Fixed Wireless Access: closing the gap for telehealth in rural areas

Even as demand for reliable broadband infrastructure grows globally, half the world's population still does not have access to reliable Internet. High speed broadband connectivity remains a pipe dream for billions globally and the repercussions of this are far reaching, into all corners of society and life.

Fixed wireless access (FWA) offers a new, viable solution. This article, by Wim van Thillo, CEO and Co-Founder at Pharrowtech, explores the significance of this emerging technology in addressing the digital divide in healthcare.

The FWA industry has grown significantly in the last year with over 77% of service providers worldwide now offering FWA. ABI research predicts FWA will reach 58 million subscriptions by 2026. The benefits of FWA have been realised by many economies with governments working tirelessly to accelerate deployment. One of the countries advancing the roll out of FWA is the United Kingdom. The government recently announced new laws to mandate new homes in England to be built with gigabit broadband connections and to allow telecoms firms to get faster broadband.

While the benefits of this new technology for home broadband are evident, commercial applications, including healthcare, are still in development.

The evolving healthcare sector

Some people have continued to be reluctant to visit their healthcare provider in person since the Covid-19 pandemic. At the same time, many providers who switched from in-person to telehealth services during lockdowns have remained reliant on telehealth well beyond social distancing mandates. Both of these factors have increased the uptake of telehealth globally.

However, for many nations, the backlog of patients waiting for healthcare treatments continues to grow. In August 2022, more than 7 million people across England were waiting for healthcare appointments. Telehealth offers an opportunity to deliver more efficient healthcare services yet the biggest barrier globally to wider adoption of telehealth services is a lack of internet access. According to ONS in the UK, the adverse effect digital exclusion has on someone’s health is most likely due to the difficultly in accessing information and acting upon it. Rural areas are significantly less likely to have reliable broadband access. It is a painful irony therefore that rural areas and hard-to-reach patients could benefit the most from access to telehealth but they lack the technology to do so.

The expanding digital divide

The digital divide is not a new problem, Covid-19 has only highlighted the importance of access and understanding of technology. It is estimated that 4% of households in the UK do not have Internet access. This problem is exacerbated in rural areas, where 17% of rural residential premises and 20% of rural commercial premises still do not have access to superfast broadband (30Mbit/s or higher). In a world where people are becoming increasingly reliant on technology, the fact that rural locations are slipping through the net presents a serious problem.

When the lockdown strategies prompted by the Covid-19 pandemic forced people to become more remote, many people embraced this new normal and worked, shopped, and accessed healthcare information and services online. The proportion of hybrid working has risen from 13% in early February 2022 to 24% in May 2022. Despite the pandemic accelerating digital adoption, however, the divide has never been wider. This is due not just to a lack of broadband connectivity but also owing to a lack of computer literacy. 26% of UK citizens who are not online do not understand the benefits, and 47% say they are not interested in using the Internet. There has also been an 18% increase since 2020 in the number of people claiming that using the internet is too complicated.

Bridging the digital divide with FWA

Another way of increasing rural connectivity is fibre broadband, but it is not a solution that will work for everyone. In these instances, fixed wireless access (FWA) can go further. This is because FWA can be used to provide Internet access where fibre cannot. FWA can provide connectivity at a similar bandwidth and latency as fibre. 5GmmWave technology falls roughly into the 30GHz-300GHz frequency range, corresponding to wavelengths that span from 1mm to 10mm. While most of the mmWave usage is centred on the licensed spectrum ranges used by tier-1 operators, a currently underused unlicensed band in the 60GHz range can amplify network connectivity in rural areas. This gigabit speed can deliver uninterrupted internet to conduct online telehealth appointments for everyone, everywhere.

An added benefit to deploying FWA in rural areas is that more remote areas do not have the infrastructure that can be upgraded, such as pipes for underground cabling. FWA can be deployed without requiring large-scale physical infrastructure, instead it replaces the fibre or copper line in the access network with a high frequency spectrum, using a mobile connection between a cell site and an antenna installed at the subscriber’s home. This reduces environmental damage to the natural surroundings in these areas.

Thus, FWA can be ideal for the healthcare industry in alleviating many of the pressures that the industry is currently facing in rural areas, such as people being unable to book online GP appointments, or order repeat prescriptions online. FWA can provide fast and reliable connectivity for those in rural areas, and it addresses the cost and environmental implications associated with alternative methods of providing connectivity such as fibre.

Fixed wireless access could be what is needed for the telehealth industry to not only survive but thrive in rural areas. With wider adoption, coupled with the supportive regulatory framework as evidenced in the UK, the potential to include those currently digitally excluded from telehealth in the UK through FWA deployment looks highly promising.