Cspan, created by americas cae companies in 1979, brought to you as a Public Service by your television provider. Host this week the communicators is on site at the federal Communications Commission here many washington d. C. Its their site of their firstever mhealth innovation expo. Its a discussion about the future of health and technology. In this program youre going to hear from regulators and innovators. Joining us on the communicators at the site of the fccss mhealth innovation expo is matt quinn, director of Health Care Initiatives for the fcc. Welcome. Guest thank you. Host why is the fcc involved in these matters . Guest were involved in lots of ways in health care and in mobile health. One of the ways that were involved is that we had an mhealth Task Force Last year say here are some ways that fcc can provide leadership in this area. We have a equipment certification program. So, basically, any piece of equipment that uses spectrum as a transmitter we approve as an agency. The other side is that we allocate spectrum. So spectrum is the oxygen on which mobile devices run, whether they be mobile devices for health or other areas. But in a more important sense, we have to collaborate and coordinate with both other federal agencies, but also with the private sector in helping entrepreneurs and innovators get to market. Host so lets take those three points that you made. Spectrum, we think about it on the cell phone and other technologies. How do these devices depend on it . Guest well, in the case of apps that run on cell phones, 3g, 4g networks, thats part of that. But theres something called a medical Body Area Network or men band. Fcc was the first, provided the first country in the world to provide allocated spectrum for medical Body Area Networks. This is something that allows monitoring of vital signs without having to have intrusive monitors. It can really be a game changer in terms of tracking Peoples Health and health care, and that requires allocated spectrum. Another way that we support innovation with spectrum is something called medical micropower networks. And so all of these things have to have a spot on the u. S. Spectrum map or else theres potential for interference with other things that are moving think the air. So for the spectrum that gets allocated for everyone, cell phones and the like, is there a special section of spectrum just for these types of devices . Guest yeah. Everything has to have its spot. Some things, for example, blue tooth and wireless mics and other things are in an area called unlicensed spectrum. So theres no guarantee against interference by with the device of the manufacturer. And so you can understand it how in Health Care Settings this could be a problem. So having allocated spectrum, for example, for mbands and other things is more and more important. Host so lets turn to the device makers, the app makers. What kinds of general technologies are we seeing in this kind of space . Guest well, there was just a study that showed there are nearly 20,000 healthrelated apps on the marketplace, but thats just one angle into this. In this room you see a diversity of all sorts of things, everything from wireless gateways and networks that connect medical devices together inside of a hospital to solutions to connect people to networks to the whole world of Remote Monitoring thats coming. Even text or sms space apps and tools that are used for, for example [inaudible] host so they all depend on the spectrum. If an app or a medical device maker depends on spectrum, does that mean they have to come to the fcc to get approval for its use . Guest yes. And there are so if you look at the back of your cell phone, you go inside, theres a little fcc key. If theres not, i have someone to see you. [laughter] everything thats a transmitter of spectrum requires fcc approval, and we have an office, we have a lab in baltimore, in columbia that runs that, but we also deputize a number of certification bodies and labs. A lot of its done in the private sector. Host now, does that fall directly under your jurisdiction or are there ohs that deal with that . Guest our office of engineering and Technology Led by julie knapp is in charge of that really important function as well as figuring out what the rules of the road are for spectrum. Host so anybody who uses or develops an app or develops a technology, uses spectrum be, they fall under regulation of the fcc. Whats the balance between how much regulation the fcc provides and not wanting to stop innovation amongst private companies . Guest well, this is really the focus last summer to this day. We worked with the fda and the office of the National Coordinator and a federal Advisory Committee of really diverse folks, everybody from App Developers to medical Device Manufacturers and in between to say what is that good balance between Patient Safety and spectrum. And innovation not just with mhealth, but with the whole array of health i. T. , and how do the regulators and other entities that are involved Work Together so that it is not stifling innovation. The fccs focus is reducing interference. Not a very funny joke i made earlier, but fda is focused on Patient Safety. And we both have equipment authorization programs for products that use spectrum. Recently, in august actually, fda put out guidance, technical guidance on wireless medical devices. We assisted them and worked with them in putting that technical guidance for folks bringing those products to market. You have to go through both processes, but theyre for slightly different things. So every platform, every app doesnt have to come through us. It may or may not have to go through fda, and they put out guidance for the very narrow set of those, but any platform thats a transmitter needs to come through fcc. Host matt quinn, when you talk about Health Information, you have to deal with areas of privacy and security. Whats the fccs role . Guest thats a very good question. We are not the lead agency in enforcing hipaa, thats the office of civil rights. We work really closely with the office of the National Coordinator on the requirements, for example, around Electronic Health records. But we havent really staked out a specific, you know, statutory role as it comes to health i. T. Host and hipaa is . Guest the Health Insurance portability and accountability act which is the law of the land for both privacy and security of health care, but also for expediting administrative transactions. Host you talked a lot about working with partners, and you listed some earlier. Talk a little bit about this partnership and how do you keep from getting in each others way. Guest well, we keep from getting in each others way by be understanding what we do. In my first few months here at fcc, a lot of it has just been explaining. So what are how is fcc involved in health care. Probably the most commonly understood part of where fcc is in health care is we subsidize broadband for Rural Health Care organizations. Actually, our Rural Health Care program and the new Health Care Connect fund is a universal service fund for making broadband more affordable not only for Rural Health Care providers, but more and more consortia of rural and urban providers and everybody in between. This really aligns really closely with, you know, efforts by medicare and other folks to connect people and help them Exchange Health information. Explaining that to them in that context, for example, how the Health Care Connect fund can support their efforts is a real eyeopener for them. From the regulatory side, i spend every thursday afternoon at the fda. [laughter] talking through things. We have regular meetings with our office of engineering and technology. And, you know, we did a workshop with them recently, were going to do some workshops on things like wireless in the future. So its a technical conversation, but its also, you know, getting to know people individually and personally conversation. Host you brought up the Health Care Connect fund, so give us a status report on rural areas across the united states. How equipped are they to handle these new technologies . Guest well, theres two sides to this. One of them is Health Care Organizations themselves. So the institutions and connecting those. And were getting a lot of progress on broadband to those folks. There are still some gaps, as commissioner clyburn talked about earlier, in getting broadband to people individually. And the fcc has taken some pretty exciting actions in that regard through the other programs. The other is just getting phones in peoples hands that need them who are underserved, and that as other parts of the universal service fund like lifeline. Weve seen some pretty exciting partnerships between those who the phone companies who provide that service, medicaid managed care, organizations and App Developers. So the power of mhealth and the power of broadband, getting it into individuals hands as well as hospitals hands are two goals that are related but operate in different ways. Host and so the fund provides money for that, how guest the Health Care Connect fund, the Rural Health Program only subsidizes broadband to Health Care Organizations. Other programs are aimed at connecting people. And also bringing broadband service, actually, to rural areas and others. Thats less under my purview. Host so you said about meeting with the fda, being here at the fcc, how often does your job involve telling whats happening in this world to the commissioners and the chairman himself . Guest the, well, the chairwoman was [laughter] commissioner clyburn was the chairwoman until recently. And so i am the person who shares that information along with oet and other folks. Its a new role. This is actually the role of director of Health Care Initiatives was recommended by the mhealth task force, and they said we need somebody to sort of, you know, to work externally and collaborate, coordinate and communication but also internally. So i spent a lot of time just trying to learn what others at the agency are doing and thinking about is there a Health Care Context to it. And then bringing it to other agencies that might be interested. So her saw is part of hhs that deals with Rural Health Care. At the conference in february, we organized a host the conference is . Guest Health Information management society. Everybody knows that. [laughter] its a big health i. T. Conference. Were having the first allday preconference symposium on rural health i. T. , overcoming the challenges ask seizing the opportunities and seizing the opportunity. And think about it as a big opportunity for all the government programs, the obvious ones like office of National Coordinator and medicare but also u. S. Department of agriculture and Veterans Administration and all of these folks to talk about their programs in context and then have beneficiaries, Health Care Organizations from that program to say heres how it actually works. Wes joining us at the site of the fcc mhealth expo is kent dicks, what is leer connect . Guest it used to be formerly known as med ops out of scottsdale, arizona. We are a remote wireless remote patient monitoring solution to be able to put devices in patients homes to be able to monitor and keep them well and have Better Outcomes and keep them out of the hospital. Host so these devices depend on the cloud and spectrum to operate . Guest they do. And they have a device i can show you today, they have wireless Cellular Technology using whats known as m to m technology host which is . Guest the kind of technology you find in your car, in your laptop, in the parking meters that are out there, very economical in sending small amounts of information to the cloud. Host walk us through how this technology works. Guest now, at alerer we have point of care devices for lipids, for a1c. We also do Health Management as well, Health Information exchange analytics. The whole spectrum of care. But this device is a regulation device to do ptinr readings. And typically a patient whos on coumadin would have to go to the doctor once a week to get a blood reading. My mom does that, goes to her doctor to make sure her blood thinners are working properly. In this device is produced by alere, it has about 100,000 patients at home, and the data goes into this device, and it can go to our service center, our nursing center, where they can help monitor the patient. If theres a problem, they can alert the patients cardiologist on in this. What were trying to do and what we are doing with this device is now we are connecting it to our mobile link which has Cellular Technology which i talked about. Connect the wire to the device, and once you take a reading, itll send it automatically to the cloud using the technology, and into a Backend System where it can be monitored. Host like an ipad or some type of device. Guest well, ive got this on an ipad, with weve got a system whering set thresholds for a patient. Theres multiple systems we can put it into, but this is our health con ii system which brings it in, alerts to be able to say i want the reading to be between one and three, and if it gets outside that range, then i want to act upon it. So from an efficiency standpoint be, a nurse thats looking at this can go through and if im doing well, then theres really nothing she has to do with me today. But if im outside of ranges, then maybe intervention needs to occur so i dont want go into the hospital. Host you have another type of technology thats webbased. Whats this device . Guest this is still under fda review, so were not selling it yet, but this is a device to be able to talk to multiple devices around it. Somebody who has comorbidities, so scale, glucose devices, the type that a patient would have in their house anyway. Host so how does it work . Guest so on this, if we sent this home with a patient whos like a copd patient, right . Ive got oxygen saturation. Dont look at my stats because theyre actually pretty poor today. [laughter] but if you look at it, itll go through and start looking, its going to do a little bit of calculation, say what my oxygen saturation is, what my heart rate is, and once it stops, its going to send it over to this device, and its going to you can put your speaker here saturation is 94 and your pulse is 107. Guest so if you left it alone for right now, it announces 94 over 107. It would actually start asking the patient questions. And fending on what fending on what program the patients in, ive got this in a diabetes program, its going to start asking questions like did you take your medication, did you exercise, has your blood glucose been below 60. We want to look at those type of behavioral parameters to determine if the patients having any type of problems and if we these to intervene. Host so, kent dicks, for a company like yours, what do you look for from the fcc, other forms of government as far as making Technology Available . Guest weve worked with them for the last three or four years, when the fcc handed off between julius and Margaret Hamburg to make it easier to be able to get through fda so we have the right Patient Safety, right, to be able to do that with these types of devices, but also from the fcc side to be able to bring the most amount of spectrum to rural and highly rural organizations and areas that are out there to try to get these devices in the patients hands. And thats what the fcc is doing. Theyre allowing us to work with additional spectrum. Theyre allowing us to get things to market quicker through fc ccertification as well. One of the things we are concerned about is the underserved population. As the chairwoman said this morning, i personally have testified for Veterans Affairs on rural and highly rural, you know, activity for veterans. If you are a veteran or any person, any u. S. Citizen living in a u. S. Area and its a rural area and its 35 hours away from your physician, youre going to tend to exacerbate the disease, make it worse. The next time you present is probably maybe going to be in the hospital, and its going to be a Higher Health care cost. So we want to try to put this technology into place to be able to monitor people that are indigent population, elderly population, a rural population. The population that is consuming 15 of the Health Care Costs that consumes 80 , thats what we want to target the keep them out of the hospital. Host kent dicks, the president and chief executive office of alere connect, thank you. Guest thanks so much, appreciate it. Host the communicators at the site of the mhealth conference joined by director mccarty, whats that title and what do you do . Guest so i am within the office of the Nati