption and promote 
health IT; (2) identifying regulatory barriers (and incentives) to the 
deployment of radio frequency (RF)-enabled advanced health care 
technologies and devices; (3) strengthening the nation's telehealth 
infrastructure through the FCC's Rural Health Care Program and other 
initiatives; (4) raising consumer awareness about the value proposition 
of broadband in the health care sector and its potential for addressing 
health care disparities; (5) enabling the development of broadband-
enabled health technologies that are designed to be fully accessible to 
people with disabilities; (6) highlighting effective telehealth 
projects, broadband-enabled health technologies, and mHealth 
applications across the country and abroad--to identify lessons 
learned, best practices, and regulatory challenges; and (7) engaging a 
diverse array of traditional and non-traditional stakeholders to 
identify emerging issues and opportunities in the broadband health 
space.
    To continue evaluating these and other challenges, we request that 
stakeholders and other interested parties provide comment, information, 
and/or data on the issues and subject matter described below. This 
Notice seeks the most current information available that is 
specifically relevant to the intersection of broadband, advanced 
technology, and health care in view of the aforementioned Task Force 
objectives. For convenience, the issues for comment are enumerated; and 
we request that parties, in their submission, identify the enumerated 
issue to which their written response pertains. We also encourage 
parties to identify any other relevant issues not covered below.

Objective I: Promote Effective Policy and Regulatory Solutions That 
Encourage Broadband Adoption and Promote Health IT

    Broadband and advanced technologies appear increasingly critical to 
the effective transformation of our health care system. First, these 
technologies enable the efficient exchange of patient and treatment 
information by allowing providers to access patients' electronic health 
records from on-site or hosted locations. Second, in many cases it can 
remove geography and time as barriers to care by enabling telehealth 
and telemedicine applications like video consultations and remote 
patient monitoring. Third, broadband provides a foundation for the next 
generation of medical devices, as well as other health innovation and 
connected-care solutions. Finally, broadband-enabled health IT offers 
real opportunities for consumers to take charge of their own health.
    To ensure that these and other benefits continue to accrue and 
expand, it is critical that we identify and engage in appropriate 
efforts to address any current and emerging issues of concern. In this 
regard, we note that there are some broad policy measures that, if 
implemented, could accelerate broadband deployment generally, and 
thereby provide greater access to broadband-enabled health 
technologies, solutions and services, especially for those consumers 
living in rural and underserved areas of the country. A prime example 
is the possible establishment of ``Gigabit Opportunity Zones.'' In 
September 2016, FCC Chairman Ajit Pai, as part of his Digital 
Empowerment Agenda for accelerating the deployment of high-speed 
Internet access, called on Congress to provide tax and other financial 
incentives for the private sector to deploy gigabit broadband services 
in low income neighborhoods, which he referred to as ``Gigabit 
Opportunity Zones.'' More recently, the Commission created the 
Broadband Deployment Advisory Committee (BDAC) to provide the 
Commission advice on, among other things, accelerating broadband 
deployment, identifying regulatory barriers to infrastructure 
investment, and making recommendations for reducing and/or removing 
regulatory barriers. We now seek additional and specific data regarding 
the pace of deployment and adoption of broadband for health and in 
health care. As detailed below, we also invite input on policies or 
initiatives that the FCC could implement to further spur deployment and 
adoption of broadband services, especially in critical need areas at 
the intersection of health and broadband (e.g., the counties identified 
in the Connect2HealthFCC Task Force's Priority 100 and Rural 100 
lists).
    1. We request suggestions regarding ways in which the FCC, based on 
its authority, can further accelerate broadband adoption in the health 
care context and promote broadband-enabled health IT solutions, either 
on its own or

[[Page 21783]]

working in collaboration with other agencies, and, at the same time, 
ensure that such services and technologies are fully available and 
accessible to all Americans, including those living in rural and remote 
areas, low density populations, Tribal lands, and in underserved urban 
areas of our country. We also seek comment on what impediments to these 
efforts exist, and how the FCC can address them.
    2. We request information and data on the types, impact, scale, and 
benefits of broadband-enabled services and technologies used for the 
delivery of health care. How is broadband currently being used to 
augment or transform existing health care delivery? What types of 
health care settings are using broadband-enabled services and 
technologies besides large medical hospitals? What variety of medical 
issues are they used for? Where are these health care settings located? 
What are some of the future plans for using broadband-enabled health 
services and technologies--not just by clinicians and hospitals but 
also by other participants in the broader health ecosystem?
    3. We are also interested in learning how health technologies and 
services can take advantage of new technological applications and 
emerging communications networks. For example, what impact will the 
Internet of Things (IoT) have on broadband-enabled health technologies 
and services such as telehealth and telemedicine? To what extent will 
pervasive connectivity and a fully connected environment around 
individuals (e.g., IoT) shift the point of care delivery? How might the 
demands on broadband networks evolve in this new environment? What, if 
any, changes are anticipated in existing broadband-enabled health 
services and technologies--operating over current mobile networks--when 
5G (Fifth Generation Mobile and Wireless Networks) becomes available? 
To what extent might telehealth and telemedicine be impacted by the 
availability of 5G networks? What medical device innovations are 
anticipated to be developed using 5G networks?
    4. What technical issues concerning the variety of broadband-
enabled health care solutions and technologies are appropriate and 
necessary for the FCC to consider with respect to efforts to accelerate 
broadband adoption and promote health IT solutions? Are there issues of 
concern with respect to access, availability, interoperability, 
capacity, reliability, privacy, security, and speed? If so, please 
describe them. Does consideration of any of these issues vary depending 
on the technology platform--e.g., digital subscriber line (DSL), cable, 
fiber, wireless, or satellite?
    5. We seek to better understand health care providers' connectivity 
requirements. What type of connectivity (e.g., wired or wireless; fixed 
or mobile) is necessary to support the deployment of health IT 
applications today and in the near future at the different types of 
health care delivery settings (e.g., tertiary care centers versus 
primary care physician practices, larger physician groups, clinics, 
hospitals, as well as ``hospital in the home'' settings).
    a. What are the minimum bandwidth and speed requirements for the 
different types of health IT applications available today and in the 
near future for clinical and non-clinical settings? We also seek 
comment on bandwidth constraints brought on by increased overall usage 
as well as the impact of data intensive medical applications. Are there 
future technologies or applications on the horizon that could be 
bandwidth intensive? If so, what are they, and to what extent could 
compression and other technologies provide a solution for such future 
technologies or applications?
    b. Some evidence suggests that real-time image manipulation and 
video (e.g., telestroke and tele-emergency applications) will stimulate 
demand for more and better broadband and at lower prices. Are there 
current issues concerning network speeds and delays for these types of 
services? Do mobile health applications present unique considerations 
in terms of coverage, reliability, and security? We seek suggestions on 
whether, and if so, how the Commission could address these issues.
    c. To what extent do rural communities and Tribal lands have access 
to Internet connection speeds that are sufficient to support the 
effective and efficient transmission of data and video to provide 
telehealth, telemedicine, and other broadband health technology 
services?
    d. What, if any, interoperability, capacity, reliability, security, 
and speed issues currently exist for wireless (i.e., radiofrequency 
(RF)-based) medical devices used by patients in both clinical and non-
clinical settings (e.g., at home); and for healthcare providers with 
respect to the provision of broadband-enabled health technologies, like 
telehealth and telemedicine services? Are there other technical issues 
appropriate for the Commission to consider?
    e. What impediments, if any, exist in trying to retrofit existing 
and future health care facilities (e.g., hospitals and clinics) for 
broadband-enabled services and technologies, given current connectivity 
needs and the existence of varied spectrum environments? Do current 
designs take into consideration any potential interference concerns 
with projected wireless networks and devices that will be used in these 
facilities? Are there (or should there be) industry standards or best 
practices for ensuring that new health care facilities consider 
broadband in their design and account for any necessary conduits, 
wiring, building configuration, and materials (e.g., there may be a 
need to consider certain materials for internal or external walls to 
better enable wireless broadband within a facility or to limit RF into 
a building) at the design and construction phase?
    6. We seek to understand the full range of issues that might be 
affecting the development and adoption of broadband-enabled technology 
and services in health care. What non-technical impediments or issues 
currently exist in the provision of broadband-enabled health technology 
services? Are there any circumstances or practical considerations 
(e.g., cost, funding, and training) that may be creating disincentives 
for clinicians and health care settings to offer broadband-enabled 
health services and technologies, such as telehealth and telemedicine? 
If so, please describe what they are, including the extent and nature 
of the Commission's authority to address them.
    7. What efforts are being made at the state and local levels to 
address broadband health technology accessibility issues in rural and 
remote areas, Tribal lands, and underserved urban areas? We seek 
specific information, particularly from states, localities, Tribal 
governments, and rural and urban medical centers, about any broadband-
enabled health IT programs that have been developed and implemented (or 
will soon be implemented) to reach these areas. How successful have 
those programs been? What are some of the lessons learned in developing 
those programs? What programs and other efforts are necessary to drive 
attention to those rural and underserved populations that need health 
technologies most? How can the Commission better facilitate the 
deployment of services and technologies as well as consumer adoption in 
those areas?
    8. We seek suggestions on ways the Task Force can effectively and 
efficiently identify any gaps in the availability of broadband-enabled 
health technologies in the country. We request any information, data, 
or studies that

[[Page 21784]]

can better inform the Task Force as to where broadband-enabled health 
services and technologies are critically needed in the country but are 
insufficient or unavailable. Why do these availability gaps exist? Maps 
and data--including those commissioned by or for states or localities--
would be particularly helpful. In August of 2016, the Task Force 
launched one such broadband health analytics tool--the Mapping 
Broadband Health in America platform--to allow stakeholders to more 
easily analyze and study the intersection between connectivity and 
health for every state and county in the United States. While the 
response to the platform--from other federal agencies, as well as 
private organizations and industry--has been uniformly positive, with 
some already using the mapping platform to improve data-driven 
decision-making around broadband health-related policies and 
initiatives, we seek additional stakeholder input. How can we further 
improve the analytic platform to encourage investment in broadband 
health networks in areas with the greatest health and connectivity 
needs? If we wanted to refine the tool to identify potential 
partnerships among health care providers or between health care 
providers and broadband service providers, what is the best way to 
achieve that goal?
    9. What are the impediments to making health IT and other broadband 
health technology services available and ubiquitous in rural and remote 
areas, low population density areas, Tribal lands, and underserved 
urban sectors? Are there any unique challenges that persist in these 
areas; if so, what are they? In particular, we seek comment on any 
deployment, infrastructure, geographic, expertise (e.g., the 
availability and adequacy of IT expertise), telecommunications carrier 
availability, cost, and any other challenges in these areas. We seek 
suggestions for how to address such challenges, including on any rule 
and/or policy changes that the Commission should consider.

Objective II: Identify Regulatory Barriers (and Incentives) to the 
Deployment of RF-Enabled Advanced Health Care Technologies and Devices

    The Commission has a long history of addressing spectrum needs for 
the development of next- generation health technologies and medical 
devices, and of exercising flexibility, as necessary and appropriate, 
in revising its rules and policies to speed up their deployment. 
However, in recent months, stakeholders in the health sector and 
commercial wireless industry have raised concerns about the likely 
surge in demand for spectrum for wireless medical devices and 
broadband-enabled services--noting trends toward fully connected 
hospitals, widespread remote patient monitoring, and leveraging 
connectivity to improve health facilities' workflow and back-office 
functions--and have sought appropriate regulatory relief. Most 
recently, in August 2016, TerreStar Corporation filed a request for 
waiver of its substantial service requirements to enable use of its 
wireless licenses in the 1.4 GHz band to provide wireless medical 
telemetry service (WMTS) operations, citing increasing demand. Several 
wireless medical device manufacturers supported the waiver request and 
argued that there was a spectrum shortage facing WMTS licensees.
    Below, we seek information and data on (i) the types of broadband-
enabled health technologies and medical devices currently in the market 
and those that may be launched in the near future; (ii) the future 
spectrum and wireless infrastructure needs in the health care sector; 
and (iii) any concerns about the increased use and proliferation of 
wireless medical devices in health care settings and public spaces. 
Also, we welcome comment on what, if any, regulatory barriers exist (as 
well as incentives that could be implemented) concerning the deployment 
of advanced broadband-enabled health care technologies and medical 
devices. For purposes of this Document, we are only seeking information 
on ``medical devices'' that use RF wireless technology or 
communications functions for diagnosis, treatment, or patient 
monitoring.
    10. We seek information on the types of broadband-enabled health 
technologies and medical devices that are currently in the market. In 
addition, what emerging types of broadband-enabled health technologies 
and medical devices are likely to be available to consumers soon? What 
are the future trends in this market area?
    11. What, if any, technical issues or concerns exist for patients 
and other users of medical devices when such devices are used in 
hospital settings? Do these concerns vary depending on the type and 
size of the hospital setting? Are these concerns exacerbated when 
medical devices are operating in large or busy hospital environments 
(which may include a wide variety of wireless technologies, some of 
which may be unrelated to clinical care); if so, what are those 
concerns, how can they be addressed?
    12. Similarly, what, if any issues or concerns exist for patients 
and other users of medical devices when such devices are used primarily 
in potentially uncontrolled, non-hospital settings (e.g., in homes, 
aircraft, cruise ships, or other close quarter, multi-unit dwellings, 
etc.), where non-health related wireless technologies that also emit 
radio frequencies (e.g., baby monitors, wireless home security systems, 
Wi-Fi routers, etc.) may proliferate? And to what extent might similar 
issues or concerns exist for emerging and future technological 
innovations (e.g., electric automobiles, smart cars, smart homes, 
etc.)?
    13. We seek comment, data, and any studies on the possible 
complexities of the future RF environment in homes, hospitals, and 
other public spaces related to the increasing number of medical 
applications and devices.
    14. How are medical devices currently being tested and evaluated to 
ensure that consumers and patients can safely use them in both clinical 
and non-clinical settings, given their operation in varied spectrum 
environments? Are there currently any FCC rules or policies that serve 
as barriers to testing and deployment of advanced health care 
technologies and medical devices? If any, please identify which 
specific rules and/or policies, and explain how they have served to 
impede the testing and deployment of health care technologies and 
medical devices. How might the Commission address such concerns?
    15. We also request recommendations on how the Commission could 
make an assessment of the spectrum and wireless infrastructure needs 
for the future of health care in the United States. We seek input from 
all relevant stakeholders, including members of the health care, 
wireless, and software industries who are developing wireless 
healthcare applications for the present and future; physicians, 
consumer advocates, and academicians; and relevant federal, state, and 
local government agencies. While we envision building upon the spectrum 
management and wireless infrastructure deployment policies that the FCC 
has successfully employed in the past to promote innovation in wireless 
health services, we ask commenters to identify any novel framework, 
including those that might include smart city initiatives or public/
private partnerships, that could be useful in planning for the wireless 
future of our nation's health care system.
    a. One of the compelling drivers of mobile technology in healthcare 
is the increasing availability of health apps for smartphones and 
tablets. There is now

[[Page 21785]]

an app for almost every conceivable healthcare need, ranging from drug 
dose calculators to fully functioning electronic medical records. We 
are also seeing the development of smart homes and automobiles that 
would enable even more sophisticated remote health monitoring. How soon 
will we see widespread adoption of these technologies and what 
implications will they have on the spectrum needs of the health care 
industry?
    b. In developing a national spectrum plan for the health care 
industry, are there particular spectrum bands that the FCC should 
consider?
    c. When it comes to increased need for spectrum-based health 
technologies, what challenges do small, rural, and critical access 
hospitals have that are different from what large hospitals face?
    d. Do health care facilities, because of their different physical 
characteristics, require different types of small cells and wireless 
infrastructure than other commercial enterprises? What are the most 
challenging impediments to the deployment of wireless infrastructure in 
hospitals and health care systems? What policies should the FCC 
consider in order to help streamline infrastructure siting that is 
necessary for the deployment of wireless networks in hospitals and 
health care systems? What state or local government regulatory policies 
have helped to facilitate streamlined deployment of wireless 
infrastructure for health care?
    e. How can new advanced spectrum sharing techniques (e.g., dynamic 
spectrum sharing through database controlled coordination, software 
designed radios, or efficient spectrum use through network 
virtualization techniques) or secondary market mechanism (e.g., 
spectrum leasing arrangements) be leveraged to meet the spectrum 
demands of cutting-edge mobile broadband-enabled health technologies 
and medical devices that may be operating in varied spectrum 
environments? Are there any issues with harmonization of spectrum for 
medical uses across international borders to ensure that consumers can 
effectively and safely use medical and other devices across borders?
    f. What are some of the recent and emerging trends in health care 
delivery (in rural and urban areas) that are implicating spectrum use 
and needs? Are these trends creating a greater need for spectrum 
wireless services, particularly in rural areas? Are these trends 
resulting in increased use of remote patient monitoring solutions?
    16. Do any regulatory barriers exist concerning the deployment of 
advanced broadband-enabled health care technologies and medical 
devices? We also welcome suggestions on any regulatory incentives (that 
are within the FCC's authority) that could serve to foster continued 
investment in and further deployment of next-generation broadband-
enabled health technologies and medical devices?

Objective III: Strengthen the Nation's Telehealth Infrastructure 
Through the FCC's Rural Health Care Program and Other Initiatives

    Broadband deployment is one of the FCC's top priorities, 
particularly in rural America. Based on current evidence, broadband can 
be a game-changer particularly in rural areas--where consumers often 
have to drive long distances to access critical or specialty care; and 
where isolated clinics and health centers can save lives and promote 
community health by using advanced communications technologies to 
connect with medical expertise not otherwise available, as well as 
monitor patients who live many miles away from a health care facility.
    The FCC's Rural Health Care (RHC) Program has helped expand 
broadband services for eligible health care providers (HCPs) in rural 
areas. Currently, the RHC Program is comprised of three programs: The 
Healthcare Connect Fund (HCF), the Telecommunications Program, and the 
Pilot Program. With respect to the Pilot Program, while no new funding 
is available, some projects continue to accept new HCP sites. As 
funding for the Pilot Program projects ends, Pilot Program projects are 
expected to apply for additional support, if needed, under the 
Healthcare Connect Fund. The FCC established the Healthcare Connect 
Fund to expand health care provider access to broadband, especially in 
rural areas, and encourage the creation of state and regional broadband 
health care networks. Under the Healthcare Connect Fund, eligible rural 
HCPs, and those non-rural HCPs that are members of a consortium that 
has a majority of rural HCP sites, can receive a 65 percent discount 
from the fund on all eligible expenses. HCPs are required to contribute 
the remaining 35 percent to participate in the program. HCPs can use 
the Healthcare Connect Fund to purchase eligible services and 
equipment, as well as construct their own broadband infrastructure 
where it is shown to be the most cost effective option. The cap on 
total funding for the RHC Program altogether, which includes the 
Telecommunications Program and the Healthcare Connect Fund, is $400 
million annually.
    The Commission's RHC Program has made the benefits of broadband-
enabled health services, such as telehealth and telemedicine, more 
available to consumers living in rural and remote areas. Such 
broadband-enabled services have provided patients in rural areas with 
access to critically needed medical specialists in a variety of 
practice areas. The availability of telehealth and telemedicine 
programs also has been found to mitigate significant challenges 
associated with disparities in access to care and healthcare workforce 
shortages. The RHC Program also has been found to save health care 
providers money as well. The Commission continues to evaluate the 
Healthcare Connect Fund (HCF) in terms of the programmatic goals of (1) 
increasing access to broadband for HCPs, particularly those serving 
rural areas; (2) fostering the development and deployment of broadband 
health care networks; and (3) maximizing the cost-effectiveness of the 
program.
    17. We seek comment and suggestions on how the FCC can further 
promote and help enable the adoption and accessibility of broadband-
enabled health technologies, like telehealth and telemedicine, in rural 
and other underserved areas. Are there other initiatives or actions 
beyond the RHC Program that the agency, or the Task Force on behalf of 
the agency, could pursue in order to promote and help enable the 
adoption and availability of broadband-enabled health technologies in 
rural and underserved areas of the country?
    18. Is the regulatory framework for the Rural Health Care program 
keeping pace with how broadband-enabled health care is being delivered 
in rural and underserved areas? If not, please explain in detail, 
describing any emerging challenges, gaps or opportunities for using 
broadband to better meet the health and health care needs of rural 
consumers.
    19. We seek current information and data, if any, that can be used 
to measure the impact that the various RHC programs have had on certain 
populations and sectors--i.e., those living in rural and underserved 
areas, low density populations, and Tribal lands; older Americans; 
persons with disabilities; military veterans; and the economically 
disadvantaged in rural and urban communities--all of which have 
traditionally faced significant health and health care challenges.
    20. We also are interested in hearing recent success stories about 
innovative health care services that were created or that became 
available as a result of the RHC Program, and how such services

[[Page 21786]]

have helped consumers in rural and remote areas. We are particularly 
interested in receiving data and information about health outcomes, 
return on investment, and the ability to reach such underserved 
population groups. First-person accounts are welcomed.
    21. We seek information, data, and studies that identify specific 
rural areas and underserved regions of the country that need funding 
assistance for the purchase of high-capacity broadband connectivity, 
connections, and any other services or equipment authorized under the 
RHC Program rules. We seek detailed information and data as to whether 
eligible health care providers in these areas and regions that require 
funding assistance have participated in the RHC Program, and if not, 
why not. We also seek suggestions on how the Commission can encourage 
or facilitate their participation. Are there specific challenges of 
which the Commission should be aware?
    22. The Task Force is interested in identifying all currently 
available public (federal, state, or local) and private (e.g., non-
profit or philanthropic organizations) funding sources for the 
provision of broadband-enabled health technologies and services (e.g., 
telehealth and telemedicine) in rural regions, Tribal lands, and in 
other underserved areas (including underserved urban areas), as well as 
for vulnerable populations. Please provide information about those 
funding sources, as well as their Web site address, if any.
    23. We seek any other comment, information, and data concerning the 
RHC Program as well as the general needs of rural consumers for 
broadband-enabled health solutions that would be helpful to the Task 
Force, given its charge and objectives.

Objective IV: Raise Consumer Awareness About the Value Proposition of 
Broadband in the Health Care Sector and its Potential for Addressing 
Health Care Disparities

    It is critically important that consumers fully understand the 
practical and personal benefits of broadband in health care and in 
facilitating greater care coordination, proactive engagement in disease 
prevention, and self-management. Placing more care decisions in the 
hands of consumers and personalizing that experience appears to be a 
major theme in health applications and product development today. We 
also recognize that as consumers fully realize the practical health 
benefits of broadband, consumer demand for broadband-enabled health 
services and technologies will serve to further accelerate broadband 
deployment and adoption altogether--a national priority.
    24. We seek suggestions on how the Commission can effectively 
increase consumer awareness about the value proposition of broadband in 
the health care sector? Are there any practical efforts that the 
Commission can undertake to accelerate consumer adoption of broadband, 
and in particular broadband-enabled health services and technologies, 
especially among underserved populations? How might the Commission 
ensure that certain groups--e.g., rural consumers, those living on 
Tribal lands, older Americans, people with disabilities, military 
veterans, non-English speakers, and the economically disadvantaged--are 
fully aware of the availability and benefits of broadband-enabled 
health services and technologies? Are there any states, cities, and 
organizations engaged in similar efforts that could lead to potential 
partnerships?
    25. We also seek comment on any concerns that may discourage 
consumers, health care providers, and others from adopting broadband-
enabled health services and other advanced health technologies, 
including telehealth and telemedicine services and emerging medical 
devices. To what extent do safety, security, reliability, and privacy 
concerns influence adoption of broadband-enabled health services and 
other advanced technologies? To what extent do costs, socioeconomic 
status, and digital literacy issues impact adoption?
    26. We request information on any studies, pilots, research, or 
other data that quantifies the benefits of broadband-enabled health 
technologies in improving patient outcomes and in reducing costs. What 
kind of return on investment have pilot and demonstration projects 
experienced?
    27. We are interested in learning how broadband can enable 
healthcare-related support systems to connect patients to the people, 
services and information they need to get well and stay healthy. In 
this regard, physicians inform us that there is growing recognition 
that the need for social services and supports (e.g., nutritionists, 
dieticians, pharmacists, family caregivers, fitness centers, and other 
health care supports or supporters outside the traditional hospital 
setting) significantly impact the ability of some consumers to become 
healthy and stay well, and that the availability of broadband is 
increasingly essential to bridging the various services and supports. 
We seek comment and suggestions on how the Commission can support the 
development and availability of these new broadband-enabled services 
and supports (outside the RHC Program) especially on Tribal lands and 
in rural, remote, and other underserved areas?
    28. We seek information and any studies about how broadband-enabled 
services and technologies have been, and could be used, to address 
health and health care disparity issues, and the impact (and successes) 
such services and technologies have had in addressing such issues.
    29. Are there any practical issues (e.g., the lack of a home 
computer) that may be impeding consumer awareness and adoption of 
broadband-enabled health technologies? What efforts can be undertaken 
to help alleviate some of these issues?

Objective IV: Enable the Development of Broadband-Enabled Health 
Technologies That are Designed to be Fully Accessible to People With 
Disabilities

    The availability and accessibility of broadband-enabled health 
technologies designed to serve the needs of Americans with disabilities 
is critically important. One recent study estimates that, in 2013, the 
overall percentage of people with a disability in the U.S., among the 
civilian noninstitutionalized population, was 12.1 percent or 
approximately 37 million people. Other studies suggest that the number 
is higher than 50 million, and that it is predicted to continue to 
increase. Given these statistics, it is imperative that we do what we 
can, within our statutory authority, to promote the goal of making 
broadband-enabled health technologies and cutting-edge health and 
medical devices and applications available, accessible, and usable by 
people with disabilities.
    Technology has historically played an important role in the 
disability community. Many people with disabilities use communications 
technology, devices, or services in their daily lives, and broadband is 
becoming an essential data transmission platform that enables a wide 
range of services and tools. Ensuring that people with disabilities are 
able to access electronic health records, engage in video consultation 
with their physicians, fully utilize the latest health apps, and 
benefit from advances in wearable health technology, for example, are 
essential to the ongoing health care transformation. Consistent with 
its charge, the Task Force will consider the extent to which broadband-
enabled services and technologies used for the provision of health and 
care are

[[Page 21787]]

available, accessible, and usable by all Americans, including those 
with disabilities. We therefore seek any data, information, and comment 
that will assist the Commission in better understanding how it may 
assist in achieving these important goals.
    30. How are broadband-enabled health technologies and medical 
devices currently being used by people with disabilities? To what 
extent can these technologies and devices address the health care needs 
of people with disabilities in the future? Provide specific examples of 
the existing barriers, if any, that these technologies and devices pose 
for people with disabilities.
    31. We seek comment on whether the design and development of 
broadband-enabled health services and technologies, as well as cutting-
edge health and medical devices and applications, are accessible to, 
and usable by, people with disabilities. Are there practical concerns 
or other issues that are inhibiting or limiting the use and 
availability of broadband-enabled health services and technologies for 
people with disabilities? How are hospitals and clinicians currently 
addressing, if at all, any of these issues? An increasing number of 
health care services provide patient portals for patients to access 
medical records and communicate with physicians and specialists. What 
measures are taken to ensure that these mechanisms are fully accessible 
to users with disabilities (e.g., accessible via screen readers used by 
individuals who are blind)?
    32. To what extent are clinicians aware of video relay service 
(VRS) and using it when remotely consulting with American Sign Language 
(ASL) users on a telephone call? Is there a need for VRS providers to 
have ASL interpreters with a knowledge of (and ability to translate) 
specialized health or medical vocabulary? Should a VRS call that 
involves consultations between a deaf or hard of hearing person and a 
doctor be given priority over other calls waiting in a queue, 
especially when there is a possible medical emergency? We also seek 
comment as to whether our telecommunications relay service (TRS) rules 
are currently optimized to encourage medical consults via telemedicine?
    33. We seek suggestions as to how the Commission can effectively 
raise awareness among people with disabilities about the value 
proposition of broadband in health? How can the Commission help to 
enable the adoption and accessibility of such services and technologies 
among people with disabilities, especially given our authority?

Objective VI: Highlight Effective Telehealth Projects, Broadband-
Enabled Health Technologies, and mHealth Applications Across the 
Country and Abroad--To Identify Lessons Learned, Best Practices, and 
Regulatory Challenges

    Related to the objective of increasing consumer awareness about the 
practical health-related benefits of broadband is the need to inform 
the public--especially those in rural and underserved regions--about 
the availability and successes of the many broadband-enabled telehealth 
and telemedicine centers and projects across the country and abroad, as 
well as existing and emerging mHealth applications, and to identify 
lessons learned and best practices.
    34. We seek current information and data on the effectiveness of 
broadband-enabled telehealth and telemedicine services, including any 
recent research on these services. How are patients responding to these 
services? We are particularly interested in receiving comments directly 
from consumers about their experience with these and other broadband-
enabled services and technologies.
    35. We also seek comment on specific challenges faced by states, 
localities, and Tribal governments, as well as communities abroad, in 
deploying effective broadband-enabled telehealth and telemedicine 
projects.
    36. We seek comment on how the public can be better informed about 
the availability of broadband-enabled health services and technologies 
and mHealth applications. What have states, localities, other federal 
agencies, Tribal governments, and hospitals and clinics done to inform 
the public about the availability of these options? How effective have 
these projects been in promoting greater broadband utilization?
    37. We seek submissions of any case studies, research and video/
audio summaries concerning recently launched applications/programs that 
are on the cutting edge of telehealth, telemedicine, mHealth, and other 
broadband-enabled health technologies and services.
    38. We seek comment on the extent to which the United States is not 
taking full advantage of the opportunities that broadband-enabled 
health technology provides. For countries that have been the most 
successful in making broadband-enabled health services and technology 
more widely available, especially in rural and underserved areas, we 
seek information on the approaches that such countries took (including 
lessons learned) in achieving success in broadband health adoption.

Objective VII: Engage a Diverse Array of Traditional and Non-
Traditional Stakeholders To Identify Emerging Issues and Opportunities 
in the Broadband Health Space

    Published reports indicate that the ``the health IT industry is 
gaining a reputation as an emerging sweet spot for technology 
investors.'' We want to be sure that Commission policies do not present 
obstacles to continued innovation and investment in broadband-enabled 
health technologies, including medical devices that rely on 
communications technology. We observe that there is a growing desire 
for such technologies--including those that are wearable or otherwise 
track and monitor personal health--and that this emerging health market 
is estimated to be worth billions. There are also countless smartphone 
apps that track health-related issues. By some estimates, there are 
over 100,000 digital health apps offered in the three major app stores. 
In addition, recent advances in broadband-enabled sensor technology 
offer the potential for the emergence of more convenient and ultimately 
less costly and less invasive health care solutions. For example, we 
may soon see the widespread use of smart clothing (or smart ``tattoo'' 
applications) that use skin-based sensors to measure things like heart 
rate, respiration, and blood pressure. Robotics, virtual reality, and 
other consumer facing health technologies also offer the potential to 
help older Americans live more independently. Some technology companies 
are even experimenting with combining web search with online health 
consultations for a one-stop offering. To help inform the Commission in 
its related and other efforts in this area, we seek comment and 
information on these and other emerging health technologies, 
applications, services, and connected medical devices.
    39. We seek comment on any emerging issues of concern (that have 
not been identified in this Document) that potentially impact efforts 
to accelerate the availability of broadband-enabled health technologies 
and services, as well as medical devices that rely on communications 
technology.
    40. While the United States has made great strides in recent years, 
many advances in digital health technologies are still not broadly 
available, widely utilized, or well-tailored to meet the

[[Page 21788]]

needs of all Americans. We seek comment on these concerns.
    41. What are the emerging opportunities for investors, innovators, 
and entrepreneurs in the broadband health space and in the development 
of the next generation of connected health technologies and converged 
medical devices? We seek suggestions on any efforts that the Commission 
might undertake to support innovation and entrepreneurship in these 
areas. Are there emerging or non-traditional stakeholders that should 
be part of the Commission's efforts? If so, please identify them and 
their respective roles in or contributions to the broadband health 
space.
    42. We seek comment on how to promote small and diverse investors, 
innovators, and entrepreneurs in the broadband health sector in order 
to better ensure that the benefits of broadband-health technologies and 
services are available to all Americans.
    43. We seek to engage all potential stakeholders in this national 
broadband health effort. Commenters should identify any additional 
stakeholders that are not specifically referenced in this Document. We 
also encourage parties to identify any other relevant issues (not 
covered in this Notice) for the Task Force, given its charge and 
objectives.
    Administrative Matters. Because this Document does not itself 
initiate a ``proceeding,'' responses to the Document are not 
``presentations'' subject to the prohibitions in restricted proceedings 
and the disclosure requirements in permit-but-disclose proceedings. 
Nonetheless, parties discussing or providing information to the Task 
Force or any other members of the Commission regarding the issues 
raised in this Document are strongly encouraged to file a memorandum in 
the docket, summarizing their discussion and/or information.

Federal Communications Commission.
Marlene H. Dortch,
Secretary.
[FR Doc. 2017-09309 Filed 5-9-17; 8:45 am]
 BILLING CODE 6712-01-P



                                                    21780                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules

                                                    in this proceeding should familiarize                   Federal Communications Commission.                    commercial overnight courier, or by
                                                    themselves with the Commission’s ex                     Marlene H. Dortch,                                    first-class or overnight U.S. Postal
                                                    parte rules.                                            Secretary.                                            Service mail. All filings must be
                                                      121. In light of the Commission’s trust               [FR Doc. 2017–09431 Filed 5–9–17; 8:45 am]            addressed to the Commission’s
                                                    relationship with Tribal Nations and                    BILLING CODE 6712–01–P
                                                                                                                                                                  Secretary, Marlene H. Dortch, Office of
                                                    Native Hawaiian Organizations (NHOs),                                                                         the Secretary, Federal Communications
                                                                                                                                                                  Commission. All hand-delivered or
                                                    and the Commission’s obligation to
                                                                                                            FEDERAL COMMUNICATIONS                                messenger-delivered paper filings for
                                                    engage in government-to-government
                                                                                                            COMMISSION                                            the Commission’s Secretary must be
                                                    consultation with them, the
                                                                                                                                                                  delivered to FCC Headquarters at 445
                                                    Commission finds that the public                        47 CFR 1, 15, 20, and 54                              12th St. SW., Room TW–A325,
                                                    interest requires a limited modification                                                                      Washington, DC 20554. All hand
                                                    of the ex parte rules in this proceeding.               [GN Docket No. 16–46; FCC 17–46]
                                                                                                                                                                  deliveries must be held together with
                                                    Tribal Nations and NHOs, like other                                                                           rubber bands or fasteners. Any
                                                    interested parties, should file                         FCC Seeks Comment and Data on
                                                                                                            Actions To Accelerate Adoption and                    envelopes must be disposed of before
                                                    comments, reply comments, and ex                                                                              entering the building. The filing hours
                                                                                                            Accessibility of Broadband-Enabled
                                                    parte presentations in the record in                                                                          are 8:00 a.m. to 7:00 p.m. Commercial
                                                                                                            Health Care Solutions and Advanced
                                                    order to put facts and arguments before                                                                       overnight mail (other than U.S. Postal
                                                                                                            Technologies
                                                    the Commission in a manner such that                                                                          Service Express Mail and Priority Mail)
                                                    they may be relied upon in the decision-                AGENCY:  Federal Communications                       must be sent to 9300 East Hampton
                                                    making process. But the Commission                      Commission.                                           Drive, Capitol Heights, MD 20743. U.S.
                                                    will exempt ex parte presentations                      ACTION: Request for comments.                         Postal Service first-class mail, Express
                                                    involving elected and appointed leaders                                                                       Mail, and Priority Mail must be
                                                    and duly appointed representatives of                   SUMMARY:   The Federal Communications                 addressed to 445 12th Street SW.,
                                                    federally-recognized Tribal Nations and                 Commission (FCC) seeks comment, data,                 Washington, DC 20554.
                                                    NHOs from the disclosure requirements                   and information on a variety of                          Additional Filing Instruction: To the
                                                    in permit-but-disclose proceedings and                  regulatory, policy, and infrastructure                extent feasible, parties should email a
                                                    the prohibitions during the Sunshine                    issues related to the emerging                        copy of their comments to the Task
                                                    Agenda period. Specifically,                            broadband-enabled health and care                     Force’s email box, at connect2health@
                                                    presentations from elected and                          ecosystem. The FCC seeks to ensure that               fcc.gov. In the email, please insert
                                                    appointed leaders or duly appointed                     consumers—from major cities to rural                  ‘‘Comments in GN Docket No. 16–46’’ in
                                                    representatives of federally-recognized                 and remote areas, Tribal lands, and                   the subject line. Copies of all filings will
                                                    Tribal Nations or NHOs to Commission                    underserved regions—can access                        be available in GN Docket No. 16–46
                                                    decision makers shall be exempt from                    potentially lifesaving health                         through ECFS and are also available for
                                                    disclosure. To be clear, while the                      technologies and services, like                       public inspection and copying during
                                                    Commission recognizes that                              telehealth and telemedicine, which are                regular business hours at the FCC
                                                    consultation is critically important, the               enabled by broadband connectivity. The                Reference Information Center, Portals II,
                                                    Commission emphasizes that the                          anticipated record will allow the                     445 12th St. SW., Room CY–A257,
                                                                                                            Commission and its                                    Washington, DC 20554, telephone (202)
                                                    Commission will rely in its decision-
                                                                                                            Connect2HealthFCC Task Force (Task                    418–0270. Documents will be available
                                                    making only on those presentations that
                                                                                                            Force) to gain a broader understanding                electronically in ASCII, Microsoft Word,
                                                    are placed in the public record for this
                                                                                                            about the current state of broadband                  and/or Adobe Acrobat.
                                                    proceeding.
                                                                                                            health connectivity. The record will also                People with Disabilities: To request
                                                    IV. Ordering Clauses                                    be used by the Task Force to make                     materials in accessible formats for
                                                                                                            future recommendations to the                         people with disabilities (braille, large
                                                      122. Accordingly, it is ordered,                      Commission.                                           print, electronic files, audio format),
                                                    pursuant to Sections 1, 2, 4(i), 7, 201,
                                                                                                            DATES:  Submit comments on or before                  send an email to fcc504@fcc.gov or call
                                                    253, 301, 303, 309, and 332 of the
                                                                                                            May 24, 2017, and reply comments on                   the Consumer and Governmental Affairs
                                                    Communications Act of 1934, as
                                                                                                            or before June 8, 2017.                               Bureau at 202–418–0530 (voice) or 202–
                                                    amended 47 U.S.C. 151, 152, 154(i), 157,
                                                                                                            ADDRESSES: You may submit comments,                   418–0432 (TTY). Contact the FCC to
                                                    201, 253, 301, 303, 309, and 332,                                                                             request reasonable accommodations for
                                                    Section 102(C) of the National                          identified by GN Docket No. 16–46, by
                                                                                                            any of the following methods:                         filing comments (accessible format
                                                    Environmental Policy Act of 1969, as
                                                    amended, 42 U.S.C. 4332(C), and                            • Electronic Filers: Comments may be               documents, sign language interpreters,
                                                                                                            filed electronically using the Internet by            CART, etc.) by email at: fcc504@fcc.gov;
                                                    Section 106 of the National Historic                                                                          phone: 202–418–0530 or TTY: 202–418–
                                                    Preservation Act of 1966, as amended,                   accessing the ECFS: http://apps.fcc.gov/
                                                                                                            ecfs/ (click the ‘‘submit a filing’’ tab).            0432.
                                                    54 U.S.C. 306108, that this Notice of
                                                                                                            Filers should follow the instructions                 FOR FURTHER INFORMATION CONTACT: For
                                                    Proposed Rulemaking and Notice of
                                                                                                            provided on the Web site for submitting               further information about this
                                                    Inquiry is hereby adopted.
                                                                                                            comments. For ECFS filers, in                         Document, please contact Ben
                                                      123. It is further ordered that the                   completing the transmittal screen, filers             Bartolome, Special Counsel,
jstallworth on DSK7TPTVN1PROD with PROPOSALS




                                                    Commission’s Consumer &                                 should include their full name, U.S.                  Connect2HealthFCC Task Force, at (770)
                                                    Governmental Affairs Bureau, Reference                  Postal service mailing address, and the               935–3383, or via email at
                                                    Information Center, shall send a copy of                applicable docket number: GN Docket                   connect2health@fcc.gov (inserting
                                                    this Notice of Proposed Rulemaking,                     No. 16–46.                                            ‘‘Question re GN Docket No. 16–46’’ in
                                                    including the Initial Regulatory                           • Paper Filers: Parties who choose to              the subject line). Press inquiries should
                                                    Flexibility Analysis, to the Chief                      file by paper must file an original and               be directed to Katie Gorscak,
                                                    Counsel for Advocacy of the Small                       one copy of each filing. Filings can be               Communications Director,
                                                    Business Administration.                                sent by hand or messenger delivery, by                Connect2HealthFCC Task Force, at (202)


                                               VerDate Sep<11>2014   15:10 May 09, 2017   Jkt 241001   PO 00000   Frm 00039   Fmt 4702   Sfmt 4702   E:\FR\FM\10MYP1.SGM   10MYP1


                                                                           Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules                                            21781

                                                    418–2156, or via email at                               coming decades. However, the United                   percentage of the U.S. gross domestic
                                                    Katie.Gorscak@fcc.gov. For additional                   States remains behind some advanced                   product and health care costs are
                                                    information about the                                   countries in the adoption of such                     projected to increase. Studies confirm
                                                    Connect2HealthFCC Task Force, please                    technology.                                           that the United States has a serious
                                                    visit the FCC’s broadband health hub at                    As discussed in this Document, the                 health care supply problem. By some
                                                    http://www.fcc.gov/health.                              Commission plays an important role in                 estimates, the country could face a
                                                    SUPPLEMENTARY INFORMATION: This is a
                                                                                                            improving the quality of health care and              shortage of up to 94,700 physicians by
                                                    summary of the Commission’s                             enabling health care innovation through               2025, and the forecast is worse for rural
                                                    document, FCC 17–46, in GN Docket                       the universal service program, spectrum               communities. The healthcare provider
                                                    No. 16–46, released on April 24, 2017.                  licensing, and other activities. In order             shortfall is likely to disproportionately
                                                    The full text of this document is                       to perform these and other important                  affect rural and remote areas which are
                                                    available on the Internet at the                        roles in the health technology space, the             already medically-underserved.
                                                    Commission’s Web site, at https://                      Commission should continue to                            At the same time, demand for health
                                                    www.fcc.gov/document/fcc-seeks-                         evaluate the nation’s broadband health                care services is increasing. Today, over
                                                                                                            infrastructure and to understand the                  320 million people in the United States
                                                    comment-accelerating-broadband-
                                                                                                            ongoing technology-based                              could, at any time, utilize health care
                                                    health-tech-availability; and it is also
                                                                                                            transformation in health care delivery.               services, with one person added every
                                                    accessible from the Connect2HealthFCC
                                                                                                            This will better assure that consumers—               12 seconds (net), yet we only have
                                                    Task Force’s Web page, at https://
                                                                                                            from major cities to rural and remote                 approximately 280,000 primary care
                                                    www.fcc.gov/health/public-notice. The
                                                                                                            areas, Tribal lands, and underserved                  physicians to meet the needs. By the
                                                    full text is also available for public
                                                                                                            regions—can access potentially                        year 2060, the number of people living
                                                    inspection and copying from 8:00 a.m.
                                                                                                            lifesaving health technologies and                    in the United States is projected to
                                                    to 4:30 p.m. Eastern Time (ET) Monday
                                                                                                            services, like telehealth and                         increase by 100 million (resulting in a
                                                    through Thursday or from 8:00 a.m. to
                                                                                                            telemedicine. Leading this effort on                  total of 425+ million people), further
                                                    11:30 a.m. on Fridays in the FCC                        behalf of the agency is its                           exacerbating the projected physician
                                                    Reference Information Center, 445 12th                  Connect2HealthFCC Task Force. Among                   shortage concern. To further complicate
                                                    Street SW., Room CY–A257,                               other things, the Task Force is charged               matters, over 100 million Americans are
                                                    Washington, DC 20554 (Telephone:                        with charting the broadband future of                 dealing with chronic diseases and
                                                    202–418–0270; TTY: 202–418–2555).                       ‘‘health and care’’ in order to ensure                conditions (e.g., heart disease, stroke,
                                                    Overview                                                that the agency stays ahead of the health             cancer, obesity, diabetes, and arthritis);
                                                                                                            technology curve. We use the phrase                   and despite best efforts, health care
                                                       Broadband networks are increasingly                  ‘‘health and care’’ deliberately in this              disparities persist across various
                                                    important to our national well-being                    Document to reflect and include the                   geographic regions and ethnic groups.
                                                    and everyday lives. As such, we must                    broad range of participants in the                    While many individuals struggle with
                                                    maximize their availability and ensure                  emerging broadband health ecosystem,                  one chronic illness, older Americans
                                                    that all Americans can take advantage of                including providers (e.g., health                     often face from two to as many as five
                                                    the variety of services that broadband                  systems, community health centers,                    chronic diseases at the same time. By
                                                    enables, including 21st century health                  clinicians, pharmacists, nutritionists,               2030, one out of every five Americans
                                                    care. In this Document, the FCC seeks                   allied health professionals); public                  (or 71 million) will be over the age of
                                                    information on how it can help enable                   health and social service agencies and                65, and 20 million will be over the age
                                                    the adoption and accessibility of                       organizations; innovators and                         of 80.
                                                    broadband-enabled health care                           entrepreneurs; academic and research                     While broadband is not a complete
                                                    solutions, especially in rural and other                facilities; state and local policymakers;             answer, there are a growing number of
                                                    underserved areas of the country. We                    patients and their caregivers; as well as             broadband-enabled solutions that can
                                                    expect to use this information to                       consumers who seek support to prevent                 play an important role in improving
                                                    identify actions that the Commission                    disease and maintain optimum health.                  population health; addressing health
                                                    can take to promote this important goal.                   This Document seeks comment, data,                 needs beyond the hospital; expanding
                                                       Ensuring that everyone is connected                  and information on a broad range of                   access to primary, acute, preventive and
                                                    to the people, services, and information                regulatory, policy, technical, and                    specialist care, especially for those
                                                    they need to get well and stay healthy                  infrastructure issues related to the                  Americans living in rural and
                                                    is an important challenge facing our                    emerging broadband-enabled health and                 underserved areas; providing more cost-
                                                    nation. Technology innovations in                       care ecosystem. Commenters should                     effective solutions; improving the
                                                    clinical practice and care delivery                     address the agency’s authority on all                 quality of care; and better engaging
                                                    coupled with burgeoning consumer                        issues raised in this Notice. The                     consumers in their health. Put simply,
                                                    reliance on mHealth and health                          comment, data, and information                        health care is being transformed by the
                                                    information technology (or healthIT) are                requested are intended to provide the                 availability and accessibility of
                                                    fundamentally changing the face of                      Commission with a broader                             broadband-enabled services and
                                                    health care, and a widespread,                          understanding and perspective on the                  technologies and the development of
                                                    accessible broadband infrastructure is                  current state of broadband health                     life-saving wireless medical devices.
                                                    critical to this ongoing shift. Indeed, the             technology and other related issues; and                 Indeed, we are already realizing some
                                                    future of modern health care appears to                 it will also inform the Task Force’s work             of the tremendous benefits that
jstallworth on DSK7TPTVN1PROD with PROPOSALS




                                                    be fundamentally premised on the                        and recommendations.                                  broadband-enabled health technologies
                                                    widespread availability and                                                                                   and innovative wireless medical devices
                                                    accessibility of high-speed connectivity.               The Broadband Health Imperative                       have to offer: Electronic Health Record
                                                    By some estimates, broadband-enabled                      Broadband holds promise for enabling                (EHR) systems can track and transmit
                                                    health information technology can help                  health care solutions and advanced                    vast amounts of patient clinical data. X-
                                                    to improve the quality of health care                   technologies that can help to meet                    rays, MRIs, and CAT scans can be
                                                    and significantly lower health care costs               America’s growing health care needs.                  transmitted seamlessly to specialists at
                                                    by hundreds of billions of dollars in the               Health care accounts for a significant                a distant hospital. Telemedicine and


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                                                    21782                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules

                                                    telehealth programs and services                        innovators and entrepreneurs,                         information by allowing providers to
                                                    provide opportunities to close access to                academia, consumers, and the health                   access patients’ electronic health
                                                    care gaps and facilitate specialized                    care community. Accordingly, we seek                  records from on-site or hosted locations.
                                                    training. Medical providers are able to                 broad public and private stakeholder                  Second, in many cases it can remove
                                                    prescribe medications electronically,                   input and collaboration on the issues                 geography and time as barriers to care
                                                    saving time and money. Surgeons are                     discussed below.                                      by enabling telehealth and telemedicine
                                                    able to perform operations miles away                                                                         applications like video consultations
                                                                                                            Request for Comment and Data
                                                    from patients via robotics. Self-service                                                                      and remote patient monitoring. Third,
                                                    health kiosks are becoming increasingly                    As part of its charge, the                         broadband provides a foundation for the
                                                    available at pharmacies and grocery                     Connect2HealthFCC Task Force is                       next generation of medical devices, as
                                                    chains, providing additional access                     focused on the following objectives: (1)              well as other health innovation and
                                                    points for primary care and disease                     Promoting effective policy and                        connected-care solutions. Finally,
                                                    screenings. Remote patient monitoring                   regulatory solutions that encourage                   broadband-enabled health IT offers real
                                                    applications and services are reducing                  broadband adoption and promote health                 opportunities for consumers to take
                                                    hospital readmissions as well as travel                 IT; (2) identifying regulatory barriers               charge of their own health.
                                                    and associated expenses for patients.                   (and incentives) to the deployment of                    To ensure that these and other
                                                    Mobile devices like smartphones and                     radio frequency (RF)-enabled advanced                 benefits continue to accrue and expand,
                                                    personal data assistants are transforming               health care technologies and devices; (3)             it is critical that we identify and engage
                                                    the way physicians manage patient care;                 strengthening the nation’s telehealth                 in appropriate efforts to address any
                                                    they are also empowering and engaging                   infrastructure through the FCC’s Rural                current and emerging issues of concern.
                                                    consumers to take a more active role in                 Health Care Program and other                         In this regard, we note that there are
                                                    managing their own health. Implant or                   initiatives; (4) raising consumer                     some broad policy measures that, if
                                                    body-worn monitoring, therapeutic, and                  awareness about the value proposition                 implemented, could accelerate
                                                    treatment technologies include wireless                 of broadband in the health care sector                broadband deployment generally, and
                                                    blood glucose monitors and automated                    and its potential for addressing health               thereby provide greater access to
                                                    insulin pumps. ‘‘Ingestibles’’ and ‘‘smart              care disparities; (5) enabling the                    broadband-enabled health technologies,
                                                    pills’’ (broadband-enabled digital tools                development of broadband-enabled                      solutions and services, especially for
                                                    that are swallowed by the patient) use                  health technologies that are designed to              those consumers living in rural and
                                                    wireless technology to monitor internal                 be fully accessible to people with                    underserved areas of the country. A
                                                    reactions in real-time, dispense                        disabilities; (6) highlighting effective              prime example is the possible
                                                    medication, and provide other granular                  telehealth projects, broadband-enabled                establishment of ‘‘Gigabit Opportunity
                                                    health data.                                            health technologies, and mHealth                      Zones.’’ In September 2016, FCC
                                                       Veterans, in particular, have seen                   applications across the country and                   Chairman Ajit Pai, as part of his Digital
                                                    tangible benefits from telemedicine.                    abroad—to identify lessons learned, best              Empowerment Agenda for accelerating
                                                    Most notably, critical mental health                    practices, and regulatory challenges;                 the deployment of high-speed Internet
                                                    services are now accessible via                         and (7) engaging a diverse array of                   access, called on Congress to provide
                                                    telemedicine to those veterans living in                traditional and non-traditional                       tax and other financial incentives for the
                                                    rural areas or abroad. In fiscal year 2014,             stakeholders to identify emerging issues              private sector to deploy gigabit
                                                    more than 690,000 military veterans                     and opportunities in the broadband                    broadband services in low income
                                                    accessed the U.S. Department of                         health space.                                         neighborhoods, which he referred to as
                                                    Veterans Administration’s (VA) health                      To continue evaluating these and                   ‘‘Gigabit Opportunity Zones.’’ More
                                                    care network using telemedicine                         other challenges, we request that                     recently, the Commission created the
                                                    programs, reflecting more than 1.7                      stakeholders and other interested parties             Broadband Deployment Advisory
                                                    million episodes of care. The Veterans                  provide comment, information, and/or                  Committee (BDAC) to provide the
                                                    Health Administration notes that                        data on the issues and subject matter                 Commission advice on, among other
                                                    ‘‘[telemedicine] technology is now                      described below. This Notice seeks the                things, accelerating broadband
                                                    considered ‘mission critical’ for                       most current information available that               deployment, identifying regulatory
                                                    effectively delivering quality healthcare               is specifically relevant to the                       barriers to infrastructure investment,
                                                    to veterans, particularly for those in                  intersection of broadband, advanced                   and making recommendations for
                                                    rural or underserved areas.’’                           technology, and health care in view of                reducing and/or removing regulatory
                                                       These are just some of the                           the aforementioned Task Force                         barriers. We now seek additional and
                                                    opportunities that broadband-enabled                    objectives. For convenience, the issues               specific data regarding the pace of
                                                    services and health-related                             for comment are enumerated; and we                    deployment and adoption of broadband
                                                    communications technologies and                         request that parties, in their submission,            for health and in health care. As
                                                    devices offer, especially for those living              identify the enumerated issue to which                detailed below, we also invite input on
                                                    in rural and underserved areas, low                     their written response pertains. We also              policies or initiatives that the FCC could
                                                    density populations, and Tribal lands;                  encourage parties to identify any other               implement to further spur deployment
                                                    for older Americans; persons with                       relevant issues not covered below.                    and adoption of broadband services,
                                                    disabilities; military veterans; and the                                                                      especially in critical need areas at the
                                                    economically disadvantaged—all of                       Objective I: Promote Effective Policy and
                                                                                                                                                                  intersection of health and broadband
                                                    whom have traditionally faced                           Regulatory Solutions That Encourage                   (e.g., the counties identified in the
jstallworth on DSK7TPTVN1PROD with PROPOSALS




                                                    significant health and care challenges.                 Broadband Adoption and Promote                        Connect2HealthFCC Task Force’s
                                                    We endeavor to foster the development                   Health IT                                             Priority 100 and Rural 100 lists).
                                                    and accessibility of these and other                      Broadband and advanced                                 1. We request suggestions regarding
                                                    emerging communications-based                           technologies appear increasingly critical             ways in which the FCC, based on its
                                                    technologies throughout the country.                    to the effective transformation of our                authority, can further accelerate
                                                    The work ahead, however, can only be                    health care system. First, these                      broadband adoption in the health care
                                                    successful if it combines the efforts of                technologies enable the efficient                     context and promote broadband-enabled
                                                    all levels of government, industry,                     exchange of patient and treatment                     health IT solutions, either on its own or


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                                                                           Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules                                            21783

                                                    working in collaboration with other                     depending on the technology platform—                 clinics) for broadband-enabled services
                                                    agencies, and, at the same time, ensure                 e.g., digital subscriber line (DSL), cable,           and technologies, given current
                                                    that such services and technologies are                 fiber, wireless, or satellite?                        connectivity needs and the existence of
                                                    fully available and accessible to all                      5. We seek to better understand health             varied spectrum environments? Do
                                                    Americans, including those living in                    care providers’ connectivity                          current designs take into consideration
                                                    rural and remote areas, low density                     requirements. What type of connectivity               any potential interference concerns with
                                                    populations, Tribal lands, and in                       (e.g., wired or wireless; fixed or mobile)            projected wireless networks and devices
                                                    underserved urban areas of our country.                 is necessary to support the deployment                that will be used in these facilities? Are
                                                    We also seek comment on what                            of health IT applications today and in                there (or should there be) industry
                                                    impediments to these efforts exist, and                 the near future at the different types of             standards or best practices for ensuring
                                                    how the FCC can address them.                           health care delivery settings (e.g.,                  that new health care facilities consider
                                                       2. We request information and data on                tertiary care centers versus primary care             broadband in their design and account
                                                    the types, impact, scale, and benefits of               physician practices, larger physician                 for any necessary conduits, wiring,
                                                    broadband-enabled services and                          groups, clinics, hospitals, as well as                building configuration, and materials
                                                    technologies used for the delivery of                   ‘‘hospital in the home’’ settings).                   (e.g., there may be a need to consider
                                                    health care. How is broadband currently                    a. What are the minimum bandwidth                  certain materials for internal or external
                                                    being used to augment or transform                      and speed requirements for the different              walls to better enable wireless
                                                    existing health care delivery? What                     types of health IT applications available             broadband within a facility or to limit
                                                    types of health care settings are using                 today and in the near future for clinical             RF into a building) at the design and
                                                    broadband-enabled services and                          and non-clinical settings? We also seek               construction phase?
                                                    technologies besides large medical                      comment on bandwidth constraints                         6. We seek to understand the full
                                                    hospitals? What variety of medical                      brought on by increased overall usage as              range of issues that might be affecting
                                                    issues are they used for? Where are                     well as the impact of data intensive                  the development and adoption of
                                                    these health care settings located? What                medical applications. Are there future                broadband-enabled technology and
                                                    are some of the future plans for using                  technologies or applications on the                   services in health care. What non-
                                                    broadband-enabled health services and                   horizon that could be bandwidth                       technical impediments or issues
                                                    technologies—not just by clinicians and                 intensive? If so, what are they, and to               currently exist in the provision of
                                                    hospitals but also by other participants                what extent could compression and                     broadband-enabled health technology
                                                    in the broader health ecosystem?                        other technologies provide a solution for             services? Are there any circumstances or
                                                       3. We are also interested in learning                such future technologies or                           practical considerations (e.g., cost,
                                                    how health technologies and services                    applications?                                         funding, and training) that may be
                                                    can take advantage of new technological                    b. Some evidence suggests that real-               creating disincentives for clinicians and
                                                    applications and emerging                               time image manipulation and video                     health care settings to offer broadband-
                                                    communications networks. For                            (e.g., telestroke and tele-emergency                  enabled health services and
                                                    example, what impact will the Internet                  applications) will stimulate demand for               technologies, such as telehealth and
                                                    of Things (IoT) have on broadband-                      more and better broadband and at lower                telemedicine? If so, please describe
                                                    enabled health technologies and                         prices. Are there current issues                      what they are, including the extent and
                                                    services such as telehealth and                         concerning network speeds and delays                  nature of the Commission’s authority to
                                                    telemedicine? To what extent will                       for these types of services? Do mobile                address them.
                                                    pervasive connectivity and a fully                      health applications present unique                       7. What efforts are being made at the
                                                    connected environment around                            considerations in terms of coverage,                  state and local levels to address
                                                    individuals (e.g., IoT) shift the point of              reliability, and security? We seek                    broadband health technology
                                                    care delivery? How might the demands                    suggestions on whether, and if so, how                accessibility issues in rural and remote
                                                    on broadband networks evolve in this                    the Commission could address these                    areas, Tribal lands, and underserved
                                                    new environment? What, if any, changes                  issues.                                               urban areas? We seek specific
                                                    are anticipated in existing broadband-                     c. To what extent do rural                         information, particularly from states,
                                                    enabled health services and                             communities and Tribal lands have                     localities, Tribal governments, and rural
                                                    technologies—operating over current                     access to Internet connection speeds                  and urban medical centers, about any
                                                    mobile networks—when 5G (Fifth                          that are sufficient to support the                    broadband-enabled health IT programs
                                                    Generation Mobile and Wireless                          effective and efficient transmission of               that have been developed and
                                                    Networks) becomes available? To what                    data and video to provide telehealth,                 implemented (or will soon be
                                                    extent might telehealth and                             telemedicine, and other broadband                     implemented) to reach these areas. How
                                                    telemedicine be impacted by the                         health technology services?                           successful have those programs been?
                                                    availability of 5G networks? What                          d. What, if any, interoperability,                 What are some of the lessons learned in
                                                    medical device innovations are                          capacity, reliability, security, and speed            developing those programs? What
                                                    anticipated to be developed using 5G                    issues currently exist for wireless (i.e.,            programs and other efforts are necessary
                                                    networks?                                               radiofrequency (RF)-based) medical                    to drive attention to those rural and
                                                       4. What technical issues concerning                  devices used by patients in both clinical             underserved populations that need
                                                    the variety of broadband-enabled health                 and non-clinical settings (e.g., at home);            health technologies most? How can the
                                                    care solutions and technologies are                     and for healthcare providers with                     Commission better facilitate the
                                                    appropriate and necessary for the FCC                   respect to the provision of broadband-                deployment of services and technologies
jstallworth on DSK7TPTVN1PROD with PROPOSALS




                                                    to consider with respect to efforts to                  enabled health technologies, like                     as well as consumer adoption in those
                                                    accelerate broadband adoption and                       telehealth and telemedicine services?                 areas?
                                                    promote health IT solutions? Are there                  Are there other technical issues                         8. We seek suggestions on ways the
                                                    issues of concern with respect to access,               appropriate for the Commission to                     Task Force can effectively and
                                                    availability, interoperability, capacity,               consider?                                             efficiently identify any gaps in the
                                                    reliability, privacy, security, and speed?                 e. What impediments, if any, exist in              availability of broadband-enabled health
                                                    If so, please describe them. Does                       trying to retrofit existing and future                technologies in the country. We request
                                                    consideration of any of these issues vary               health care facilities (e.g., hospitals and           any information, data, or studies that


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                                                    21784                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules

                                                    can better inform the Task Force as to                  sector and commercial wireless industry                  12. Similarly, what, if any issues or
                                                    where broadband-enabled health                          have raised concerns about the likely                 concerns exist for patients and other
                                                    services and technologies are critically                surge in demand for spectrum for                      users of medical devices when such
                                                    needed in the country but are                           wireless medical devices and                          devices are used primarily in potentially
                                                    insufficient or unavailable. Why do                     broadband-enabled services—noting                     uncontrolled, non-hospital settings (e.g.,
                                                    these availability gaps exist? Maps and                 trends toward fully connected hospitals,              in homes, aircraft, cruise ships, or other
                                                    data—including those commissioned by                    widespread remote patient monitoring,                 close quarter, multi-unit dwellings,
                                                    or for states or localities—would be                    and leveraging connectivity to improve                etc.), where non-health related wireless
                                                    particularly helpful. In August of 2016,                health facilities’ workflow and back-                 technologies that also emit radio
                                                    the Task Force launched one such                        office functions—and have sought                      frequencies (e.g., baby monitors,
                                                    broadband health analytics tool—the                     appropriate regulatory relief. Most                   wireless home security systems, Wi-Fi
                                                    Mapping Broadband Health in America                     recently, in August 2016, TerreStar                   routers, etc.) may proliferate? And to
                                                    platform—to allow stakeholders to more                  Corporation filed a request for waiver of             what extent might similar issues or
                                                    easily analyze and study the                            its substantial service requirements to               concerns exist for emerging and future
                                                    intersection between connectivity and                   enable use of its wireless licenses in the            technological innovations (e.g., electric
                                                    health for every state and county in the                1.4 GHz band to provide wireless                      automobiles, smart cars, smart homes,
                                                    United States. While the response to the                medical telemetry service (WMTS)                      etc.)?
                                                    platform—from other federal agencies,                   operations, citing increasing demand.                    13. We seek comment, data, and any
                                                    as well as private organizations and                    Several wireless medical device                       studies on the possible complexities of
                                                    industry—has been uniformly positive,                   manufacturers supported the waiver                    the future RF environment in homes,
                                                    with some already using the mapping                     request and argued that there was a                   hospitals, and other public spaces
                                                    platform to improve data-driven                         spectrum shortage facing WMTS                         related to the increasing number of
                                                    decision-making around broadband                        licensees.                                            medical applications and devices.
                                                    health-related policies and initiatives,                   Below, we seek information and data                   14. How are medical devices currently
                                                    we seek additional stakeholder input.                   on (i) the types of broadband-enabled                 being tested and evaluated to ensure
                                                    How can we further improve the                          health technologies and medical devices               that consumers and patients can safely
                                                    analytic platform to encourage                          currently in the market and those that                use them in both clinical and non-
                                                    investment in broadband health                          may be launched in the near future; (ii)              clinical settings, given their operation in
                                                    networks in areas with the greatest                     the future spectrum and wireless                      varied spectrum environments? Are
                                                    health and connectivity needs? If we                    infrastructure needs in the health care               there currently any FCC rules or policies
                                                    wanted to refine the tool to identify                   sector; and (iii) any concerns about the              that serve as barriers to testing and
                                                    potential partnerships among health                     increased use and proliferation of                    deployment of advanced health care
                                                    care providers or between health care                   wireless medical devices in health care               technologies and medical devices? If
                                                    providers and broadband service                         settings and public spaces. Also, we                  any, please identify which specific rules
                                                    providers, what is the best way to                      welcome comment on what, if any,                      and/or policies, and explain how they
                                                    achieve that goal?                                      regulatory barriers exist (as well as                 have served to impede the testing and
                                                      9. What are the impediments to                        incentives that could be implemented)                 deployment of health care technologies
                                                    making health IT and other broadband                    concerning the deployment of advanced                 and medical devices. How might the
                                                    health technology services available and                broadband-enabled health care                         Commission address such concerns?
                                                    ubiquitous in rural and remote areas,                   technologies and medical devices. For                    15. We also request recommendations
                                                    low population density areas, Tribal                    purposes of this Document, we are only                on how the Commission could make an
                                                    lands, and underserved urban sectors?                   seeking information on ‘‘medical                      assessment of the spectrum and wireless
                                                    Are there any unique challenges that                    devices’’ that use RF wireless                        infrastructure needs for the future of
                                                    persist in these areas; if so, what are                 technology or communications                          health care in the United States. We
                                                    they? In particular, we seek comment on                 functions for diagnosis, treatment, or                seek input from all relevant
                                                    any deployment, infrastructure,                         patient monitoring.                                   stakeholders, including members of the
                                                    geographic, expertise (e.g., the                           10. We seek information on the types               health care, wireless, and software
                                                    availability and adequacy of IT                         of broadband-enabled health                           industries who are developing wireless
                                                    expertise), telecommunications carrier                  technologies and medical devices that                 healthcare applications for the present
                                                    availability, cost, and any other                       are currently in the market. In addition,             and future; physicians, consumer
                                                    challenges in these areas. We seek                      what emerging types of broadband-                     advocates, and academicians; and
                                                    suggestions for how to address such                     enabled health technologies and                       relevant federal, state, and local
                                                    challenges, including on any rule and/                  medical devices are likely to be                      government agencies. While we
                                                    or policy changes that the Commission                   available to consumers soon? What are                 envision building upon the spectrum
                                                    should consider.                                        the future trends in this market area?                management and wireless infrastructure
                                                                                                               11. What, if any, technical issues or              deployment policies that the FCC has
                                                    Objective II: Identify Regulatory Barriers              concerns exist for patients and other                 successfully employed in the past to
                                                    (and Incentives) to the Deployment of                   users of medical devices when such                    promote innovation in wireless health
                                                    RF-Enabled Advanced Health Care                         devices are used in hospital settings? Do             services, we ask commenters to identify
                                                    Technologies and Devices                                these concerns vary depending on the                  any novel framework, including those
                                                      The Commission has a long history of                  type and size of the hospital setting? Are            that might include smart city initiatives
jstallworth on DSK7TPTVN1PROD with PROPOSALS




                                                    addressing spectrum needs for the                       these concerns exacerbated when                       or public/private partnerships, that
                                                    development of next- generation health                  medical devices are operating in large or             could be useful in planning for the
                                                    technologies and medical devices, and                   busy hospital environments (which may                 wireless future of our nation’s health
                                                    of exercising flexibility, as necessary                 include a wide variety of wireless                    care system.
                                                    and appropriate, in revising its rules                  technologies, some of which may be                       a. One of the compelling drivers of
                                                    and policies to speed up their                          unrelated to clinical care); if so, what              mobile technology in healthcare is the
                                                    deployment. However, in recent                          are those concerns, how can they be                   increasing availability of health apps for
                                                    months, stakeholders in the health                      addressed?                                            smartphones and tablets. There is now


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                                                                           Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules                                             21785

                                                    an app for almost every conceivable                     technologies and medical devices? We                     The Commission’s RHC Program has
                                                    healthcare need, ranging from drug dose                 also welcome suggestions on any                       made the benefits of broadband-enabled
                                                    calculators to fully functioning                        regulatory incentives (that are within                health services, such as telehealth and
                                                    electronic medical records. We are also                 the FCC’s authority) that could serve to              telemedicine, more available to
                                                    seeing the development of smart homes                   foster continued investment in and                    consumers living in rural and remote
                                                    and automobiles that would enable even                  further deployment of next-generation                 areas. Such broadband-enabled services
                                                    more sophisticated remote health                        broadband-enabled health technologies                 have provided patients in rural areas
                                                    monitoring. How soon will we see                        and medical devices?                                  with access to critically needed medical
                                                    widespread adoption of these                                                                                  specialists in a variety of practice areas.
                                                    technologies and what implications will                 Objective III: Strengthen the Nation’s                The availability of telehealth and
                                                    they have on the spectrum needs of the                  Telehealth Infrastructure Through the                 telemedicine programs also has been
                                                    health care industry?                                   FCC’s Rural Health Care Program and                   found to mitigate significant challenges
                                                       b. In developing a national spectrum                 Other Initiatives                                     associated with disparities in access to
                                                    plan for the health care industry, are                     Broadband deployment is one of the                 care and healthcare workforce shortages.
                                                    there particular spectrum bands that the                FCC’s top priorities, particularly in rural           The RHC Program also has been found
                                                    FCC should consider?                                    America. Based on current evidence,                   to save health care providers money as
                                                       c. When it comes to increased need                   broadband can be a game-changer                       well. The Commission continues to
                                                    for spectrum-based health technologies,                 particularly in rural areas—where                     evaluate the Healthcare Connect Fund
                                                    what challenges do small, rural, and                    consumers often have to drive long                    (HCF) in terms of the programmatic
                                                    critical access hospitals have that are                 distances to access critical or specialty             goals of (1) increasing access to
                                                    different from what large hospitals face?               care; and where isolated clinics and                  broadband for HCPs, particularly those
                                                       d. Do health care facilities, because of                                                                   serving rural areas; (2) fostering the
                                                                                                            health centers can save lives and
                                                    their different physical characteristics,                                                                     development and deployment of
                                                                                                            promote community health by using
                                                    require different types of small cells and                                                                    broadband health care networks; and (3)
                                                                                                            advanced communications technologies
                                                    wireless infrastructure than other                                                                            maximizing the cost-effectiveness of the
                                                                                                            to connect with medical expertise not
                                                    commercial enterprises? What are the                                                                          program.
                                                                                                            otherwise available, as well as monitor
                                                    most challenging impediments to the                                                                              17. We seek comment and suggestions
                                                                                                            patients who live many miles away from
                                                    deployment of wireless infrastructure in                                                                      on how the FCC can further promote
                                                                                                            a health care facility.
                                                    hospitals and health care systems? What                                                                       and help enable the adoption and
                                                    policies should the FCC consider in                        The FCC’s Rural Health Care (RHC)                  accessibility of broadband-enabled
                                                    order to help streamline infrastructure                 Program has helped expand broadband                   health technologies, like telehealth and
                                                    siting that is necessary for the                        services for eligible health care                     telemedicine, in rural and other
                                                    deployment of wireless networks in                      providers (HCPs) in rural areas.                      underserved areas. Are there other
                                                    hospitals and health care systems? What                 Currently, the RHC Program is                         initiatives or actions beyond the RHC
                                                    state or local government regulatory                    comprised of three programs: The                      Program that the agency, or the Task
                                                    policies have helped to facilitate                      Healthcare Connect Fund (HCF), the                    Force on behalf of the agency, could
                                                    streamlined deployment of wireless                      Telecommunications Program, and the                   pursue in order to promote and help
                                                    infrastructure for health care?                         Pilot Program. With respect to the Pilot              enable the adoption and availability of
                                                       e. How can new advanced spectrum                     Program, while no new funding is                      broadband-enabled health technologies
                                                    sharing techniques (e.g., dynamic                       available, some projects continue to                  in rural and underserved areas of the
                                                    spectrum sharing through database                       accept new HCP sites. As funding for                  country?
                                                    controlled coordination, software                       the Pilot Program projects ends, Pilot                   18. Is the regulatory framework for the
                                                    designed radios, or efficient spectrum                  Program projects are expected to apply                Rural Health Care program keeping pace
                                                    use through network virtualization                      for additional support, if needed, under              with how broadband-enabled health
                                                    techniques) or secondary market                         the Healthcare Connect Fund. The FCC                  care is being delivered in rural and
                                                    mechanism (e.g., spectrum leasing                       established the Healthcare Connect                    underserved areas? If not, please explain
                                                    arrangements) be leveraged to meet the                  Fund to expand health care provider                   in detail, describing any emerging
                                                    spectrum demands of cutting-edge                        access to broadband, especially in rural              challenges, gaps or opportunities for
                                                    mobile broadband-enabled health                         areas, and encourage the creation of                  using broadband to better meet the
                                                    technologies and medical devices that                   state and regional broadband health care              health and health care needs of rural
                                                    may be operating in varied spectrum                     networks. Under the Healthcare Connect                consumers.
                                                    environments? Are there any issues                      Fund, eligible rural HCPs, and those                     19. We seek current information and
                                                    with harmonization of spectrum for                      non-rural HCPs that are members of a                  data, if any, that can be used to measure
                                                    medical uses across international                       consortium that has a majority of rural               the impact that the various RHC
                                                    borders to ensure that consumers can                    HCP sites, can receive a 65 percent                   programs have had on certain
                                                    effectively and safely use medical and                  discount from the fund on all eligible                populations and sectors—i.e., those
                                                    other devices across borders?                           expenses. HCPs are required to                        living in rural and underserved areas,
                                                       f. What are some of the recent and                   contribute the remaining 35 percent to                low density populations, and Tribal
                                                    emerging trends in health care delivery                 participate in the program. HCPs can                  lands; older Americans; persons with
                                                    (in rural and urban areas) that are                     use the Healthcare Connect Fund to                    disabilities; military veterans; and the
                                                    implicating spectrum use and needs?                     purchase eligible services and                        economically disadvantaged in rural
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                                                    Are these trends creating a greater need                equipment, as well as construct their                 and urban communities—all of which
                                                    for spectrum wireless services,                         own broadband infrastructure where it                 have traditionally faced significant
                                                    particularly in rural areas? Are these                  is shown to be the most cost effective                health and health care challenges.
                                                    trends resulting in increased use of                    option. The cap on total funding for the                 20. We also are interested in hearing
                                                    remote patient monitoring solutions?                    RHC Program altogether, which                         recent success stories about innovative
                                                       16. Do any regulatory barriers exist                 includes the Telecommunications                       health care services that were created or
                                                    concerning the deployment of advanced                   Program and the Healthcare Connect                    that became available as a result of the
                                                    broadband-enabled health care                           Fund, is $400 million annually.                       RHC Program, and how such services


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                                                    21786                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules

                                                    have helped consumers in rural and                      broadband-enabled health services and                 support the development and
                                                    remote areas. We are particularly                       technologies will serve to further                    availability of these new broadband-
                                                    interested in receiving data and                        accelerate broadband deployment and                   enabled services and supports (outside
                                                    information about health outcomes,                      adoption altogether—a national priority.              the RHC Program) especially on Tribal
                                                    return on investment, and the ability to                   24. We seek suggestions on how the                 lands and in rural, remote, and other
                                                    reach such underserved population                       Commission can effectively increase                   underserved areas?
                                                    groups. First-person accounts are                       consumer awareness about the value                      28. We seek information and any
                                                    welcomed.                                               proposition of broadband in the health                studies about how broadband-enabled
                                                       21. We seek information, data, and                   care sector? Are there any practical                  services and technologies have been,
                                                    studies that identify specific rural areas              efforts that the Commission can                       and could be used, to address health
                                                    and underserved regions of the country                  undertake to accelerate consumer                      and health care disparity issues, and the
                                                    that need funding assistance for the                    adoption of broadband, and in                         impact (and successes) such services
                                                    purchase of high-capacity broadband                     particular broadband-enabled health                   and technologies have had in addressing
                                                    connectivity, connections, and any                      services and technologies, especially                 such issues.
                                                    other services or equipment authorized                  among underserved populations? How                      29. Are there any practical issues (e.g.,
                                                    under the RHC Program rules. We seek                    might the Commission ensure that                      the lack of a home computer) that may
                                                    detailed information and data as to                     certain groups—e.g., rural consumers,                 be impeding consumer awareness and
                                                    whether eligible health care providers in               those living on Tribal lands, older                   adoption of broadband-enabled health
                                                    these areas and regions that require                    Americans, people with disabilities,                  technologies? What efforts can be
                                                    funding assistance have participated in                 military veterans, non-English speakers,              undertaken to help alleviate some of
                                                    the RHC Program, and if not, why not.                   and the economically disadvantaged—                   these issues?
                                                    We also seek suggestions on how the                     are fully aware of the availability and               Objective IV: Enable the Development of
                                                    Commission can encourage or facilitate                  benefits of broadband-enabled health                  Broadband-Enabled Health
                                                    their participation. Are there specific                 services and technologies? Are there any              Technologies That are Designed to be
                                                    challenges of which the Commission                      states, cities, and organizations engaged             Fully Accessible to People With
                                                    should be aware?                                        in similar efforts that could lead to                 Disabilities
                                                       22. The Task Force is interested in                  potential partnerships?
                                                    identifying all currently available public                 25. We also seek comment on any                       The availability and accessibility of
                                                    (federal, state, or local) and private (e.g.,           concerns that may discourage                          broadband-enabled health technologies
                                                    non-profit or philanthropic                             consumers, health care providers, and                 designed to serve the needs of
                                                    organizations) funding sources for the                  others from adopting broadband-                       Americans with disabilities is critically
                                                    provision of broadband-enabled health                   enabled health services and other                     important. One recent study estimates
                                                    technologies and services (e.g.,                        advanced health technologies, including               that, in 2013, the overall percentage of
                                                    telehealth and telemedicine) in rural                   telehealth and telemedicine services                  people with a disability in the U.S.,
                                                    regions, Tribal lands, and in other                     and emerging medical devices. To what                 among the civilian noninstitutionalized
                                                    underserved areas (including                            extent do safety, security, reliability,              population, was 12.1 percent or
                                                    underserved urban areas), as well as for                and privacy concerns influence                        approximately 37 million people. Other
                                                    vulnerable populations. Please provide                  adoption of broadband-enabled health                  studies suggest that the number is
                                                    information about those funding                         services and other advanced                           higher than 50 million, and that it is
                                                    sources, as well as their Web site                      technologies? To what extent do costs,                predicted to continue to increase. Given
                                                    address, if any.                                        socioeconomic status, and digital                     these statistics, it is imperative that we
                                                       23. We seek any other comment,                       literacy issues impact adoption?                      do what we can, within our statutory
                                                    information, and data concerning the                       26. We request information on any                  authority, to promote the goal of making
                                                    RHC Program as well as the general                      studies, pilots, research, or other data              broadband-enabled health technologies
                                                    needs of rural consumers for broadband-                 that quantifies the benefits of                       and cutting-edge health and medical
                                                    enabled health solutions that would be                  broadband-enabled health technologies                 devices and applications available,
                                                    helpful to the Task Force, given its                    in improving patient outcomes and in                  accessible, and usable by people with
                                                    charge and objectives.                                  reducing costs. What kind of return on                disabilities.
                                                                                                            investment have pilot and                                Technology has historically played an
                                                    Objective IV: Raise Consumer                            demonstration projects experienced?                   important role in the disability
                                                    Awareness About the Value Proposition                      27. We are interested in learning how              community. Many people with
                                                    of Broadband in the Health Care Sector                  broadband can enable healthcare-related               disabilities use communications
                                                    and its Potential for Addressing Health                 support systems to connect patients to                technology, devices, or services in their
                                                    Care Disparities                                        the people, services and information                  daily lives, and broadband is becoming
                                                      It is critically important that                       they need to get well and stay healthy.               an essential data transmission platform
                                                    consumers fully understand the                          In this regard, physicians inform us that             that enables a wide range of services
                                                    practical and personal benefits of                      there is growing recognition that the                 and tools. Ensuring that people with
                                                    broadband in health care and in                         need for social services and supports                 disabilities are able to access electronic
                                                    facilitating greater care coordination,                 (e.g., nutritionists, dieticians,                     health records, engage in video
                                                    proactive engagement in disease                         pharmacists, family caregivers, fitness               consultation with their physicians, fully
                                                    prevention, and self-management.                        centers, and other health care supports               utilize the latest health apps, and
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                                                    Placing more care decisions in the                      or supporters outside the traditional                 benefit from advances in wearable
                                                    hands of consumers and personalizing                    hospital setting) significantly impact the            health technology, for example, are
                                                    that experience appears to be a major                   ability of some consumers to become                   essential to the ongoing health care
                                                    theme in health applications and                        healthy and stay well, and that the                   transformation. Consistent with its
                                                    product development today. We also                      availability of broadband is increasingly             charge, the Task Force will consider the
                                                    recognize that as consumers fully realize               essential to bridging the various services            extent to which broadband-enabled
                                                    the practical health benefits of                        and supports. We seek comment and                     services and technologies used for the
                                                    broadband, consumer demand for                          suggestions on how the Commission can                 provision of health and care are


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                                                                           Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules                                             21787

                                                    available, accessible, and usable by all                disabilities, especially given our                    areas, we seek information on the
                                                    Americans, including those with                         authority?                                            approaches that such countries took
                                                    disabilities. We therefore seek any data,                                                                     (including lessons learned) in achieving
                                                                                                            Objective VI: Highlight Effective
                                                    information, and comment that will                                                                            success in broadband health adoption.
                                                                                                            Telehealth Projects, Broadband-Enabled
                                                    assist the Commission in better                         Health Technologies, and mHealth                      Objective VII: Engage a Diverse Array of
                                                    understanding how it may assist in                      Applications Across the Country and                   Traditional and Non-Traditional
                                                    achieving these important goals.                        Abroad—To Identify Lessons Learned,                   Stakeholders To Identify Emerging
                                                       30. How are broadband-enabled                        Best Practices, and Regulatory                        Issues and Opportunities in the
                                                    health technologies and medical devices                 Challenges                                            Broadband Health Space
                                                    currently being used by people with
                                                    disabilities? To what extent can these                     Related to the objective of increasing                Published reports indicate that the
                                                    technologies and devices address the                    consumer awareness about the practical                ‘‘the health IT industry is gaining a
                                                    health care needs of people with                        health-related benefits of broadband is               reputation as an emerging sweet spot for
                                                    disabilities in the future? Provide                     the need to inform the public—                        technology investors.’’ We want to be
                                                    specific examples of the existing                       especially those in rural and                         sure that Commission policies do not
                                                    barriers, if any, that these technologies               underserved regions—about the                         present obstacles to continued
                                                    and devices pose for people with                        availability and successes of the many                innovation and investment in
                                                    disabilities.                                           broadband-enabled telehealth and                      broadband-enabled health technologies,
                                                                                                            telemedicine centers and projects across              including medical devices that rely on
                                                       31. We seek comment on whether the
                                                                                                            the country and abroad, as well as                    communications technology. We
                                                    design and development of broadband-
                                                                                                            existing and emerging mHealth                         observe that there is a growing desire for
                                                    enabled health services and
                                                                                                            applications, and to identify lessons                 such technologies—including those that
                                                    technologies, as well as cutting-edge
                                                                                                            learned and best practices.                           are wearable or otherwise track and
                                                    health and medical devices and                             34. We seek current information and
                                                    applications, are accessible to, and                                                                          monitor personal health—and that this
                                                                                                            data on the effectiveness of broadband-
                                                    usable by, people with disabilities. Are                                                                      emerging health market is estimated to
                                                                                                            enabled telehealth and telemedicine
                                                    there practical concerns or other issues                                                                      be worth billions. There are also
                                                                                                            services, including any recent research
                                                    that are inhibiting or limiting the use                                                                       countless smartphone apps that track
                                                                                                            on these services. How are patients
                                                    and availability of broadband-enabled                                                                         health-related issues. By some
                                                                                                            responding to these services? We are
                                                    health services and technologies for                                                                          estimates, there are over 100,000 digital
                                                                                                            particularly interested in receiving
                                                    people with disabilities? How are                                                                             health apps offered in the three major
                                                                                                            comments directly from consumers
                                                    hospitals and clinicians currently                                                                            app stores. In addition, recent advances
                                                                                                            about their experience with these and
                                                    addressing, if at all, any of these issues?                                                                   in broadband-enabled sensor technology
                                                                                                            other broadband-enabled services and
                                                    An increasing number of health care                                                                           offer the potential for the emergence of
                                                                                                            technologies.
                                                    services provide patient portals for                       35. We also seek comment on specific               more convenient and ultimately less
                                                    patients to access medical records and                  challenges faced by states, localities,               costly and less invasive health care
                                                    communicate with physicians and                         and Tribal governments, as well as                    solutions. For example, we may soon
                                                    specialists. What measures are taken to                 communities abroad, in deploying                      see the widespread use of smart clothing
                                                    ensure that these mechanisms are fully                  effective broadband-enabled telehealth                (or smart ‘‘tattoo’’ applications) that use
                                                    accessible to users with disabilities (e.g.,            and telemedicine projects.                            skin-based sensors to measure things
                                                    accessible via screen readers used by                      36. We seek comment on how the                     like heart rate, respiration, and blood
                                                    individuals who are blind)?                             public can be better informed about the               pressure. Robotics, virtual reality, and
                                                       32. To what extent are clinicians                    availability of broadband-enabled health              other consumer facing health
                                                    aware of video relay service (VRS) and                  services and technologies and mHealth                 technologies also offer the potential to
                                                    using it when remotely consulting with                  applications. What have states,                       help older Americans live more
                                                    American Sign Language (ASL) users on                   localities, other federal agencies, Tribal            independently. Some technology
                                                    a telephone call? Is there a need for VRS               governments, and hospitals and clinics                companies are even experimenting with
                                                    providers to have ASL interpreters with                 done to inform the public about the                   combining web search with online
                                                    a knowledge of (and ability to translate)               availability of these options? How                    health consultations for a one-stop
                                                    specialized health or medical                           effective have these projects been in                 offering. To help inform the
                                                    vocabulary? Should a VRS call that                      promoting greater broadband                           Commission in its related and other
                                                    involves consultations between a deaf or                utilization?                                          efforts in this area, we seek comment
                                                    hard of hearing person and a doctor be                     37. We seek submissions of any case                and information on these and other
                                                    given priority over other calls waiting in              studies, research and video/audio                     emerging health technologies,
                                                    a queue, especially when there is a                     summaries concerning recently                         applications, services, and connected
                                                    possible medical emergency? We also                     launched applications/programs that are               medical devices.
                                                    seek comment as to whether our                          on the cutting edge of telehealth,                       39. We seek comment on any
                                                    telecommunications relay service (TRS)                  telemedicine, mHealth, and other                      emerging issues of concern (that have
                                                    rules are currently optimized to                        broadband-enabled health technologies                 not been identified in this Document)
                                                    encourage medical consults via                          and services.                                         that potentially impact efforts to
                                                    telemedicine?                                              38. We seek comment on the extent to               accelerate the availability of broadband-
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                                                       33. We seek suggestions as to how the                which the United States is not taking                 enabled health technologies and
                                                    Commission can effectively raise                        full advantage of the opportunities that              services, as well as medical devices that
                                                    awareness among people with                             broadband-enabled health technology                   rely on communications technology.
                                                    disabilities about the value proposition                provides. For countries that have been                   40. While the United States has made
                                                    of broadband in health? How can the                     the most successful in making                         great strides in recent years, many
                                                    Commission help to enable the adoption                  broadband-enabled health services and                 advances in digital health technologies
                                                    and accessibility of such services and                  technology more widely available,                     are still not broadly available, widely
                                                    technologies among people with                          especially in rural and underserved                   utilized, or well-tailored to meet the


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                                                    21788                  Federal Register / Vol. 82, No. 89 / Wednesday, May 10, 2017 / Proposed Rules

                                                    needs of all Americans. We seek                         raised in this Document are strongly                  Replies to an opposition must be filed
                                                    comment on these concerns.                              encouraged to file a memorandum in the                on or before May 26, 2017.
                                                       41. What are the emerging                            docket, summarizing their discussion
                                                    opportunities for investors, innovators,                                                                      ADDRESSES:Federal Communications
                                                                                                            and/or information.
                                                    and entrepreneurs in the broadband                                                                            Commission, 445 12th Street SW.,
                                                                                                            Federal Communications Commission.                    Washington, DC 20554.
                                                    health space and in the development of
                                                                                                            Marlene H. Dortch,
                                                    the next generation of connected health                                                                       FOR FURTHER INFORMATION CONTACT:
                                                                                                            Secretary.
                                                    technologies and converged medical                                                                            Mark Montano, Wireless
                                                    devices? We seek suggestions on any                     [FR Doc. 2017–09309 Filed 5–9–17; 8:45 am]
                                                                                                                                                                  Telecommunications Bureau, (202) 418–
                                                    efforts that the Commission might                       BILLING CODE 6712–01–P
                                                                                                                                                                  0691, email: mark.montano@fcc.gov.
                                                    undertake to support innovation and
                                                                                                                                                                  SUPPLEMENTARY INFORMATION:      This is a
                                                    entrepreneurship in these areas. Are
                                                                                                            FEDERAL COMMUNICATIONS                                summary of Commission’s document,
                                                    there emerging or non-traditional
                                                                                                            COMMISSION                                            Report No. 3077, released May 1, 2017.
                                                    stakeholders that should be part of the
                                                                                                                                                                  The full texts of the Petitions are
                                                    Commission’s efforts? If so, please                     47 CFR Parts 1 and 54
                                                    identify them and their respective roles                                                                      available for viewing and copying at the
                                                    in or contributions to the broadband                    [WC Docket No. 10–90, WT Docket No. 10–               FCC Reference Information Center, 445
                                                    health space.                                           208; Report No. 3077]                                 12th Street SW., Room CY–A257,
                                                       42. We seek comment on how to                                                                              Washington, DC 20554 or may be
                                                    promote small and diverse investors,                    Petitions for Reconsideration and/or                  accessed online via the Commission’s
                                                    innovators, and entrepreneurs in the                    Clarification of Action in Rulemaking                 Electronic Comment Filing System at
                                                    broadband health sector in order to                     Proceeding                                            http://apps.fcc.gov/ecfs/. The
                                                    better ensure that the benefits of                      AGENCY:  Federal Communications                       Commission will not send a
                                                    broadband-health technologies and                       Commission.                                           Congressional Review Act (CRA)
                                                    services are available to all Americans.                                                                      submission to Congress or the
                                                                                                            ACTION: Petitions for reconsideration
                                                       43. We seek to engage all potential                                                                        Government Accountability Office
                                                                                                            and/or clarification.
                                                    stakeholders in this national broadband                                                                       pursuant to the CRA, 5.U.S.C. because
                                                    health effort. Commenters should                        SUMMARY:   Petitions for Reconsideration              no rules are being adopted by the
                                                    identify any additional stakeholders that               and/or Clarification (Petitions) have                 Commission.
                                                    are not specifically referenced in this                 been filed in the Commission’s                          Subject: Connect America Fund;
                                                    Document. We also encourage parties to                  rulemaking proceeding by Caressa D.                   Universal Service Reform—Mobility
                                                    identify any other relevant issues (not                 Bennet, on behalf of Rural Wireless                   Fund, Report and Order, FCC 17–11,
                                                    covered in this Notice) for the Task                    Association, Inc.; Krista L. Witanowski,              published at 82 FR 15422, March 28,
                                                    Force, given its charge and objectives.                 on behalf of CTIA; Brian Gelfand, on                  2017, in WC Docket No. 10–90 and WT
                                                       Administrative Matters. Because this                 behalf of Buffalo-Lake Erie Wireless                  Docket No. 10–208. This document is
                                                    Document does not itself initiate a                     Systems, L.L.C. (Blue Wireless); Robert               being published pursuant to 47 CFR
                                                    ‘‘proceeding,’’ responses to the                        A. Silverman, on behalf of Panhandle                  1.429(e). See also 47 CFR 1.4(b)(1) and
                                                    Document are not ‘‘presentations’’                      Telephone Cooperative, Inc. and Pine                  1.429(f), (g).
                                                    subject to the prohibitions in restricted               Belt Cellular, Inc.; John Prendergast, on               Number of Petitions Filed: 7.
                                                    proceedings and the disclosure                          behalf of the Blooston Rural Carriers;
                                                    requirements in permit-but-disclose                     David A. LaFuria, on behalf of Rural                  Federal Communications Commission.
                                                    proceedings. Nonetheless, parties                       Wireless Carriers; and Cathleen A.                    Marlene H. Dortch,
                                                    discussing or providing information to                  Massey, on behalf of T-Mobile USA, Inc.               Secretary.
                                                    the Task Force or any other members of                  DATES: Oppositions to the Petitions                   [FR Doc. 2017–09462 Filed 5–9–17; 8:45 am]
                                                    the Commission regarding the issues                     must be filed on or before May 16, 2017.              BILLING CODE 6712–01–P
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Document Created: 2017-05-10 00:00:57
Document Modified: 2017-05-10 00:00:57
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionProposed Rules
ActionRequest for comments.
DatesSubmit comments on or before May 24, 2017, and reply comments on or before June 8, 2017.
ContactFor further information about this Document, please contact Ben Bartolome, Special Counsel, Connect2HealthFCC Task Force, at (770) 935-3383, or via email at [email protected] (inserting ``Question re GN Docket No. 16-46'' in the subject line). Press inquiries should be directed to Katie Gorscak, Communications Director, Connect2HealthFCC Task Force, at (202) 418-2156, or via email at [email protected] For additional information about the Connect2HealthFCC Task Force, please visit the FCC's broadband health hub at http://www.fcc.gov/health.
FR Citation82 FR 21780 
CFR Citation47 CFR 1
47 CFR 15
47 CFR 20
47 CFR 54

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