Efforts to increase the transparency of Oklahoma Universal Service Fund recipients and how hospitals use Internet services for telemedicine were among the topics discussed Tuesday at the Oklahoma Corporation Commission.
The commission's public utility division held the second of three technical conferences on proposed changes to the state's Universal Service Fund, which comes from fees tacked onto landline and wireless telephone customers in Oklahoma.
A portion of the fund goes to telemedicine services, but there has been concern providers have been overselling equipment and services to hospitals beyond what they need. Reimbursements for telemedicine made up the largest part — $27.8 million — of the $32 million paid out by the Oklahoma Universal Service Fund in fiscal year 2013.
Commission staff asked representatives from Cox Communications, AT&T Inc. and other providers what kinds of issues were unique to the pricing of broadband Internet for telemedicine.
“Our concern is that to the extent something is free of charge, there may not be that much incentive to shop around various carriers,” said Maribeth Snapp, the commission's telecom policy director.
Debi Sovereign, a consultant for the Telehealth Alliance of Oklahoma, said timing is critical for emergency telemedicine. She said bandwidth and latency, or lag in the connection, are keys to effective telemedicine support.
“The more bandwidth you have, the smaller your latency,” Sovereign said. “Latency is critical, for example, when you're watching a heart and need to see the waves in that heart. It's a motion that you're looking for, and if you have any latency at all, then you might miss something. That is one of the things that is driving bandwidth.”
Sovereign said hospitals have requirements for pricing and competitive bidding. She said they try to get at least two or three bids on telemedicine contracts.
Pam Forducey, director of telehealth for Integris Health, said Integris uses its broadband connections for distance learning and education as well as stroke, neonatal and speech therapy consultations. Integris has done more than 700 TeleStroke consultations with patients in rural hospitals, she said.
“It truly is life and death,” Forducey said. “Every minute, a million brain cells die. ... We're doing other applications with NICU (neonatal intensive care unit) babies who are transferred from small hospitals in Oklahoma, where the parents can see the progress in real time.”
Brandy Wreath, director of the commission's public utility division, said the staff wasn't interested in limiting telemedicine services. The commission would probably look at what's needed on a case-by-cases basis for hospitals and clinics that need broadband services at higher levels than most others.
“But we need to look at if there are other alternatives to compounding bandwidth or are there ways to control the flow in that bandwidth that is awarded?” Wreath said. “... We want to get away from allegations of overselling and allegations of oversubscription and just have data that says this is what we need and why.”
The Oklahoma Universal Service fund also provides discounted or free telecommunications services to schools, libraries and low-income consumers. It is a companion program to the federal Universal Service Fund, which has different rules.
set Sept. 12
The state Corporation Commission's third technical conference on changes to the Oklahoma Universal Service Fund will be Sept. 12 in Oklahoma City.