Net Neutrality:how its elimination might

impact patients & healthcare

Kimberley R. Barker, MLIS

Librarian for Digital Life

Claude Moore Health Sciences Library

The University of Virginia

Overview• What is the Open Internet?

• What is Net Neutrality?

• Background

• Why is it important?

• What does it mean specifically for healthcare?

• How would its elimination affect healthcare?

The Open Internet

“…the idea that the full resources of the Internet and means to operate on it should be easily accessible to all individuals, companies and organizations.

This often includes ideas such as net neutrality, open standards, transparency, lack of Internet censorship, and low barriers to entry.”

Net Neutrality (in other words)

•“The term net neutrality has come to encapsulate the idea that Internet providers such as Comcast or Verizon should treat all web traffic equally and fairly. This means they can't block access to any websites or apps, and can't meddle with loading speeds. The 2015 rules also included a ban on so-called paid prioritization: the idea that Internet providers shouldn't give special treatment to apps and websites that pay extra.”

Background

•Communications Act of 1934•Services divided into two groups: Title 1

(Information Services) & Title 2 (Common Carriers telephones; trains)

•Title 1 was considered non-essential; Title 2 was considered essential put under federal oversight; regulated.

Background (2)

• Oct 2002- FCC treats cable Internet access and DSL internet access differently; deregulates cable (Title 1)

• Jan 2003- Professor Tim Wu coins term “net neutrality”

• March 2005- FCC fines an ISP for preventing its subscribers from using a VoIP service that competes with its own voice calling offering.

Background (3)• Oct 2007- then-Senator Obama expresses support for net

neutrality

• May 2010- the FCC votes for strong net neutrality protections (ISPs cannot block or impose limits)

• Jan 2011- Verizon files a federal lawsuit against the FCC

• Jan 2014- Federal Appeals Court strikes down the FCC’s 2010 vote

Background (4)

• Jan 2014- A user-created petition on “We The People” called for the Obama administration to restore net neutrality protections

• Sept 2014- FCC opens a public comment period on internet regulatory structure (15 million Americans commented; more than ever had before- on any issue)

• Nov 2015- then-President Obama called for strong laws to protect net neutrality

Background (5)

• 2015 – The Open Internet Order; the FCC reclassifies broadband as Title 2• focuses on three specific rules for internet service: no blocking, no

throttling, and no paid prioritization

• Feb 2016- the FCC votes to enforce strong net neutrality laws

• June 2016-federal court of appeals fully upholds the FCC’s strong net neutrality rule

• May 2017- the FCC, under new leadership, votes to begin the process of rolling back net neutrality protections

• Sept 2017- Net Neutrality proponents rally

One Possible Future

Healthcare areas at risk

•Telemedicine deployment

•Use of wellness apps

•Sharing of healthcare data

•Remote monitoring

Healthcare areas at risk

•Connected sensors/devices

•EHRs (high-speed connectivity crucial)

•Public health outreach (barber shops; churches)

•Patient education (videos, etc)

Populations at risk

•Poor• Relegated to the “slow lane” of the Internet because

they can’t pay for the “fast lane”

•Rural• Current lack of infrastructure means rural people will be

at further disadvantage for accessing content

What’s next?

•As of 8/3/2017, the FCC was finally fully staffed with five members.

•Ajit Pai (who opposes net neutrality) is the FCC Chairman; he must be reconfirmed or step down by the end of 2017.

Resources• “What is Net Neutrality?”

• http://whatisnetneutrality.org/timeline

• Net Neutrality• http://observer.com/2014/12/net-neutrality-explained-in-one-image/

• 7 Possible Consequences Of Losing Net Neutrality• https://www.psfk.com/2014/01/7-consequences-net-neutrality.html

• “What would the end of net neutrality mean for healthcare?”• http://www.healthcareitnews.com/news/what-would-end-net-neutrality-mean-

healthcare

Resources• “AMIA presses FCC on broadband access as a health issue”

• http://www.healthcareitnews.com/node/538320

• “Net Neutrality Debate and Connected Health”• http://www.cchpca.org/sites/default/files/resources/Net%20Neutrality%20D

ebate%20and%20Connected%20Health%20FINAL_0.pdf

• “The End of Net Neutrality Could Shackle the Internet of Things”• https://www.wired.com/2017/06/end-net-neutrality-shackle-

internet-things/

Resources• “FCC's net neutrality reversal threatens telehealth, remote

monitoring and data sharing”• http://www.fiercehealthcare.com/regulatory/net-neutrality-reversal-

threatens-telehealth-remote-monitoring-and-data-sharing

• “What happens to telemedicine if we lose net neutrality?”• http://www.healthcaredive.com/news/what-happens-to-telemedicine-if-

we-lose-net-neutrality/443908/

• “Family physicians to FCC: Net neutrality is 'paramount' for US healthcare”• http://www.beckershospitalreview.com/healthcare-information-

technology/family-physicians-to-fcc-net-neutrality-is-paramount-for-us-healthcare.html

Resources• “Rolling back net neutrality would hurt minorities and low-

income families”• http://thehill.com/blogs/pundits-blog/healthcare/333581-

rolling-back-net-neutrality-would-hurt-minorities-and-low

• FCC back to full five members as net neutrality vote looms – 8/3/2017• http://www.politico.com/story/2017/08/03/fcc-nominees-

confirmed-jessica-rosenworcel-brendan-carr-241298