Internet Availability with Chris Hutchings

I see the lack of access to the internet as a brick wall. I believe we're at an important time in history right now. we can make investments and we can do the hard work of bringing the right people together and having the right conversations and we can create a foundation that will bring returns to generations that go beyond us. You can do more than you think is possible. Healthcare can be such an inspiring voice for people to come together and make it happen

welcome to a virtual view where we talk about telehealth, healthcare and everything in between.

I have the pleasure with speaking with Chris green today on our podcast to talk a little bit more about. Broadband. Chris, why don't you give a little bit of an introduction to our audience of just your experience in broadband and just a little bit of information about your.

Sure. I'm Chris green Hutchings and I'm the program manager for the Michigan moonshot which is a collective call to action to bridge the digital divide here in Michigan. We are working in collaboration with merit network and some other nonprofits based here in Michigan. And our goal is to work with. Local communities that want to expand the number of residents that have access to broadband. So maybe I'll back up a little bit and talk about how I ended up in this role. I graduated years ago with a degree in liberal arts and shortly thereafter, I moved back to my hometown of traverse city, Michigan, and I was working in a small medical clinic there in town, and really got to see that great cross section of society that you get exposed to when you work in the healthcare field. And ultimately we decided to relocate to Anarbor and I then took a job at Michigan medicine this time in the information technology department. And I worked there for many years worked. To being the chief of staff for the it department there. Obviously we did quite a bit of networking at that time the concept of telemedicine was pretty new. It was more of an experimental thing that maybe we might dabble with on the side, trying to think through the networking implications of having, access to, proprietary and protected health information at a remote location. You guys remember. And then I moved over to Beaumont health, which is another large healthcare provider here in Ms. To head up their office of the chief information officer. Now, while I was working at Beaumont, one of the many duties that I had was promoting telehealth use Beaumont had about 4,000 physicians that were working with us in one capacity or another. And We started doing these road shows where we would, provide dinner for and a presentation about how telemedicine was the future and people should really sign on. And after doing this for well over a year, I think we had gotten a few times. Uh, Providers to sign up. And so it was still something that we were promoting at the time when the COVID-19 pandemic surfaced in Michigan. And for those first, oh, I don't know, two months let's say that it was in Michigan. Beaumont health was really the epicenter of the care that was being provided to COVID positive patients at that time. At that time, Beaumont had eight hospitals around the Metro Detroit region. And I remember there was a time when about 80% of the people who were COVID positive in Michigan were in one of our hostile. And then they had asked Beaumont asked staff if they would like to be reassigned to help address the COVID pandemic. And I raised my hand and I got to work in our emergency response center and it was. A very exciting thing for me to do because I felt so close. We put together these dashboards so we could see, how many people are waiting at each of our ERs. How long have they been waiting? How many people are in beds? Looking at all of the the key information that we need to look at to manage resources across this large health system. And it was so exciting to me to be so close to patient care. I think I had forgotten, that back in those days, working at that small. How neat it was to be able to interact directly with patients. I remember, back in the day I used to cover for our receptionist at lunch. So I would see all of the patients that came in and help them, fill out their paperwork back in the day and working in the emergency management center was a way for me to. I feel a lot closer to those health outcomes. So when the opportunity came to be a part of the Michigan moonshot and translate my knowledge of healthcare and my knowledge of technology into something that is going to help improve overall health in Michigan, I was really excited about this job and I still can't believe that I have this job because I'm so thrilled to be able to take these things that I know and put them into practice. So I'm just really happy that I can work with communities and help them find a path because let's face it. There are a lot of people who would benefit from telemedicine that just can't get internet at their house.

Yeah, absolutely. And it's great to hear, you've had the experience from multiple different perspectives and, when it comes to broadband, there's so many different disciplines that, that touches. So you know, the variety of different experiences they've, you've been able to have. I think really helps to build a good foundation understanding of the need for broadband access as well as to have, the technical expertise to be able to work in that particular space.

yeah, it's been helpful. It's also, interesting because when you work with technology specifically infrastructure like fiber internet it's so much more clear cut than. Modern health care, right. working, especially with these large health systems, they're almost like a university where there are all of these different disciplines and leaders and, strategic directions that somehow come together and have to work together. Where, as when you're working at an organization that's providing, middle mile infrastructure, like it's pretty clear exactly what we do. And how we work together and make it happen. It can be difficult for people who are in those more straightforward industries to understand why is it so hard to work with healthcare? There's definitely some value in being able to understand the intricacies of how decision-making happens in a complex organization and the interplay of interests. So for many years both at Michigan medicine and it. I was involved in it governance specifically. Decision-making about how to invest money that had been set aside for information technology projects. I wish the general public knew how earnest. People in healthcare, we're about trying to do the very best thing and do the most good with the minimal amount of money that is available.

Yeah, absolutely. And, as you, you made this transition to work with a specific broad band focused in the midst of the pandemic. And so I'm curious, what did broadband access look like in Michigan prior to the pandemic? And has there been significant strides and improving broadband access across the state during the pandemic?

Sure. The assessment that was done just prior to the pandemic, I believe was in 2018, we assessed that there are about 350,000 households in Michigan that cannot get internet access for love or money. And I want to give you some examples just within the last two months, I spoke to someone about a week ago, who said that they called the nearest internet service provider and said, what can I do to get internet at my house? And the service provider said, it's expensive for us to invest in, this hardware we have to install to get to your house. But, it would probably cost if you could pony up about $11,000, we might be able to make that happen.

Wow.

And then probably two weeks before that I was in a meeting with someone else, similar situation, she called her local ISP. They said, there's a gap of about $60,000 to get internet to your area. And so unfortunately, the benefit during the pandemic was that everyone became very suddenly aware that this was a problem. There's something we call the education gap which was quantified in a research that merit network did with the Quello center in Michigan state university, where they looked at a variety of school districts around the state. And we're able to actually assess the difference in student performance between students who had internet access at home and those who did not. And there's some really great summaries out there if you want to read more, but I'll just leave you with this little piece, is that students who do not have internet access at home on average, they have a half a grade lower than the students who do. And they are awareness that came out of the pandemic that we needed to address those issues. The majority of the work that was done to provide internet to cover those gaps during the pandemic were temporary measures. So they were things like lending hotspots to people to take home helping people cover the cost of the increased data cap on their cellular plan so that they could use their cellular phone as a hotspot for a device at home. And then there were some creative solutions. People were driving buses around that would provide wireless service. We'll be in your neighborhood from nine to noon on Tuesdays, come outside and sit in a launch. And do your homework then. The good news is the pandemic inspired people to realize there was a problem and take action for it. The challenge there is. It takes quite some time to plan and raise the funds for, and build the infrastructure that is missing to get internet service to these neighborhoods and homes that do not have it today.

Yeah. And it's interesting to see, that's why some of these creative solutions have. Been birthed out of this particular issue there's a lot of money to, bring that broadband, especially when you're looking at. More rural areas or perhaps you're looking at areas where there's perhaps terrain that makes it difficult to put in cables, such as water mountains, things like that. To where, they're having buses that drive around and provide wifi as well. As we've seen several. Throughout the pandemic several libraries that are starting to, allow people to come into their parking lot, get access to wifi through that means as well. And these are good. But I guess from those who maybe aren't as familiar with what the process is of installing fiber and maybe why it's so expensive. Can you just elaborate on that for a little bit?

Sure. I will admit that most of my work is done with community organizing and on the planning side. And we do have people that are engaged here at merit network who work with communities to do the engineering and the planning and the project management for the construction. But I guess that's the key word right? There is construction. So in order to get, reliable high-speed internet to folks we're talking about building something and like many things that rely on power, the further away you get from the source, the weaker the signal is. Let's say you're going to run fiber optic cables out to a tower. And from that tower, you're going to transmit a wireless signal that people can then receive in their homes through a special, recent. Even if we're talking about something as simple as that there's a limited range which that tower's going to be able to serve, and you've got to pay for running the wire out there. Finding the site, building the tower, installing the equipment that's on the tower, installing the equipment that's in the home. And so I guess what my point is, either way you slice it, we're talking about constructing thousands and thousands of miles of fiber optic infrastructure and the other challenges, even if fiber optic cable is running down your street, there may not be a drop where it can actually come to your home and it costs money for the company to come in and install that drops so that you can. So one of the reasons it costs a great deal and take some amount of time is that we're talking about infrastructure. I know there was a time when people would think about high-speed internet in the same way we might think about cable TV oh it's something nice to have, but it's a luxury, it's not something you need, you can get by without it. Today. I think we could all agree that having access to high-speed internet is a lot more like water electricity and heat. It is critical. So here's a great idea. I was at the Michigan rural health conference just last month. And I was talking with two case managers from spectrum who work in rural counties here in Michigan. And one of them said to me, a big part of our work is going out to the patient's home and helping them figure out how they can access services online. And she said, it's a real problem because. Many of our patients don't have internet at home, but air even areas in Michigan. And I'm sure there are in other areas of the Midwest that don't even have cellular service. So here are these case managers coming into a home and they're planning to use their cell phone as a hotspot so they can help this patient go online and apply for the services they need and they still don't have access and more and more government services are moving online. So I think we can all agree that it's become a necessity for life in the 21st century.

Absolutely. That's a great point. It's a necessity, just like water and electricity. to build. Broadband infrastructure into a mountain is an astronomical task. And so for the individuals that are living in those communities it's difficult to even get. Government support or other support, that's going to be substantial enough to really help bring those resources to them. And it's sad to see that in some of these communities that, because of the cost and because it is infrastructure, that it is so difficult to be able to get these communities connected to these resources.

But it is an exciting time right now because last November Congress passed the infrastructure, investment and jobs act. And in that there are over $48 billion in programs that are dedicated to getting broadband. To places like that, places that are on the side of a mountain, places that are on islands, places that are out in the middle of a very lowly populated area where a regular telecom company would never build infrastructure because they can't expect to generate a profit from that infrastructure. So it's a really exciting time because what seemed impossible before is becoming past.

Absolutely. And we've seen more state governments really. Focus on this as a particular concern. I know in Indiana specifically, there was a large amount of funding from the state that went out to broadband initiatives. And and I do want to mention, the few examples we've talked about is more rural, but urban communities too, still struggle with having, high speed internet. And that becomes a problem for all of the reasons that Chris and I. I already mentioned here. So it's not a issue specific to rural. A lot of our urban communities, suburban communities may have some of these similar struggles as well.

It, and it comes from that history of this not developing as public infrastructure, but as private for-profit. And that made sense until it became a necessity for daily life. So now the government is stepping in and making the means for us to make that happen. However, I really. I was glad to be invited on the show today because I really want to share that message that it's not guaranteed that your community or the community where your patients reside is going to receive the funding and be able to build this infrastructure unless someone is taking proactive measures to make sure it happens.

Absolutely. So how can organizations help address some of these broadband challenges that their communities face.

I think the first and most important message I want to share. You can do more than you think more than you think is possible. And it requires a few, probably like most good things, right? A few passionate stakeholders. One rather simple thing that can make a big impact is if you are with a local healthcare provider, Really does not matter the size of the organization, writing a letter to your county board of commissioners on behalf of your organization and letting them know about the impact that access to high-speed internet could have on the health of people in the county can make a huge impact on whether or not your county, your leadership at the county level decides are we going to invest on. Expanding animal control or do we want to invest in getting some of our most disconnected residents connected to the services? That can make a big difference. Other ways that people can get involved is coalition building. So libraries are very interested in this. I think I've mentioned local governments, but oftentimes there are nonprofits starting the conversation amongst other human services groups that are in your area. It doesn't mean that you have to own making it happen. But healthcare can be such an inspiring voice for people to come together and make it happen. Because as I mentioned before, It's not guaranteed that any community is going to get the funding that they need to build this, unless they have some powerful local stakeholders who were willing to work together to advocate for putting together a plan, putting together grant proposals and ultimately overseeing construction, whether that's managing it within your locality or partnering with, a technology committee. There are many roads forward, but they all start with local conversations.

I think an important piece that you touched on there is, it takes a collaboration amongst multiple industries and specialties to really make this happen. we know this is an issue for our patients and is impacting access to care for our patients. And so how can we work with these different community leaders, non-profits governments technology companies to see how we can come together really help meet the need of this. And I think, that takes some of the pressure off It's not saying that, health care organizations figure it out, you know, you can do it.

You're smart. You have people.

It's going to be one of those things of, really leaning into multiple different specialties and seeing how you all can work together to solve that

yes. I see the lack of access to the internet as a brick wall. So if I was coming at that from a healthcare provider perspective, I would say, oh, I want to reach out to these patients. Oh, hit a brick wall. They don't have access to the internet. I guess I have to turn around now. And what they don't know is on the other side of that brick wall are dozens of people, organizations, people like the Michigan moonshot. I want to bring that wall down. And the people on the other side of the wall have the tools. They have the know-how, they have the connections, they're all set. They just need someone to push on the wall and they will help bring it down. That's why I want people who are involved in the healthcare industry to know, The people who you want to work with to make it happen, are out there and they're ready to work and they will be inspired to make it happen. If you can work with.

Yeah. And I think, that's.

That's

the thing with a lot of, some of these large issues and to your point, Chris, really knowing that there are resources out there and sometimes that can be the biggest barrier. You just don't know who's working in that area, what organizations are doing this and unless you're sitting down and. Really researching what organizations are there or you happen to just stumble upon someone. It can be hard to make some of those connections. And But when you can make those connections, how much of an impact that can have, and, we're always looking to see how can we have collective impact in our communities. And we can't do that in silos. We do have to work with others and figure out opportunities to collaborate in order to make that happen. And you've hit on it a few times and I wanted to just dive into this a little bit deeper. We've talked about. The lack of broadband or lack of high-speed internet, impacts access for care for patients. But broadband specifically has been called out as the super social determinant of health. So can you just explain a little bit more from your perspective why broadband now is being called out as, an even larger predictor of poor health outcomes? If it can't be addressed.

Yes, I'm glad you brought that up. Cam. I think there's a fairly common way of talking about social determinants of health. That goes something like this, to 55 year old males walk into an emergency. And, without knowing anything about their medical history or their genetic code, I can tell you what their outcome is going to be based on the zip code on their driver's license. And then that kind of starts the conversation about there are these factors that need to be overcome in order for us to have a healthier in a similar way, a study was done that was published earlier this year about COVID mortality. And they found that the number one factor that correlated with COVID mortality was internet speed at home. Sorry, I'm getting a little worked up here. I just think that's absolutely ridiculous. That is as upsetting thinking about that. It's your zip code, but even that, because we know there are situations where one neighborhood has internet and the next doesn't and. Knowing that not only information is power, apparently information is health. And how do we make that happen? I'm here to tell you there, there is a way to make that.

It's always heartbreaking to hear that when you live in a community where you have easy access to broadband or high speed internet that we often take for granted is such a predictor for health for communities outside that maybe don't have access to those resources.

The things that's frustrating cam is that. Years ago, the federal communications commission created this working group called connect to health and this task force put together a map where they overlaid. A map, showing access to broadband with a map of healthcare outcomes. And that's been around since 2016. And then they came back around in, I believe it's 2019 and they identified counties. Around the United States that were most in need of investment to increase access to high speed internet, because they were certain, it would improve health outcomes in those counties. And five of those counties are right here in Michigan. And as far as I can tell, I've not been made aware of any investment in those counties to. And that's one of those frustrating things we have right. Where we know there's good information, but how do we get it into the right hands? The business case is certainly there.

Yeah when we have access to this information, making sure the individuals who are making decisions on either where the money goes for those particular projects or has the know-how to make it happen really has that information and can move things forward. And I think with the COVID-19 pandemic, as we've talked about, it has placed a very special spotlight on this particular issue. We had children that for the first time, we're having to figure out how to do virtual school and the assumption that every child that was in school had access to internet. If anyone has. Assumption before that was shot in the past two years. And so I, I feel encouraged that, there's been a lot of hardship that has come through the pandemic, but highlighting some of these issues and bringing more attention to some of these issues is something that I think will have a lasting impact for broadband access in communities.

Yes. I believe we're at an important time in history right now. Where we can make investments and we can do the hard work of bringing the right people together and having the right conversations and that we can create a foundation that will bring returns to generations that go beyond us. And that's a very exciting prospect for us to be able to have that kind of impact.

Absolutely. And that is always one of our biggest hopes when we're working in healthcare is how do we build a better foundation for the future and how do we address. Some of the inequality that exists in our current system to provide equitable care to all communities, regardless of where they're located, regardless of their racial or ethnic background. And I think it's encouraging to see what some of this will look like in the future. And even some of the changes that we've already seen. In the past couple years, and, as we get close to wrapping up our time today, Chris, I want to give just a little bit of time for you to talk through. Are there any other resources that you would recommend for an audience if they want to learn more about broadband, if they want to learn more about, how does broadband impact health what are some resources that you would share with them?

So first and foremost our website, Michigan moonshot.org. We have a great deal of information. We have webinars on a regular basis. We have a great educational resource called the broadband framework that is soup to nuts from the beginning of what exactly is broadband all the way to, maybe you decide that you want to run broadband for your for your community. So it's everything in between. It's all online and free. We have, other things such as, newsletters and. We have two wonderful annual events that people might be interested in as well. But there are some other organizations out there who are also doing great work in this space. I want to recommend the tele-health equity coalition, which I think is how you and I met camp. The insure the uninsured project they are actually doing. Quite a bit in the realm of what we would call digital equity and how that contributes to the health of folks who are uninsured, actually health.gov has information about internet access. of course I recommend the tele-health resource centers and the rural health information hub. They both have good information if you're looking for it.

Those are all great resources, Chris. And I just want to thank you just for, taking some time just to come and chat with us about broadband. I'm looking forward to being able to have conversations with you more in the future. But just want to thank you for your time and for your expertise today.

thank you so much for having me.

Thank you for listening to a virtual view. You can find more information about today's episode in the show notes below. If you would like to support our podcast, please rate and review us on your favorite podcast player. Do you have any questions or topics you'd like us to discuss? If so, contact us at info at UMTRC dot org or through the form found in the show notes. Also, we'd like to give a special thanks to our editor. Finally a special thanks to the health resources and service administration. Also known as HERSA. Our podcast series of virtual view is sponsored in part by hearses telehealth resource center program, which is under hers is office of the administrator and the office for the advancement of tele. The content and conclusions of this podcast are those of Cameron hilt of the UMTRC and should not be construed as the official policy of, or the position of nor should any endorsements be inferred by HERSA, HHS, or the U S government. Thanks for listening and have a great day.