When developing a shopping mall, the key first step is to sign up “anchor tenants,” the large stores such as Macy’s or Sears that anchor a mall, with space for the smaller stores to fill in afterwards. The same principle applies to broadband networks and smart infrastructure projects. An anchor tenant such as a community college or health care center can help justify a bigger pipe for an entire community or small town. Once that bigger pipe is in place, residences and other businesses can take advantage of the pipe to gain better service at lower cost.
A health care center in a small town is an excellent example of an anchor tenant. As part of its broader support for health information technology, the Recovery Act provides $2 billion for the acquisition of health IT systems by health centers serving the medically underserved.
Health centers for the medically underserved are prime candidates for a broadband upgrade. Bandwidth of at least 1 megabit per second—and possibly more—is desirable to support high volumes of clinical transactions such as e-prescriptions, lab orders and results, and patient data exchange with other providers for the purposes of care coordination, including telemedicine. These clinical uses will be key to the utility of health IT, and HHS is virtually certain to define them as core elements of “meaningful use” (the standard against which providers must qualify in order to receive health IT incentive payments under the Recovery Act).
The positive spillovers from the health center’s use of broadband are familiar from the first round of Internet growth in the 1990s. Under the E-Rate program, schools and libraries received early funding to connect to the Internet (then operating at dial-up speeds that are too slow for many of today’s applications). The schools and libraries became the physical place where millions of Americans experienced the Internet for the first time. A generation of American schoolchildren—including the less wealthy—learned computer and Internet skills far sooner than they would have at home. And any visit to a public library today shows the incredible range of people who line up for Internet service.
The next step is to bring fast broadband to far more homes and businesses, creating the platform for education, economic growth, and civic participation. Because modern applications require ever-greater bandwidth, families and businesses that lack access to broadband will find it increasingly difficult to compete in education and the economy.
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