The following transcript has been edited for length and readability. Listen to the entire discussion here on The Broadband Bunch. The Broadband Bunch is sponsored by ETI Software.
Joe Coldebella:
This episode of the Broadband Bunch is sponsored by ETI Software and VETRO FiberMap.
Hello, and welcome to another episode of The Broadband Bunch. I’m Joe Coldebella. Our topic: telehealth. It’s one of those issues that’s gotten a lot of attention during the pandemic. But as we’ve sort of returned to normal — and I say normal with air quotes — it sort of hit the back burner because obviously, we’ve got bigger fish to fry not only in the broadband industry but in everything else that we do. But as we become more connected, we’ve got to make sure that telehealth adoption is as close to universal as possible. Joining me is a frequent contributor to the show. He’s a telehealth advocate and podcaster himself, Mr. Craig Settles. Craig, welcome to The Broadband Bunch.
Craig Settles:
Howdy, and thank you for having me again.
Joe Coldebella:
Hey, it’s always great to have you. Before we sort of examine the world of telehealth, I was hoping that you could just give our listeners a little background on yourself.
Craig Settles:
Sure. I spent 20 years doing marketing and high-tech services for technology companies. And I would say the last 15 or 16 years I have been a broadband industry analyst and also a consultant helping cities that want to build broadband in their communities, for their communities. And in the last six years or so, I’ve become very heavily in support of telehealth, actually very, very adamantly supporting it because I had a stroke eight years ago and telehealth is one of the reasons I’m still here. But because of my understanding of the broadband world and the broadband need, I’ve been able to understand how telehealth can make a major impact. And so as I go forward professionally, I’m still advocating and consulting with both the broadband side and the telehealth side. And then eventually they’ll be the same.
Joe Coldebella:
Yeah. It’s one of those things as well where I think that’s why your voice is so important in telling the story because you’ve lived it. You know how important telehealth is. Craig, when I’m doing a little bit of research in terms of all the things involved with telehealth and healthcare in general, it’s incredibly daunting. I would love to get your thoughts on what it is, I guess the big hiccup? Is it the technology? Is it that healthcare doesn’t want to embrace telehealth? I would love to get your thoughts.
Craig Settles:
Well, there are several elements of the audience for telehealth. From the doctor’s perspective and the patient’s perspective, telehealth is increasing its acceptance. So the challenge becomes delivering medical care via telehealth because broadband is the problem, the sticking point. Without broadband, as we have found out during the pandemic and beyond, this is a big deal when you have health facilities geared up to be able to deliver telehealth and the patients for one reason or another, don’t have the broadband connectivity. So there is an issue of people not being able to get to the technology. So that’s one.
Then you have the players, the insurance companies, the large hospitals concerned because they are of the mindset that they have a certain way of doing business and priorities and so forth. And telehealth doesn’t necessarily jive with that. And so this is a problem. It affected the rules that were set up by Congress before the pandemic, and it continues to be an issue where state legislatures can be very hostile to telehealth because their insurance company donors and their hospital entities are beating the drum about this problem or that problem and so forth. And they’re trying to use, I mean, these private sector companies try to use the legislature, either state or federal, to make things more what they want to deal with or what they want to have been the case among patients in hospitals.
Joe Coldebella:
Yeah, it is not an easy subject because there are so many moving parts. Also, it’s important to everyone, and it’s their health. One of the things that I’d love to talk about with you is I know that the NTIA has classified several groups that are being left behind when it comes to telehealth. And I want to focus on those. But before we do, I would love it if we could just zoom out a little bit and first start with in terms of telehealth as well, in terms of adoption, I think that we need to make sure that everyone knows that those who are connected, to the two sort of best things that we can sort of pull from telehealth and hopefully make it more, I guess, adoption-centric is that one, that it’s super cost-effective.
And then two, in terms of accessibility, it opens the doors to a lot of people. And so then the question becomes why is telehealth important for the future of the healthcare industry. So Craig, just in terms of doing research here, I’ve got a question for you. Do you care to guess what the median average income for Americans is in the United States? Just a ballpark figure. Want to make you a guess?
Craig Settles:
That’s way beyond me.
Joe Coldebella:
Well, I’ll sort of reveal, it’s about $60,000 a year. And then if you delve a little deeper in terms of the average cost of healthcare in the United States, it’s about $12,000. So that’s roughly 20% of a person’s income dedicated to health. And obviously, we know that that’s untenable. So I think that the really important thing that we need to focus on when we talk about telehealth is that there’s a real opportunity for us to make a true sea change in terms of just lowering costs and bringing accessibility to folks. And so just as I’m going through, how much do you think it is for the average doctor’s visit, Craig? Just ballpark. That’s okay.
Craig Settles:
Something like what, $3,000 to $4,000? It depends on the extent of what timing for just a regular doctor visit, it’s probably more in the round of 500 to 600 bucks I guess when you add in the —
Joe Coldebella:
Well, that’s a little high. Hopefully, it’s not that bad in California where you are, but the average doctor’s visit is about $100 to $200 all in. But the crazy thing about that though is that for a telehealth visit, it’s $40 to $90. So right there, the hospitals, the insurance companies, the doctors, there’s real true savings there. And especially for that group that we’re going to talk about, it’s important because money is always tight.
Craig Settles:
Right, that is true. And what we’re dealing with is the question of telehealth and healthcare. There are a multitude of other costs associated with interacting with the doctor. So going to the doctor, you’ll have to deal with public transportation, which can be a couple of hours. You must go and get a car if you’re going from a rural area to wherever the nearest, your doctors are, your specialists in particular. So there are costs for that. There are costs for once your doctor gives you the prescription, then you have to go find the pharmacist. Now, pharmacists are making it a little easier, but it’s one more step and you must look at that.
Then you also look at the initial cost of being diagnosed, and then there are the long-term results of that diagnosis. If I find out that I now have diabetes, I have a regimen that’ll be pretty much my lifetime, that adds to the cost, to the medical cost. The same way if you break your arm, that’s one thing. If you have a heart attack, there’s a whole slew of other costs later and disability costs and on, and on, and on.
So when you’re looking at the cost of healthcare, yes, the simple doctor’s visit is straightforward and cheap. And at the same time if you can lower the cost of the doctor’s visit by using telehealth, I mean that’s good. That’s good. But then like I said, when you look at the other factors of what that diagnosis means, you’ve got to look at all these kinds of things that are related.
Joe Coldebella:
I think you nailed it on the head there in terms of accessibility. And I think what you’re also saying, and please correct me if I’m wrong, is that the idea is that for us to use telehealth, it’s one of those things where it’s not an exclusive thing. It’s like you’re not going to the doctor every single time. I don’t think anyone is advocating that, but I think that the idea is that we’ve got to make sure that we integrate telehealth into the patient-doctor arc if you will. Maybe the first visit is an in-person visit, and the second visit is a telehealth visit. Then maybe the sixth visit is a telehealth visit, and then the seventh visit is an actual visit to the doctor’s office.
So would you agree that that’s one of the things that we need to do is that we’ve got to understand that it just can’t be a black-and-white issue? We’ve got to integrate it, whereas you go to the doctor when you need it. But if you’re just there to pick up a prescription or have a five-minute conversation with your healthcare provider, that’s something we should consider for a telehealth option.
Craig Settles:
That’s a factor. I think that you also need to look at, some folks will go to a doctor via telehealth more frequently by a few percentage points, whatever.
Joe Coldebella:
That’s a great point.
Craig Settles:
Because it’s now convenient. Some people don’t go to the doctor because it’s such a hassle to go to the doctor. So if you make that process of the doctor visit easier, there are going to be some number of folks that will take advantage of it or maybe take advantage of it from an issue. I may have an issue with it, I have a cold. That’s one thing. But I might think, “Oh, well, this knee issue is starting to create a bigger thing.”
So again, I’d have to go initially to the doctor, then I may take advantage of that. So I think that we must look at the amount of access because it’s cheap. And then also, does your doctor visiting regimen get expanded because of the cheapness factor or the inexpensive factor? That just needs to be looked at in terms of how we assess, does this make sense or not?
Joe Coldebella:
100%. And I think the illustration you gave was great. So if you have a knee issue, and rather than go to your primary physician, maybe reach out via telemedicine, and he or she says, “Hey, listen, why don’t you come in?” Or they could say, “Hey, listen, instead of you coming in, let’s just send you to a physical therapist right away. If the problem persists, you can come back to me as well.” So I think there’s a real opportunity for us to also streamline the process and make sure that the problem is solved. And to your point earlier, that it’s not put off.
Craig Settles:
Right.
Joe Coldebella:
So I would love it if we could dive into the NTIA’s group that has been left behind. And I would just touch on why we need to focus on these folks because I think ultimately at the end of the day that there’s a large swath of folks that healthcare is expensive, but they’re able to get what they need. But then there’s this group of folks that fall through the cracks. And I would love it if we could just touch on each one of those and just maybe some solutions or reasons that they have the problems. So the first one that I’d love to talk with you about is seniors. So why is it that seniors aren’t embracing telehealth? Or if they are, what can we do to make them even more excited about it?
Craig Settles:
Well, there’s a certain amount of comfort level. So there are some number of folks who will not be comfortable with talking to their doctor over the computer screen. Now, again, there’s a set of seniors who will take advantage of the technology, and they’re usually the first seniors to have smartphones telehealth visits, and so forth. So you always have the initial adopters, same as everything as any other kind of population. You may have less of them by percentage. There may be a smaller percentage of folks who will not take advantage of telehealth because they’re kind of set in their ways, right?
Joe Coldebella:
Sure.
Craig Settles:
And I would say I think that’s a large part of the dynamic, how effectively a doctor can usher seniors into a telehealth situation is going to be a big factor. I would also think that the ways that folks deal with telehealth may be different depending on the situation. So if I go to the doctor, I may want to talk to my primary care physician. However, when that person says, “Okay, well, we need to do monthly checkups with a heart specialist.” That person, by default, you aren’t using a cardiologist in the first place. You may not have a long-term type of relationship as you do with your primary care.
So they are sent to a cardiologist who can then take one of the devices like the digital stethoscope, that can allow them to track their historical health data and their current heart condition and so forth. But the dynamic of how you get there is different than how you deal with your primary care specialists.
Joe Coldebella:
So let me ask you this. Would it make sense that if they need to go to a specialist, if they’re a senior person, maybe the first time that they’re introduced to telehealth, that they’re introduced to telehealth in their own primary care physician’s office?
Craig Settles:
Yes.
Joe Coldebella:
So as they’re walking through the doctor can answer any questions that they might have. Is that something that’s under consideration, or is that something that maybe should be considered?
Craig Settles:
I think so because a lot of how seniors deal with doctors is long-term. They’ve had the same doctor for 10, 15, 20 years. So that dynamic is sort of built into the system. You’ve gone to the same doctor. You’re fine; you’re healthy; and you’re comfortable. And then the specialists, and the therapists, and all the secondary aspects of the healthcare professionals that you have to deal with, it’s a very different personal dynamic.
Joe Coldebella:
Sure.
Craig Settles:
So I think you must look at how you use the personal dynamic that you have established and use that to get people over the hurdle.
Joe Coldebella:
I think that’s a great point. Just as an example, I was visiting my folks in Arizona. And I wish we had used telehealth because my father needed to go to an appointment. So being the good and wonderful son that I am, I drove him. But it was over half an hour each way for us to go there. And he was in the office for, I want to say less than a minute. So literally we checked in. He went back then he came back. Isn’t that the perfect time for a doctor a PA or a physician’s assistant to be online and have a quick call? And it’s like, “Hey, listen, here are your results. They came out great. Unless anything happens, you’re good to go”?
So the interesting thing about it is who’s going to be the one that sort of insists that happens? Because I think you’re right. Older patients tend to be a little bit less willing to adopt new technologies. So I think that maybe it’s either the doctor or the health network that sort of tries to not force-feed, but make sure that folks understand that there is a telehealth option for seniors.
Craig Settles:
Right. And I think that people are starting to talk about the fact that we often think about the doctor-patient relationship. But they don’t think about the doctor, patient, and caregivers. And some of the telehealth applications that are now being developed will have a component that’ll address that issue. So when a good son or daughter gets connected to the doctor as in a caretaker role, that person could have the tools necessary to monitor scheduling, monitor follow-ups, follow up with what happens with the different specialists, pharmacists, therapists, and all of that. We need to also have a digital role for the caretaker because so many people have them.
So from a broadband perspective, you should look at how your network either deals with the caregiver who is present in that town or what have you, but also what kind of tools you have for the caregiver that needs to be remote. Now you’re having two relationships the patient and the doctor, and the caregiver and the patient and the doctor. And so you need to have tools that allow you to easily bring these people into the picture. There may be some ISPs that may not see this as a necessary thing, especially if the caregivers are in another place, so they’re not technically a customer of an ISP. But from a quality of customer service, you want to make sure that tools that support the caretaker are addressed in some way, form, or fashion.
Joe Coldebella:
I love that a lot. I think that’s something that’s overlooked we think straight for the patient and the doctor. But there’s the back-of-the-house stuff that can be done by the caretaker and the doctor’s staff. So when there is an actual interaction between the doctor and the patient, a lot of the technical or administrative stuff is already done. So that’s a great point that I think we need to make sure that when these processes are sort of rolled out, what are the alternatives or alternative folks that patients can use to make the process a little bit easier?
Because you’re dealing with your health, but it’s also the technology that’s so daunting for seniors because it’s always being updated. It’s always changing. Caregivers are maybe a few years younger, and they’re a little more tech-savvy. It’s just that much more reassuring for those folks that, “Hey, listen, I’ve got someone here who understands what’s going on, and then I can ask the questions that are important to me and that are specifically about my health.” So a great point. And I would say that that’s probably the same for rural communities as well, which is the next group; correct?
Craig Settles:
Mm-hmm. And I think also you need to look at the customer relationship. One of the advantages that an ISP, is that it is a local wireless ISP as opposed to the large conglomerates. The smaller folks have better levels of customer service. And so if you incorporate extra value into the customer relationship, this is people’s healthcare. So if they have a relationship with anyone good, they’re not going to be swayed by the price of the month kind of approach that incumbents try to use often to try to keep those customers. They just want to hijack the customers. So because healthcare is so important, no one’s going to easily think about moving from the local ISP to Comcast or Verizon if the local ISP incorporates these different service elements.
Joe Coldebella:
Are you saying that these local ISPs have customer service reps dedicated to some aspect of telehealth? So when a customer that’s in a rural area has a question they can be, I guess, connected to someone who might have a little bit more information for them in terms of just connecting for a telehealth appointment. Is that sort of what you’re saying?
Craig Settles:
Exactly. I mean, it’s like the whole theme behind the digital navigator. The digital navigator is a role that has evolved in the last couple of years, which means we’re going to have people who are not being hired because of their technical expertise. They’re hired by their ability to provide good service.
Joe Coldebella:
So they’d be telehealth navigators?
Craig Settles:
So the next thing is the telehealth navigators. That’s a similar kind of thing. But the ability to provide care and handholding is the next level from the digital navigator, you have the health navigator. And the value to everyone, both the doctor and the patient, is that if there’s a problem, there’s a digital navigator to help people walk through that.
And the value is all about I am handling a very serious relationship issue, which is the healthcare. It is vital. So if we give a little extra time and a little extra concern, it is a marketing advantage for the ISP because one thing that people don’t think about too is, okay, if I have a chronic illness, I would maybe be talking to the doctor monthly. This means I will become more proficient in the technology. And so you become more adapted at being able to use, solve problems, etc.
But if I use it only once a year, if I had my stroke, I go to the cardiologist maybe twice a year. Well, I forget, and not even because of the stroke. I just forget how these certain processes work or how to log on because the cardiologist may have a different login procedure than my primary care. And that is a bear to remember. Then the doctor and the doctor’s staff are kind of suffering while you try to figure out what you are supposed to be doing. So with healthcare beyond chronic illnesses, a lot of the trial of the technology is if you don’t use it regularly and seniors will fall in that category. What are you going to do about that?
I mean, there are various solutions you can work on. But if you don’t have that in mind and all you’re doing is prescribing to the senior, “Here, we’re going to do telehealth.” And you haven’t thought about the fact that when she’s dealing with the telehealth connection six months down the road, we could have a problem. And it affects the smoothness of the relationship between caregiver, doctor, and patient.
Joe Coldebella:
And it seems that this is unfortunately a problem with seniors in rural communities as well as the travel communities. And they’ve also got the problem that generally they’re in remote areas and have less access to healthcare professionals. So I think it’s important for the ISPs to be the conduits, to be the teachers, and to make these folks aware that there is a telehealth option.
Craig Settles:
Right. Now, one of the things that should be kept in mind is that as we start becoming more proficient at artificial intelligence, I am not a big fan at all of having medical decisions created or dictated by artificial intelligence. However, the process of training a senior, who may not remember how to do a task, but the task can be done or automated by artificial intelligence.
I think that makes all the sense in the world because when we’re talking about people that are only going to the doctor two or three times a year. And you don’t want to have this hiccup of, “Well, how do I do X, Y, and Z?” Create an AI app. Some tools are coming into play. And again, you must look at it from the perspective of if I value the relationship and I want to make sure the relationship doesn’t get hijacked by a $5 discount ISP service from Comcast, then you incorporate these factors. And I think that’s a key element that needs to be adhered to as we go forward.
Joe Coldebella:
As you were explaining you said AI. It’s an interesting sort of Pandora’s box with how we’re treating AI. We don’t want folks to use AI to diagnose an ailment. But ironically, there was an article in the Wall Street Journal maybe two or three months ago that the symptoms were plugged into the AI, and it was also given to a doctor. Amazingly enough, the AI’s diagnosis was as good, and this is going to scare me, or better than the actual doctor. So maybe we don’t use AI as the first sort of interaction, but it could be an excellent sort of second opinion.
And to your point earlier, it would be great if a senior doesn’t know how or may have forgotten how to administer something, that they use AI to just get them to lay out what they need to do. So I hadn’t thought about using AI before, but I think that’s another door we can go through to make telehealth easier for seniors. That’s a great point.
Craig Settles:
Right. And I think that the ISPs must build their systems with this increase in data traffic as part of the equation. I know that there’s a process where people use averages and so forth and try to direct customers at the times when they’re not going to be working the system hard. So you try to manage or direct your traffic patterns. And I think the danger of that is you may not address correctly that data traffic pattern. So as you plan your networks, you must look at how we are managing that data flow. Because every time we add a new application, a new technology, or a device that gets locked onto the laptop, all of that means data traffic.
And when you’re talking about trying to deal with urban areas where you have lots of people in a very small space, if you will, you have to worry about data traffic. If you’re talking about the rural area, you don’t have much congestion. But you have distances, and you can’t be in the country and not be able to have a guaranteed liability. Because if you are having a heart attack, this is not the time for there to be a glitch in the system.
Joe Coldebella:
Absolutely. But one of the other groups that is not getting the attention they deserve is the urban communities as well as the ESL or English as a second language folks. I would love it if you could unpack that for us. What are some of the things that we can do for those communities to make telehealth a more viable option?
Craig Settles:
First off, people have to stop making this assumption that because there’s an AT&T store or a Verizon store in every mall, every urban person has broadband. That is erroneous. It is detrimental to us overcoming the digital divide because it is not the case. There are so many cases where the incumbents either have done redlining, or they refuse to change or increase the service of their infrastructure, and so forth. And the result of all of that is that the urban folks can be just as screwed over as the rural areas, right?
Joe Coldebella:
Yeah, I often say that my big fear is that what’s going to eventually happen is that the digital divide is going to grow as opposed to shrink in both rural and urban areas that don’t have the same sort of access that maybe a suburban area does. So yeah, it’s a great point.
Craig Settles:
No doubt about it. And I think that if you look at the broadband numbers, that gives you a pretty good predictor of the healthcare issues and the lack of access. You’ll find that whether we’re talking about veterans, seniors, or rural versus urban, you are looking for the same kinds of disparities between health and broadband. And so if you are making strides at addressing the issue of broadband, you just need to step over to the telehealth side because you’ll have the same problems. You’ll have the same inadequacies. You’ll have the same parts of the population that will not have healthcare, that don’t have broadband.
Joe Coldebella:
So I’ve got a question for you then.
Craig Settles:
Yeah.
Joe Coldebella:
Those are really good points, and I would love it if we could delve a little deeper. Talking to people in general they ask the question cell phone versus a desktop/computer. A phone can do amazing things. Is a phone enough or does someone need broadband access with a little bit more connectivity?
Craig Settles:
By the nature of the beast, a smartphone has significantly fewer numbers of data points that can expressed for the user. I mean, if I’ve got an application that’s running on my laptop, and it has 15 different features. And if I have a hundred different data points being managed and massaged in the application, by default, a smartphone will not have the same numbers. It’ll not have the same number of features. It’ll not have the same number of data points that are being expressed. And by default, we have allowed ourselves to say, “If you are poor and you can’t afford a laptop, here is this phone, and it’ll be just as good.” And it’s not; it is not. I mean, I can’t emphasize it enough.
And this isn’t an issue between urban and rural. It’s an across-the-board kind of thing. We just have smaller numbers. There are smaller numbers of people populations in rural areas, but the problem between having a smartphone versus a laptop is the same.
Joe Coldebella:
Okay. That’s interesting because there’s also the wearable technology, which would either integrate through your phone or your laptop. But your point is well taken. You’re handcuffing folks when you don’t have access to as much juice, so to speak, for analyzing data.
Craig Settles:
Right.
Joe Coldebella:
That’s great. Hey, two more areas, and then we can sort of start to wind down. But one of the areas that I thought was interesting that doesn’t get nearly the attention that it deserves is those folks who are incarcerated. And I was wondering if we could quickly talk about what’s the opportunity there. Is it one of those things where it may not necessarily be telehealth in a traditional sense, but it’s an opportunity for mental health or an opportunity for folks to break the cycle?
Craig Settles:
Our incarcerated populations are screwed. We don’t care about them. We have the attitude that they did wrong, whether they did three strikes and you’re out kind of situation, they just stole a thing of bubble gum, or they’re a mass murderer. And we just run them all into the same scenario, and we don’t care about those people. And because we don’t care about those people, there will be lots of lip service. “Yes, we’ll take care of the incarcerated.” But I don’t feel that these folks will be recoverable. I don’t think they’ll be in a situation where they’ll have any kind of advocacy people trying to work on their behalf.
I mean, looking at mental health for example. There may be, was it 63% of incarcerated people cannot get mental health treatments while they’re in jail. The numbers are like this across every other aspect of mental health and chronic care. And it is always starting with an issue that we don’t care about as a society. What’s ironic is that we have the same issue with people with disabilities. There is lip service given to people in situations where they can’t see, hear, or whatever. Now, they will have more compassion. They will look at the incarcerated as a thing that we do because we want to not be a total jerk about it. We are sympathetic, but we don’t want to talk about that.
We get uncomfortable talking about it. And we get uncomfortable being around people with disabilities. But at the same time, one in four adults has a disability of one sort or another. Whereas one of my doctor buddies is like, “Every time you add a decade, you find new disabilities. It’s the cost of being a human being.”
And so we have all those folks that we will just not want to deal with them. How many people will have a placard in an office building? Okay, we’re wheelchair accessible. Well, that’s fine until you show up and the elevator’s not working. Not only is it not working, but we also don’t know when it’s going to get fixed.
We’re talking about using telehealth, creating these kiosks, but if you don’t have thought ahead of time, you can likely get somebody into one of those cubes, and all of a sudden, it’s like, “Well, there’s no space for a wheelchair.” And again, it’s not intentional. It is the role that people with disabilities have. And so we’ll talk about why it’s valuable, but we won’t do that stuff. And that’s unfortunate.
Joe Coldebella:
Sure.
Craig Settles:
The upside is the NTIA highlighted areas that often are not highlighted — the incarcerated, people with disabilities, and people speaking English as a second language. But when the money comes from the White House to the State House and then it gets dispersed into the neighborhood, these issues for the incarcerated and the people with disabilities, how much will they be listened to? Who’s advocating for them? How are their digital navigators selected that can deal with someone who’s been in jail for 20 years or someone who’s been crippled all their life?
Joe Coldebella:
It is a hard issue. Craig, I appreciate all your time. Just talking to you and listening to your perspective is awesome because it allows me to think from a different perspective.
Craig Settles:
Sure.
Joe Coldebella:
So the last group that I wanted to talk about is veteran groups because they have the VA. They have legion posts where they can come together as a community. I hope that maybe, hopefully, possibly, fingers crossed, that maybe the VA and veterans have an opportunity to really sort of be leaders in the world of telehealth. What can we do to make sure that our veterans get the healthcare that they deserve, especially in the area of mental health? I know that unfortunately a real problem in the post-military, there’s a lot of suicide and drug addiction. So I think that’s one of the areas that we should focus on. I would love to get your thoughts on that as well.
Craig Settles:
Yeah. Probably outside of Health and Human Services, the Veterans Administration is doing the most for using telehealth across the board. They have created these things called ATLAS. Okay, I’m not sure what the acronym stands for, but they have in the last five to six years been pushing both rural and urban where they’re trying to use telehealth and the latest inventions within telehealth to address the veterans’ issues. And mental health is a key part of that.
It’s very similar to how it was with people with disabilities. One in four veterans struggle with mental illness of one sort or another. The number of suicides among veterans is depressing, all things considered. So the point that I want to make is that the Veterans Administration is very proactive with their use of telehealth across the board in my humble opinion.
Joe Coldebella:
That’s phenomenal because I think that mental health is one of those things where telehealth can be beneficial. When reading different studies and articles, I have learned that one of the biggest barriers for folks to get help is going to the psychologist or going into different areas because people feel embarrassed when they shouldn’t be. But what telehealth could potentially do is lower that barrier. It’s a lot easier to speak to someone inside your home when you feel comfortable and to tell folks your problems as opposed to going into someplace. And even though it wouldn’t be the case, some people might think, “All these people think less of me.” And that’s one of the barriers that I think telehealth allows us to hopefully overcome.
Craig Settles:
Right. And I would say that is the case that people will welcome the ability to get help without being on display. I mean, it is like there are stories of small towns where everybody knows your business, and it’s pretty much the same thing if you’re in the public housing projects and whatnot, they have the same issue. And so the ability to get help at home is key. But it is also very, very important to understand that some living situations are not conducive to having a telehealth session when you have four or five kids running around and the neighbors dropping in, it’s like the door’s part of the freeway off-ramp.
And because of that, there must be solutions that incorporate a physical place that is also not marked, “Crazy people come here” kind of thing.
Joe Coldebella:
Sure, absolutely. Yeah.
Craig Settles:
But you need to have the two of them. That’s one of the first lessons I learned about six years ago was that yes, we’re going to make every effort to make broadband available so people can do stuff at home. But at the same token, like I said, often it’s a function of poverty too. I mean, you can’t afford your place, and so you have people who just wander a lot, They’re transient almost. So with that lack of privacy, that becomes part of the dilemma of being low-income. So you have to address it in some way.
Joe Coldebella:
Yeah. We’ve got a lot of work to do, but it’s awesome that we have you on our side, Craig. It was a phenomenal visit. I appreciate you taking the time to share with our audience just how layered this issue is. If folks want to get in touch with you, where can they go to either learn more about you or just connect with you?
Craig Settles:
LinkedIn is always my first social media site, and craig@cjspeaks.com is my email. And so the writings and stuff are on my website, which is cjspeaks.com. And I’m sorry, I was just like Facebook is kind of less on the
Joe Coldebella:
Yeah, we’ll stay away from Facebook. What I’ll do is I’ll put your website as well as your LinkedIn information when we release the episode.
Craig Settles:
Not a problem. Lots of fun to discuss because it is a complex issue, telehealth. And some of us are still trying to find our way. So it’s good to have the back-and-forth of this kind of conversation. I would say that I probably like the idea of showing people elements of telehealth. I think that it’s important that people see what’s on the horizon. And I think there’s a mindset of some number of folks who feel, well, we just can put the bare minimum out because we’re making software that takes up less space and less data traffic, and so forth and so on. But there’s stuff that’s coming down the pike that you cannot short-chain the broadband.
You are going to need the hundred meg, the gig, and all that kind of stuff. I think that people try to do the bare minimum because it’s costing them some money. And you got to rip out concrete and put fiber in the ground and all that kind of stuff. And this stuff that’s coming off the drawing board is fricking amazing. When I had this person explain to me, you got a headset with goggles. Being able to take seven mini cameras that work in harmony, that takes an image. Whereas a person would not be able to see that image and we put these cameras and stuff in place. And it moves the image in front of the person’s eyes, that’s like potent stuff.
Joe Coldebella:
It’s crazy where technology is going to be going, and I think it’s going to be fun. Hopefully, in six months or so, we’ll come back together; and we will discuss those things. But it’s been a phenomenal visit, Craig.
Craig Settles:
Ah, great. I appreciate it. It was a lot of fun. We’ll do it again sometime.
Joe Coldebella:
Awesome. Well, that’s going to wrap up this episode of The Broadband Bunch. Until next time, we’ll see you guys later.
