Hospitals and providers in rural areas suffer from a lack of broadband internet services due to a lack of profitability for internet service providers in areas where the population density of consumers and commercial users is inadequate to provide a digital health space.
This is true for large areas of many states where there is a dichotomy between metropolitan areas and smaller towns and cities. While there has been a fairly rapid expansion and upgrades in bandwidth in the past five years there remains serious inadequacy for rural health providers.
State and Federal grants are on the way, but the process is slow and frustrating. Administrative bureaucracy can be overwhelming for entities who wish to participate.
Several stopgaps emerged. Larger institutions, hospitals, and group medical practices have invested in direct backbone feed using point-to-point microwave links.
Other options for rural internet broadband, range from DSL, fiber optic, and microwave.
The need for very high-speed internet broadband seems exponential with electronic health records, cloud computing, telehealth, imaging, and now artificial intelligence.
A limiting factor for hard-wired fiber is the capital expense of installation, acquiring right of way, cable trenching, and necessities of construction. Balancing income, cash flow, and expense create a real barrier to rapid expansion without venture capital and/or government subsidy or outright grants.
Several entities are developing low earth orbital (LEO) constellations which may prove to help. Starlink is the first major provider and it is already providing services in many areas of the world. SpaceX offers business and residential services. Business service is $500 per month and a $2500 monthly fee. SpaceX promises higher speed and reliability with larger antennas for users. SpaceX has the largest build-out as of today. Both services can be affected by adverse weather such as heavy precipitation. Maritime access is available in equatorial areas of the globe.
SpaceX and Starlink are rapidly building out global coverage with the launch of 60 or more satellites per month.
In addition to Starlink, there are other satellite internet providers. Each one has it's own unique price point, terms of the contract, speed, and latency specifications.
The choices include the two big satellite providers, HughesNet and Viasat, which have been around for some time. These two providers are in a geosynchronous orbit, at about 25,000 km in altitude. The latency for these two satellite providers is about 450 msec as opposed to Starlink (45-60 ms) in low earth orbit at an altitude of about 500 km.
ViaSat pre-launch
Starlink Home Antenna
Starlink is the most expensive but provides the best speeds. Hughesnet and Viasat are less expensive but are no longer state of the art. For simple non-video applications, they would be adequate.
Government Broadband Initiatives
Taking the guesswork out of getting funding for broadband internet
While billions of dollars have been earmarked to build out rural broadband internet it is up to state and local regions to organize and develop their own ISPs. Commercial companies such as NOKIA.
The Rural Digital Opportunity Fund RDOP, Tribal Broadband Connectivity, The Capital Projects Fund CPF, and the American Rescue Plan Act ARPA are funding sources.
https://acrobat.adobe.com/link/review?uri=urn:aaid:scds:US:23799de0-b86a-43a6-af7d-b0e8da3f49f4
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