"The doctor of the future, by means of this instrument, will be able to feel his patient, as it were, at a distance. … The doctor manipulates his controls, which are then manipulated at the patient’s room in exactly the same manner. The doctor sees what is going on in the patient’s room by means of a television screen."
Remote surgery is one of the use cases envisioned for 5G networks, but the "doctor of the future" described above was imagined long before 5G. The passage above comes from a 1925 issue of Science and Technology, published when scientists were first beginning to understand the potential of radio.
Ninety-three years later, remote surgery remains more of a goal than a reality, but other forms of telemedicine are starting to have a real impact on patient outcomes, and the FCC is taking note.
"I am really focused on what can happen outside the walls of the hospital," FCC Commissioner Brendan Carr said in an interview. "If you have a virtual visit, it is around 75% less cost, and you also see better outcomes. Also, you may see things that you would miss otherwise."
Carr said virtual visits can often highlight problems faster than regular doctor visits can because of consistency. Patients who use wireless networks to regularly submit data to their doctors may have an advantage over those who are seen periodically or who don't present for treatment until problems have become acute.
Glucose monitoring for patients with diabetes is the classic example of how remote monitoring can cut costs and improve outcomes. Carr said he realized the value of this approach when he visited Mississippi's North Sunflower Medical Center. The physicians there partnered with C Spire, Intel, GE, the University of Mississippi Medical Center and the state of Mississippi to give patients connected tablets that enable them to upload data from monitors and connect with caregivers. Doctors say the program has dramatically reduced both blood glucose levels and Medicaid expenses in Mississippi, and will now be expanded to other chronically ill populations.
Monitoring the chronically ill is one important use case for telemedicine, but Carr said wireless networks also play a key role in emergency medical situations. He said that when stroke victims are connected to hospital staff by videoconference during the ambulance ride to the hospital, they can get admitted faster and get access to blood clot medicine more quickly, meaning that they lose fewer brain cells.
The farther patients live from a hospital, the more valuable telemedicine can be, which is why the FCC is focused on ways to extend high-speed wireless networks to rural America. Even though IoT is not likely to be a near-term use case for 5G, Carr predicts that eventually 5G will expand the potential of telemedicine, and he wants the FCC to help operators extend the benefits of high-speed wireless to rural America.
"I do think there is a role the FCC can play in helping to support these deployments," Carr said. "The Universal Service program is a key piece of connectivity in rural America."
Geoffrey Starks, whom President Trump has nominated to fill the vacant spot on the FCC, has also spoken publicly about the role the FCC can play in advancing telemedicine. Starks said members of his family are physicians who have experience with the benefits of telemedicine.
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Regulatory relief is another way the FCC can help make it easier for operators to extend their networks to underserved areas, according to Commissioner Carr. He said that if a municipality charges too much for the right to attach small cells to city-owned poles, carriers will not have as much capital to extend those small cell networks to the smaller towns nearby.
Carr is leading the FCC's wireless infrastructure initiatives and scored big points with the industry earlier this year when he announced the relaxation of rules governing historical preservation review and environmental impact review for small cells. Now Carr and his team have turned their attention to fees and permitting rules, and the commissioner said his team has had productive meetings with state and local groups. Industry observers expect another FCC announcement on the small cell front this week.