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EDITOR’S NOTE: Craig Settles, who has written extensively about broadband for the Daily Yonder, has been organizing a public health project in 10 U.S. cities. The settings include Wilson, North Carolina, which has a population just under 50,000 and is the central city of the Wilson micropolitan statistical area. The project will put equipment in barbershops and hair salons to introduce people to the concept of telehealth and identify people with hypertension. Craig also wants to see if the community-based service could help drive demand for broadband and increase access for underserved areas. The project launches today in Wilson and will roll out in other cities in the coming weeks.
Patrons of DiFrent Level Barber Studio in Wilson, North Carolina, can get a little off the top and take the first step toward a telehealth consultation in one stop.
The barber shop is one of 10 locations around the country that are participating in an experiment to deliver telehealth services, address hypertension, and determine whether community-based telehealth programs can increase broadband access for underserved communities.
In Wilson, the Wilson County Department of Health is partnering with DiFrent Level Barber Studio to provide healthcare services.
“If a patient is referred to us from the barbershop for further evaluation, they can see one of our family nurse practitioners even if they don’t have insurance,” says Kimberly Almkuist, DNP, FNP and project lead for the department. “Our fee for them is based on a sliding scale for uninsured patients.”
Barbershops and Salons as Anchor Institutions
As part of the project, barbershops and hair salons in 10 different cities will receive digital blood-pressure monitors to take customers’ BP levels.
The healthcare partner, barbershops, and the salons download copies of telehealth vendor Vsee’s Vsee Clinic for free. The HIPAA-compliant software enables video conferencing and chat. If customers want to participate, the shops send customers’ data to their healthcare provider partners. The providers review the data and then send appropriate content and advice back to the customers. Customers are not obligated to respond to any advice received.
Waverly Willis, owner of Cleveland’s Urban Kutz barbershops (also pilot participants), has conducted a manual hypertension screening program for 12 years. He reports, “About 90% of customers discover they have high blood pressure the first time they’re screened. Several customers’ blood pressure was so high they went straight to the ER.”
The new project will add telehealth tools that allow the shops to send data directly to healthcare providers.
Once the barbershops and salons are sending healthcare data, the next phase of the pilot program is to coordinate meetings between shop owners, healthcare providers, and several community stakeholders to determine if other telehealth services can be delivered from the shops.
In Wilson, the health department’s Almkuist and DiFrent Level Barber Studio owner Kahmahl Simmons are already believers in telehealth.
The Wilson County Health Department initiated telehealth last February into the Wilson Area School Health (WASH) clinics. The department can serve two schools and see more patients while reducing Almkuist’s drive time. The department also uses telehealth to deliver mental health services.
“This project will have a positive impact on our community and will help screen high-risk patients that may not normally see a provider,” Almkuist said.
Simmons said the project has the potential to help his community.
“Telehealth will bring insight on common health issues that a lot of people in my community may overlook,” he said. “The value of this program is not just in getting valuable information out of the barbershop experience, but the experience you might help or change your life.”
No Broadband? No Telehealth
In the third phase of the project, we will see if shops providing telehealth services can serve as broadband hubs and help build demand for broadband in their communities. Wilson already has access through its Greenlight public fiber network, but other locations may lack sufficient broadband or need fixed wireless service and fiber or both to operate effectively.
The program expands the meaning of “community anchor institutions,” which are traditionally places like schools or libraries. But community-based businesses that also serve as gathering places can fit the definition, too, according to Matt Larsen, owner of rural wireless internet service provider (WISP) Vistabeam.
“I would designate the barbershop or salon as a ‘community anchor institution,’ which are the magic words broadband industry people understand,” he said. “Then you use telehealth through the anchors to drive new subscribers to the network in neighborhoods around the barbershop.”
Deborah Simpier, co-founder and COO of Althea, a hybrid WISP-community co-op, said cooperative ownership would help advance the idea of community service.
“When profits are shared by members, focus shifts to how this infrastructure can most effectively benefit the community, such as introducing telehealth,” she said. “This can lead to a more sustainable solution, especially in the often overlooked rural areas.”
Wilson’s Greenlight public fiber network ensured universal availability by passing every premise in the county, but can low-income residents afford broadband for telehealth? Greenlight and the pilot participants will explore options such as limiting telehealth as a free or heavily discounted service on the network. Another approach is that of Longmont, Colorado, where the city network established a fund to enable access for those who cannot afford broadband.
Thought leaders are connecting the dots between broadband and healthcare. For example, “Digital Prosperity: How broadband can deliver health and equity to all communities” was released February 27 by Angela Siefer and Bill Callahan of the National Digital Inclusion Alliance (NDIA) along with Adie Tomer and Lara Fishbane of Brookings Metropolitan Policy Program.
Seifer tells NDIA, “Because broadband affects nearly every social determinant of health, barriers to adoption and use represent significant challenges. Overcoming these barriers requires collaboration across the private, public, and civic sectors.”
In addition to Wilson County, there will be four other pilot locations in the Stroke Belt, the nine-state region where strokes are especially prevalent. The Stroke Belt has an adult population 34% more likely to die from a stroke than the rest of the U.S. The regions include Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia.