Deep divides in internet infrastructure across South Carolina persist, but with new data and a refreshed call to action brought by the COVID-19 pandemic, improvements seem more likely than ever.
Research commissioned by state health organizations show for the first time where residents can’t buy a reliable internet plan. The analysis found 193,000 households, or nearly one in 10 in South Carolina, don’t have a good connection.
BAMBERG, SC—Palmetto Care Connections (PCC) Chief Executive Officer Kathy Schwarting announces that Scott Moody has joined PCC as director of finance.
In his role, Moody oversees the financial operations of PCC including implementing financial policies, overseeing financial records, and completing assessments, reports, annual budgets and financial projections.
“In the past, PCC has contracted with an independent entity for financial services and audits, but as our organization continues to grow, it became more advantageous for PCC to establish more financial operations in-house,” said Schwarting. “Scott’s experiences and expertise in health care finance and management are tremendous assets to Palmetto Care Connections and we’re excited to have him on our team.”
Moody has more than twenty-five years of management, consulting and leadership experience in the areas of hospitals, non-profits, ambulatory surgery centers, large group physician practices and outpatient diagnostic centers. Prior to joining PCC, Moody was owner of Integritas, LLC, 2018 to present; director of practice operations for Surgical Specialists of Charlotte 2014-2017; practice management consultant for Mecklenburg Foot & Ankle Associates of Charlotte, 2013-2014; chief executive officer of Urology Center of Spartanburg and Lowcountry Urology Clinics, 2006-2014; practice management consultant Carolina Eyecare Physicians of Charleston 2005-2006; administrator, Trident Health System Ambulatory Surgery Centers in Walterboro and Charleston, 2000-2005; and executive director Lowcountry Area Health Education Center – MUSC, 19932000.
Moody received his Master in Health Administration degree from the Medical University of SC in Charleston and a Bachelor of Arts degree in political science from the College of Charleston.
Originally from Walterboro, S.C., Moody has lived the Spartanburg area for a total of more than ten years. He and his wife, the late Lynn Moody, have two grown children, son Marshall Scott Moody Jr. who is a student at the University of South Carolina – Upstate, and daughter Janice Elizabeth Moody who is a student at Converse College.
Moody is a member of El Bethel United Methodist Church in Spartanburg where he has served on the administrative board and has worked with the UMC Youth Group.
Established in 2010, PCC is a non-profit organization that provides technology, broadband, and telehealth support services to health care providers in rural and underserved areas in S.C. PCC leads the S.C. health care broadband consortium which facilitates broadband connections for health care providers throughout the state. PCC co-chairs the South Carolina Telehealth Alliance, along with the Medical University of South Carolina, partnering with health care organizations and providers to improve health care access and delivery for all South Carolinians.
While telehealth interests have been broadly served by Coronavirus relief bills to date, a group of lawmakers is looking for more support in the next package.
Led by Senator Brian Schatz (D-HI), a longtime supporter of connected health adoption, a group of senators is lobbying to add $2 billion to the next relief bill for broadband expansion, a key and often overlooked component to nationwide telehealth adoption. They’re calling on Congress to add that money to the Rural Health Care (RHC) Program.
“Congress must do more for our health care providers so that they can meet telehealth needs during the COVID-19 pandemic,” the senators wrote in a letter to Congressional leadership. “This additional support would expand the reach of the RHC Program to enable health care providers at non-rural and mobile health care facilities to engage in telehealth, eliminate administrative red tape that slows down the ability of front-line providers to obtain broadband connectivity, and provide more resources to current health care providers in the RHC Program so they can increase their broadband capacity to effectively treat their patients.”
Comprised of the Telecommunications Program, which makes up for the difference between urban and rural connectivity costs, and the Health Care Connect Fund, which covers as much as 65 percent of those connectivity costs, the RHC Program was established in 1997 and given a $400 million cap. In 2018, with demand for funding outpacing resources, the FCC added money to the fund.
But demand for rural broadband access is still growing, caused in part by an expansion of telehealth programs. To help healthcare providers and others looking to build out their telemedicine and mHealth platforms, the FCC has launched a three-year, $100 million Connected Care Pilot Program and, more recently, the $200 million COVID-19 Telehealth Program, the latter funded by the Cares Act.
Schatz and his colleagues – Senators Lisa Murkowski (R-AK), Angus King Jr. (I-ME) and john Boozman (R-AR) – say the ongoing COVID-19 emergency will add to the pressure on the RHC Program, as more and more providers turn to telehealth to improve access to care and payers ease restrictions during the pandemic to make that happen.
“The coronavirus pandemic has dramatically increased the need to expand telehealth so that health care providers can treat patients safely, without putting themselves or their patients at risk,” the senators said. “As a result, many health care providers are facing connectivity challenges in meeting this new demand for telehealth. It is imperative that Congress act to ensure our front-line responders have the tools they need to combat this deadly virus.”
In the weeks that have seemingly passed very slowly, we have learned these five things relatively quickly from being in public health emergency.
1. Bureaucracy impedes emergency response. Our governmental infrastructure is simply clunky in overly complicated ways. The best intentions behind legislative acts and executive orders have been gummed up by administrative and bureaucratic processes at both federal and state levels. The very system designed to appropriately bestow power has proven impotent amidst the public health emergency.
2. Policy has been out of sync. In a day when people carry around more technology in the palm of their hands than was used to land on the moon, it took COVID-19 to demonstrate that healthcare policy, which drives both reimbursement and access to care, has been running in last place.
3. People are always our best resources. When state and federal stockpiles of PPE came up short, every little old lady (myself included) came to the rescue by pulling out sewing machines and scrap fabric in an effort reminiscent of WWII bandage-making. Likewise, local restaurateurs have kept our COVID units fed even when their own businesses have been shuttered. Acts of charity and kindness, both big and small, have supported healthcare professionals on the front line. It has been a win for humanity.
4. Culture undergirds strategy. Organizations that are team-oriented and encourage collaboration have been more nimble than rigid top-down driven healthcare systems. Any effective emergency response relies not only on skill and training but also on innovation and mission. A healthy culture will stay grounded even when forced to color outside the lines.
5. Our reality has changed. Uncertainty and inconvenience have altered our sense of reality. The perception that we, as a society and as an industry, were unalienable has crumbled. Focusing on the greater common good and acknowledging past vulnerabilities will certainly shape more robust leadership as we move forward.
Of the lessons learned, the ones which have impacted us to our core will be what fuels survival and restored viability. Some of the challenges will remain out of our direct control. For those we will be forced to remain reactive. However, the things that are in our control—how we adjust, lead and serve—can be a positive impetus for any healthcare organization rising from the ashes.
Patty Harper
The coronavirus pandemic has slowed the momentum in growth for the healthcare industry this year, but experts say COVID-19 has brought opportunities for healthcare startups to succeed and innovate.
In 2019, billions were invested in digital healthcare companies, with $7.4 billion invested across 359 deals, according to Rock Health, a venture fund for digital health. A strong first quarter showed 2020 would have continued on that trend, but the pandemic caused investors to slow down, according to a panel of industry experts who spoke on Industry Update and Market Trends for HIMSS20 Digital. Moderator Indu Subaiya is a cofounder of Health 2.0 and senior advisor for HIMSS.
Still, digital communication companies are thriving amidst a boom in telemedicine brought on by the pandemic, while companies such as Doctor on Demand are hiring more physicians to meet the surge in virtual care.
Megan Zweig, director of research and marketing at Rock Health, said companies that strengthened during the recent period of growth are stepping up to challenges created by the pandemic.
“Without COVID, the story would have continued from last year as this was a healthy, growing space with a lot of momentum behind it,” Zweig said. “I think that momentum has turned into just incredible urgency and demand for communication, testing, monitoring, care – all of those things done at a distance.”
Zweig said $3.1 billion invested in 104 digital health companies at the start of this year indicates continued growth from 2019, a year that also saw Google purchase Fitbit. The pandemic has not caused all investors to stop funding healthcare companies, but that there are mixed feelings on how much capital will be available for startups this year, she said.
“A lot of them are still planning on deploying capital at the same rate they have in the past. Others said they are pulling back,” Zweig said. “The vast majority of them do believe healthcare startups are going to have a harder time raising capital this year than in the past.”
Zweig described the pandemic as a “stress test” for a healthcare system in which digital platforms had been strengthening in recent years.
Lawrence Byrd, technology evangelist for communications APIs for cloud-communications-provider Vonage, said many of Vonage’s customers are telehealth providers. Many have seen 20 times their normal traffic in the last few weeks.
“We’re seeing massive expansion of the use of telehealth, and I think it has gone very well,” Byrd said.
Part of what has allowed digital health platforms to find success is the fact that many applications had already been designed to meet HIPAA privacy standards, according to Byrd.
Panelists said privacy has become a growing concern for people using digital platforms such as Zoom. Use of “off-the-shelf” products in the education field has led to privacy and security threats, Byrd said.
“Tele-industry, much more mature. We have the applications,” Byrd said.
Many adequate applications for telemedicine already exist in doctors’ offices, and, since they are generally built in the cloud, they are easy to expand.
Jumping into the race for innovation has not been easy for all companies during the pandemic.
Home-test companies like EverlyWell initially saw an opportunity to produce COVID-19 tests, according to Jonah Comstock, Editor-in-Chief and Director of Content Development with HIMSS Media. The Food and Drug Administration initially indicated it would relax restrictions on producing tests, but walked that back out of concern for unvetted tests hitting the market.
“Similar to telehealth, they saw sort of a time to shine,” said Comstock, who said home-testing had otherwise begun to “arrive” before the pandemic. “This crisis is ultimately, once they work out all the kinks, is going to rush it into arriving even faster.”
With growing use of digital medicine will come a debate about how companies should be held accountable for their products, holding vast storages of private healthcare data, according to Travis Holt, CEO and cofounder at BCP Tech, a division of Brush Creek Partners. Recent data breaches, such as the one at Equifax, have raised awareness among consumers for privacy protection.
Precedent has been set for companies selling digital products. For instance, the buyers of Microsoft Office 365 agree in the terms and conditions not to hold the company responsible for the product’s use, he said. Holt expects the courts to decide in the next five or 10 years whether companies can similarly remove their liability when their products are used in sensitive industries such as healthcare.
“I think there’s going to have to be some tragedy and then some subsequent litigation,” Holt said. “As we dig into healthcare, which is a much more sensitive area, I think we’re going to see a shift in the way that’s perceived.”
Max Sullivan is a freelance writer and reporter who, in addition to writing about healthcare, has covered business stories, municipal government, education and crime. Twitter: @maxsullivanlive [email protected]
“Hello, this is Congressman Jim Clyburn. I proudly represent the 6th Congressional District of South Carolina. I also serve as the House Majority Whip, as Chair of the House Select Committee on COVID-19 and as Chair of the House Democratic Rural Broadband Task Force.
This week, members of our task force and the Energy and Commerce Committee Chair Frank Pallone unveiled our plan to connect all Americans to affordable broadband internet. The COVID-19 pandemic has laid bare the digital divide that exists in our great country.
Families that lack accessible, affordable high-speed internet are unable to work from home, learn remotely and consult with medical professionals via telemedicine. These are all critical components to our ability to be safe, healthy and productive during this crisis.
I am reminded of a book, The Next Greatest Thing, which chronicled our country’s rural electrification efforts in the 20th century. The title of the book came from comments made by a farmer speaking to a gathering in a small rural Tennessee church in the 1940s. He proclaimed, ‘Brothers and sisters: I want to tell you this. The greatest thing on Earth is to have the love of God in your heart. And the next greatest thing is to have electricity in your house.’
Just as the Great Depression made clear to many that electricity was the ‘next greatest thing’ in the 20th century, the coronavirus pandemic is making clear to all that broadband is the ‘next greatest thing’ for many in the 21st century.
Our announcement this week of the House Democrats’ plan to connect all Americans to affordable broadband internet is an updated and expanded version of the broadband provisions of our framework for Moving America Forward. It is the product of significant collaboration between the Rural Broadband Task Force, the Energy and Commerce Committee and many Members of the House Democratic Caucus.
Democrats welcome recent reports that Republicans support the idea of including broadband investment in upcoming coronavirus response legislation, and the President expressed the need for affordable universal broadband when I discussed it with him in an infrastructure meeting last year.
BAMBERG— As the nation battles the coronavirus, the need for telehealth becomes more apparent. Here in South Carolina, Palmetto Care Connections (PCC), a non-profit telehealth network, has been promoting telehealth to rural and underserved areas for more than a decade. With the coronavirus pandemic, the time for rural telehealth has finally come.
Since 2010, PCC helped rural health care providers implement telehealth solutions to see and treat patients virtually. “We focus on three areas of work – telehealth programs, broadband and technology for rural health care providers throughout the state,” said PCC Chief Executive Officer Kathy Schwarting. PCC leads the South Carolina Health Care Broadband Consortium, filing for federal subsidies that result in up to 65% savings on broadband, internet costs and equipment for rural providers.
“In 2019, PCC filed for $5,392,741 in broadband savings for S.C. health care providers, through the Health Care Connect Fund,” Schwarting said.
One of the health care providers that PCC has assisted is Bamberg Family Practice, a rural health clinic owned by Danette McAlhaney, MD. Dr. McAlhaney has been one of the first private practitioners to adopt telehealth in rural S.C. Dr. McAlhaney provides telehealth services to schools in her community, and she uses telehealth to connect patients in her office to specialists, such as behavioral health specialists at MUSC. Most recently, in March, PCC helped Dr. McAlhaney implement a telehealth platform so she can provide care from her office to patients in their homes.
Before March 15, AnMed Health hosted few telehealth channels aside from MyChart e-visits.
By March 23, the Anderson health care system had served more than 8,000 patients through remote services including video visits with doctors and telephone check-ups for patients without video-conferencing capability.
According to Kim Burden, AnMed’s Physician Network director, the hospital system built a telehealth matrix across in its multi-countywide web of physician practices in three days.
“We’re providing a lot of care through telemedicine services today and we weren’t actually doing any of those things with the exception of e-visits a month ago,” she said.
The program, developed in-house, runs off FaceTime, Google Duo and Epic to connect to patients and record symptoms as patients fear contact with COVID-19.
“We think the door has opened with these services,” Burden said. “Previously, these were only available in rural areas as far as reimbursement was concerned.”
AnMed Health has joined Prisma Health, the Medical University of South Carolina’s Virtual Urgent Care, and others in the rapid adoption of telehealth care as the first pandemic wave crashed on South Carolina. Health care professionals believe it’s here to stay.
Prisma Health is now receiving hundreds of telehealth calls each day across the Upstate and Midlands, while the number had been in the teens prior to the outbreak.
“You have to be close enough to a phone to access a Prisma Health provider. Through our virtual visit program, anyone who has an Android or IOS smartphone could access one of our providers,” said Dr. Matt Bitner, chairman of the Prisma Health Department of Emergency Medicine.
The health care provider had previously outsourced some telehealth services to national providers but has since brought the system back to South Carolina with in-house operators.
“Telehealth is really important, because the first step is talk to your physician via telehealth before you go to the emergency room,” said Thornton Kirby, president of the S.C. Hospital Association. “That message got out really effectively early on, and emergency rooms are down to about 40% of normal [visits].”
Despite increased production of personal protective equipment, Kirby said a shortage persists across the state but the scarcity is mitigated by telehealth capabilities.
Still, with telehealth technology just now taking center stage as a result of the pandemic, Thornton says a legacy payment system and patchy rural broadband may slow widespread take-off of virtual health care for the time being. He said many homes in rural regions lack access the internet bandwidth necessary for telehealth consults, but bipartisan efforts on the state and federal level have begun to make better bandwidth widely accessible.
“We are making slow and steady progress,” he said. “I think this COVID pandemic is going to, in retrospect, be a spark that really kicks it into a higher gear.”
Jon-Michial Carter, co-founder and CEO of Chartspan, noted enrollment for his company’s telehealth services have spiked by 30% in the past month in the largest month-over-month increase he has ever seen. Over half of his customers — expansive healthcare networks and private clinics alike — have abbreviated their hours or suspended their practice. The Greenville-based company serves more than 100 health care systems and practices across the country, including some Upstate providers.
“We work with their elderly patients making sure that their care needs are being followed, so we become the first line of defense for those patients that are managing healthcare concerns, especially COVID-19 concerns,” Carter said. Chartspan’s clinicians screen patients’ symptoms, which are analyzed using algorithm-based protocols, and then prompt them to schedule an appointment with their doctor, visit the emergency room or stay home.
Last month, Chartspan fielded 30,000 patient calls with 76% involving COVID-19 symptoms. Out of these COVID-19 screenings, 98.1% of all cases did not require a follow-up appointment. According to Carter, such services help strained health care providers focus on patients in critical need and shields vulnerable populations from increased infection.
He has met some resistance from skeptical doctors, but Carter argues that telehealth expansion during the epidemic is only the beginning.
“The horses have left the barn and they are never returning,” he said. “You are about to see a dramatic and sustained increase in telehealth, and you will see a dramatic change in the way health care happens in this country because of telehealth.” Carter said he expects one-quarter of all health care encounters to transition to remote health platforms.
Dr. Graham Adams, CEO of the S.C. Office of Rural Health, also sees the epidemic as a tipping point for widespread use of telehealth among smaller providers as well as existing pioneers. The recent passing of the CARES act grants reimbursement for some telehealth activity and has stimulated additional growth, even if the terms of billing regulation are not yet clear.
“Those capabilities have been in place for a long time,” Adams said, noting that regulations usually thwarting telehealth expansion have been suspended during the pandemic. “If there is a silver lining to this, it might, at least in our state, serve to accelerate a lot of the telehealth technologies at a greater rate than it would’ve been.”
But not all offices are created equal in terms of underlying IT security or broadband access.
Maps developed by Palmetto Care Connections, SCHA and S.C. Office of Rural Health portray miles of Upstate households lacking access to broadband. Handfuls of orange blotches portraying 25 to 199 unserved households per square mile arise in all Upstate counties, while southern and northwestern areas of Greenville county operate below 10 megabits per second.
Oconee, Greenwood, Laurens and Abbeville counties are spotted with a few red patches representing more than 200 unserved households per square mile.
“It’s certainly our rural communities that struggle with that more. Again, the lack of reliable, affordable internet is a problem, not just with the healthcare environment, but also in ensuring that folks can work remotely from home, that school children can have the ability to do school work from home — all those things that when you live in Greenville, Columbia or Charleston, you kind of take for granted,” Adams said.
This article first appeared in the April 20 print edition of the GSA Business Report.
Reach Molly Hulsey at 864-720-1223.
-mHealth Intelligence
– Some $200 million is available right now to help healthcare providers launch or expand telehealth programs during the Coronavirus pandemic, and another $100 million is set aside to expand connected health programs to rural areas over the next three years.
All courtesy of the Federal Communications Commission, whose goal is to improve the lines of communication – literally – upon which these platforms operate.
(For more coronavirus updates, visit our resource page, updated twice daily by Xtelligent Healthcare Media.)
“We’ve been active in supporting internet connectivity in telehealth for really over a decade,” says Brendan Carr, one of the FCC’s five commissioners. “What we’ve primarily done is support through funding high-speed connections to brick-and-mortar healthcare facilities, and that type of work has delivered some really amazing results.”
During an episode of Xtelligent Healthcare Media’s Healthcare Strategies podcast series recorded earlier this week, Carr explained how telehealth programs across the country are moving toward what he calls “connected care,” which changes the dynamic from patients seeking care at a hospital to patients accessing care at their convenience.
Palmetto Care Connections (PCC) is the telehealth network for South Carolina that offers telehealth support services to rural and underserved health care providers.
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