A Look into the Rural Texas Communities
Texas had strong broadband at Community Anchor Institutions but struggled with widespread consumer broadband as well as at healthcare sites.
The Program in Texas
The Telehealth Broadband Pilot Program focused on six rural counties in Texas: Crosby, Fisher, Haskell, Jones, Lamb, and Mitchell.
While some institutions met connectivity standards, many residents and healthcare providers, particularly those in rural areas, faced inconsistent and often insufficient internet performance. Addressing these challenges through targeted infrastructure improvements and leveraging the strengths of Community Anchor Institutions can enhance telehealth accessibility, ultimately improving healthcare outcomes in rural Texas communities.
Insights in Rural Texas
Explore the broadband access and gaps, telehealth challenges, and opportunities for community-driven solutions.
Strategies and Learnings from West Virginia
Effective Outreach Strategies
Boots-on-the-Ground Engagement
Direct, in-person outreach proved most successful. The Texas Community Lead Partner (CLP) found that having a strong outreach strategy and plan as well as engaging in door-to-door visits were more effective than emails or phone calls in establishing trust and securing participation in the TBP Program.
Data Collection Methods
Extensive Monitoring Deployment
Over 228 monitoring devices ("pods") were deployed across 179 locations, collecting more than 2.5 million speed tests. This extensive data collection provided a comprehensive view of broadband performance in the focus counties.
Challenges in Data Consistency
Challenges with Healthcare Sites Outsourced healthcare security vendors blocked participation despite local interest. As a result, this reduced our coverage of small health sites in these findings.
Key Takeaways
Importance of Local Relationships
The lack of pre-existing relationships in the focus counties initially hindered outreach efforts. Building local partnerships, especially in rural communities, was crucial for effective community engagement and project success.
Need for Infrastructure Investment
The findings highlight a significant need for targeted investment in broadband infrastructure to ensure consistent, high-quality connectivity, which is essential for reliable telehealth services.
Our Recommendations
Invest in Broadband Infrastructure
Address gaps in broadband access across the six focus counties, with priority given to underserved and rural areas where consumer and healthcare connectivity consistently falls below standards.
Leverage Strong CAIs
Build on the robust performance of Community Anchor Institutions by expanding their role as telehealth hubs and community access points for reliable broadband.
Support Healthcare Connectivity
Strengthen partnerships with healthcare facilities to improve broadband measurement to ensure seamless telehealth services.
Broadband Performance Variability
Inconsistent Access Across Counties
Broadband availability varied widely across the focus counties. While some areas approached the new broadband standard of 100 Mbps download and 20 Mbps upload speeds, others lagged significantly behind.
Variable Mobile Coverage
Mobile broadband coverage, including 4G LTE and 5G services, differed notably between counties. For instance, only 81.9% of Mitchell County had 4G LTE coverage, compared to over 94% in other counties.
Consumer Access Below Standards
Low-Speed Connections
Consumers experienced the lowest quality internet connections. Over 63% of speed tests at consumer locations fell below the minimum broadband threshold of 25 Mbps download and 3 Mbps upload speeds, making effective telehealth usage challenging.
Limited High-Speed Options
Only about 10% of consumer speed tests met or exceeded the new broadband standards, indicating scarce availability of high-speed internet for residents.
Healthcare Connectivity Challenges
Inconsistent Performance at Healthcare Sites
While healthcare facilities showed higher average speeds, over half of the speed tests at these sites fell between the old and new thresholds. Approximately 11% of tests fell below even the minimum 25 by 3 Mbps threshold.
Impact on Patient Care
Fluctuating internet speeds, including those experienced in Texas, can disrupt telehealth services, leading to delays or interruptions in patient consultations and access to critical health information.
Community Anchor Institutions as Potential Hubs
Superior Connectivity at CAIs
Community Anchor Institutions (CAIs), such as schools and libraries, generally had better broadband connectivity. Around 70% of speed tests at these sites met or exceeded the new broadband standards.
Opportunity for Telehealth Expansion
Given their stronger connections, CAIs could serve as central hubs for telehealth services, benefiting the wider community by providing reliable access points.