Let’s Close Military Veterans’ ‘Digital Divide’

Posted to Technology August 26, 2024 by Michael O’Rielly

 With little dispute, broadband internet technology delivers a wealth of opportunity and information to its users. Thus, much attention focuses on our nation’s “digital divide,” the term often used to describe the gap between the people able to connect to broadband of sufficient quality and those who are not.

With fiber, cable, fixed wireless, mobile, satellite and other technology options providing increasing connectivity, many consumers have multiple ways to obtain an internet connection. To address those still without, the federal government is spending more than $100 billion to expand broadband access to every American household by subsidizing internet network builds throughout unserved areas. In short, the much-discussed digital divide — if all things go right and bureaucratic burdens stay to a minimum — will be eliminated (albeit at a much slower pace than originally estimated).

But what about military veterans? Sadly, a digital divide-like situation remains. And it is limiting and hindering the healthcare they receive.

The reality is that most of our Veterans Affairs hospitals are using a decades-old Electronic Health Records computer system. Each of these antiquated systems has been in use longer than acceptable and inadequately patched repeatedly.

It has gotten to the point that each VA health records computer system is isolated from the rest of the healthcare world. That means VA hospitals are unable to share our veterans’ health records with other healthcare providers — public or private. Not with other VA hospitals. Not with Department of Defense facilities. And not with any non-military providers. That’s a serious healthcare defect and a significant disgrace to those who served our nation.

The inability of these systems to communicate with private providers is crippling the implementation of what most experts believe to be a sound veterans’ healthcare reform law, the VA MISSION Act of 2018. The law, in part, strengthened the nationwide VA Health Care System by empowering veterans with more healthcare options.

Former VA Secretary Robert Wilkie said it best about the VA MISSION Act, “The changes not only improve our ability to provide the healthcare veterans need but also when and where they need it. … It will also put veterans at the center of their care and offer options, including expanded telehealth and urgent care, so they can find the balance in the system that is right for them.”

Under the new Veterans Community Care Program, veterans are permitted to work with their VA healthcare provider or other staff to see if they are eligible to receive community care. “Community care” is essentially private providers helping veterans when local VA hospital cannot. But veterans, in most instances, cannot take advantage of this array of added care options easily or in a prompt fashion because many VA hospitals are unable to digitally share patient records.

Thankfully, help is attainable in the form of the MHS Genesis, a fully interoperable Electronic Health Records system. The Defense Department has completed implementation and adoption in all its facilities. Attention has now turned to the VA.

Today, there are 84 VA hospitals nationwide. So far, five have implemented the new MHS Genesis system. The latest to go online was in March of this year —  the Capt. James A. Lovell Federal Health Care Center (Lovell FHCC) in Illinois.

According to the VA EHR Modernization Integration Office’s statement, the Lowell joint deployment of the Electronic Health Records system,“will provide a more coordinated experience for patients and the clinicians who care for them.”

Likewise, Dr. Lester Martínez-López , the assistant secretary of Defense for health affairs, stated, “The launch of the Federal EHR at Lovell FHCC will help DOD and VA deliver on the promise made to those who serve our country to provide seamless care from their first day of active service to the transition to veteran status.”  

Implementation at the Lowell facility is an explicit acknowledgment that private providers, from whom veterans have legal permission to receive care thanks to the VA MISSION Act, are important partners in veterans’ healthcare equation.

For far too many of our veterans, it has been difficult, if not impossible, to take advantage of their new healthcare choices because their respective VA hospitals are digitally walled off from the rest of the world.

Now, for the tens of thousands of veterans of Lovell and the four other VA hospitals that have implemented MHS Genesis, those freedoms and choices have arrived. In essence, their digital divide has been closed. It is time to finish the implementation of MHS Genesis throughout the entire VA hospital system and close it for the rest of America’s veterans.

Michael O’Rielly served as a commissioner of the Federal Communications Commission from 2013 to 2020. He wrote this for InsideSources.com.

 

An Agency Most Haven't Heard Of, But That's Very Relevant

By Michael O'Reilly

August 29, 2024

In today’s divided government, federal agencies are constantly testing the faith and legal authority bestowed upon them by Congress. Instead of focusing on the specifics required by statute or guidance offered by congressional committee leaders, agencies often continue to pursue their own agendas divorced from their legislative foundations. Even more questionable is the case when Congress tries to boost an agency’s importance and functions only to have the agency rebuff it. Yet, this is exactly what is happening at the National Telecommunications and Information Administration (NTIA). To successfully move forward on communications policy, NTIA would do well to deepen its focus on spectrum matters, as required by law, and avoid any freelancing into unrelated or unauthorized matters.

Most Americans have never heard of NTIA, a small agency within the Department of Commerce which serves as the President’s chief advisor on communications and as the lead on federal government spectrum holdings and policy. Its relevance has tended to ebb and flow as new administrations come into power. Decades ago, Congress considered ways to eliminate its direct functions and transfer that workload to other parts of the government. Conversely, the Biden Administration’s infrastructure investment law provided the agency with a huge new role of implementing and overseeing a singular investment to ensure broadband reaches the unserved Americans. More recently, the House of Representatives – by a vote of 374 to 36, including 85% of Republicans – agreed to elevate the agency’s head within the Commerce Department flowchart and enhance its role over Federal users of the electromagnetic spectrum.

Despite this newfound confidence from Congress, NTIA seems to be finding new ways to falter. I have written before about my concerns with respect to the work NTIA is doing implementing the BEAD program in contravention to the crafted statute passed by Congress. What is striking is NTIA’s attempts to justify its statutory end-runs in a recent House hearing by stating it was merely enacting certain conditions on states. Predictably, this gobbledygook did not sit well with Members, including the Ranking Member of the Senate Commerce Committee.  Nor should it. Getting funding to help providers who know how to and are able to build broadband well and quickly is critical for these hard-to-reach locations. Every delay is only extending the time until we can solve the connectivity issues for those Americans unserved.

On spectrum, Congress has tried repeatedly to impress upon NTIA how it needs to better manage and direct Federal agency spectrum use rather than serving as a bystander to other agencies’ visions of spectrum management. By statute and practice, it is the job of NTIA to act as the Executive Branch’s voice on spectrum policy matters. Yet it issued a National Spectrum Strategy that grants all other agencies equal voice on the future of key spectrum bands as “co-leads” of spectrum studies.

In fact, earlier this summer, NTIA found itself invited and then disinvited to a spectrum meeting instigated by the Department of Defense and outside parties to discuss a critical spectrum band – the future of which NTIA has been tasked by the Biden National Spectrum Strategy to decide. That is, the agency charged with overseeing all Federal user spectrum wasn’t included in a meeting to discuss key Federal spectrum allocation and assignments. Huh. How is that acceptable protocol for the Biden Administration? Think about if this practice existed in other settings: could the Defense Department be left out of conversations about upcoming military strike scenarios, or Pete Buttigieg told to skip the next White House meeting on closing the nation’s airports? Those scenarios are laughable because their equities are too significant to be ignored. The same would seem to apply to NTIA on Federal spectrum.       

Concerns for the treatment of NTIA should stretch beyond hurt feelings. Substantively, no other Executive Branch department or agency is designed to function as an unbiased and facts-based spectrum arbitrator. Without some entity to serve as credible authority, every Federal spectrum licensee will continue to fight any proposal to alter spectrum policy based on myopic self-interest, especially injecting itself into non-Federal spectrum and commercial bands. Federal spectrum stagnation also means that the rest of the world’s wireless connectivity will advance as American wireless consumers miss out. Just as Congress is asking NTIA to step forward, other Federal agencies are trying to relegate the agency’s spectrum role to that of a younger sibling. Not only should NTIA be included in any spectrum conversation involving Federal spectrum users, but it should be the one convening any such meetings and deciding who else to include.

Power in Washington, DC, a necessary component for effectuating policy for the betterment of the American people, is a constant turf war between one entity to another. The larger risk of NTIA’s failure to properly assert itself, whether its wasting time and resources on overreach or the failure to lead on spectrum, is that Congress reconsiders the agency’s relevance. If the agency is unwilling to comply with the law, continues to play legal games to push its own whims, or allows itself to be shoved in the proverbial corner when the big boys are having spectrum conversations, then Congress will and should turn to other administration officials to do the work. NTIA’s value, and that of the Commerce Department, will wither. 

As the country faces an election in a few months, it would be appropriate for the new President, whoever it might be, to focus special attention on NTIA and require that it rise to the goals and duties established by Congress and expected of it. America’s economic leadership depends on it.

Michael O’Rielly is a former commissioner of the FCC. 

 

 

FCC SHOULD ACT NOW ON LOWER 12 GHZ BAND TO HELP CLOSE THE DIGITAL DIVIDE AND ADVANCE U.S. WIRELESS LEADERSHIP

It has been over 500 days since the Federal Communications Commission (FCC) lost spectrum auction authority. With only a handful of legislative weeks remaining this year, the prospects for its renewal before 2025 appear rather bleak. The 12.2 – 12.7 GHz band (the lower 12 GHz band) offers a unique opportunity to unlock 500 MHz of spectrum without waiting for Congress to finally reauthorize the Commission’s lapsed authority. This opportunity is one that is too important to pass up and one that the Commission should seize upon.

The inaction on spectrum auction authority is especially vexing given the importance of spectrum allocations for advancing U.S. competitiveness globally and for enabling the deployment of new technologies, such as fixed wireless service—which has proven to be a valuable tool for helping to facilitate broadband access and injecting competition in certain markets.

Having served as an FCC Commissioner, I understand the agency’s limited options to make more spectrum available absent Congressional action on auction authority. Despite this challenge, there is a prime opportunity before the Commission in the pending lower 12 GHz proceeding that would enable more efficient use of spectrum even while Congress works to restore auction authority. The Commission should not wait to act on this proceeding and should move to adopt final rules to authorize the use of high-power two-way, fixed wireless service in the band. The Commission had already been long overdue in updating its nearly two-decade-old rules for the lower 12 GHz band, but the Congressional standstill on auction authority makes this need even more pressing.

Updating the lower 12 GHz rules would enable increased deployment of fixed wireless service, fostering greater connectivity across the country, especially in rural and tribal areas. This would come at a key time as states will soon start implementing their federal Broadband Equity, Access, and Deployment (BEAD) program funding allocations, with some states allowing for this funding to be used for fixed wireless deployments.

The lower 12 GHz band — which has different circumstances and is at a different stage of discussions than upper 12 GHz band — is ready for deployment, with no federal incumbents and few license holders, most of whom strongly support expanding flexible use. A robust record has been established before the Commission demonstrating that any potential harmful interference can be mitigated or managed as necessary. Similarly, lower 12 GHz flexible use proponents agree its use would not interfere with upper 12 GHz services. The band can and should be shared.  

Given current constraints within spectrum policy, the lower 12 GHz band represents a real option and perhaps the only way to bring forward additional capacity for fixed wireless services in the near term. The FCC would be wise to take advantage of this opportunity for consumers. 

MPORielly Consulting Inc.

mike@mporinc.com

(202) 412-3892