Pottsboro Public Library provides its community Wi-Fi and helps with telehealth access. (Photo by Dianne Connery)

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A couple of years ago I wrote several pieces advocating for libraries to become part of telehealth hubs.,

I argued that libraries reach out and touch virtually everyone in their communities across the entire economic spectrum and that they should explore partnering with innovative medical practices and insurance companies to offer basic services to their patrons.

At the time, some libraries were lending mobile hotspots to their patrons for several weeks up to  a year. Surgery patients could borrow hotspots and use a telehealth option to facilitate recovery and home healthcare while they got back on their feet. Although the promise was there,the technology didn’t take off with other libraries. 

If there’s one thing the Covid-19 pandemic accomplished, it would be highlighting how inadequate broadband is within many communities and how it inhibits telehealth from reaching rural areas. But the pandemic has also accelerated innovative thinking about telehealth and libraries.      

The library in Pottsboro, Texas, “is not about storytimes or even books, really,” said Dianne Connery, the library’s director. “Our library is about Internet access. And innovation. Ten years ago it was funded by donations and bakes sales – and it was getting ready to close.” 

Connery and volunteers figured out that doing innovative projects brought them attention. If they wrote proposals that involved something daring and innovative, the library was more likely to get funding. So they started writing more and more grant proposals. 

Early on these innovations took a healthy turn. Grant money funded a community garden because Pottsboro is a “health desert.” Many residents don’t have transportation, so the library got cargo bicycles that enable people to reach the nearest grocery store and bring home food. They also started 100 individual garden beds so homes can grow their own organic produce and fruits. 

Covid-19-Era Changes

Covid-19 changed things. Before the pandemic, telehealth consisted of showing patrons sources of Internet-based medical and healthcare content. Even Pottsboro Library’s first Covid-related funding went for general broadband projects.

“We wrote and won a $25,000 grant from the Texas State Library & Archives Commission (TSLAC) to put Internet access in low-income students’ homes,” Connery said. “It’s a state agency funded by the federal Institute of Museum & Library Services (IMLS).  Tekwav, a local WISP, will put wireless equipment on water towers and parents come in to the library to check out portable Wi-Fi routers.”

A hotspot was installed by the Pottsboro Public Library at a bait and tackle shop for area kids to use for remote learning in a low-income area with limited internet access. (Photo by Dianne Connery)

The Gigabit Library Network (GLN), a global collaboration of tech savvy libraries, funded three neighborhood access stations, each for under $5,000. “The stations use WiFi and are enabled by Educational Broadcast Services spectrum – EBS,” said GLN director, Don Means. These stations are similar to parking lot Wi-Fi, but they’re located closer to where people live.” Tekwav allows unlimited Internet access from the stations.

The Magic of Telehealth

Pottsboro’s open-space, one-room library was the only viable enclosed public space with Internet service. Connery scheduled patrons’ Internet access throughout the pandemic. Before long she started getting calls from patrons saying their doctors didn’t want them coming to the office for appointments. She offered her office, the library’s only separated room, for video consultations with patrons’ doctors. 

“In the past couple of months we’ve had some behavioral health, weight loss management, and  dermatology appointments,” Connery said. “Somebody did four weeks of C-section followup treatments.  Another person … was acutely vulnerable to Covid. Many of our patients don’t have the Internet at home.” 

Connery had hoped she could find libraries further down the telehealth path that Pottsboro could emulate, but pioneers were but a few. “I applied for a $20,000 grant from the Network of National Library of Medicine to launch a substantial telehealth program,” she said. After we got the grant, I contacted colleagues in North Texas. There was a general consensus among us that libraries are a natural fit for delivering telehealth. So how can we each own a piece of the equation?”

Within the next two months the library will create and soundproof a room within the structure, add monitors, good lighting, and enhance the Internet connection. Starting in January, they’ll have patrons regularly connecting with their doctors. “Being a librarian I can help patrons with technology, of course,”she said. “But after a visit, if the patron needs some information on diabetes, hypertension or whatever, I can help them find it.” Here knowledge is the coin of the realm. 

According to Connery, rural libraries have a huge advantage because typically they are given freedom to innovate. How receptive librarians and their staff are to telehealth depends on how risk averse they are. Connery has been an entrepreneur much of her life and is comfortable pushing this envelope.   

She is working on her masters of library science degree, and one of her professors is pursuing a grant to recruit and train 20 people on how to provide these services in libraries in the most rural parts of Texas. Some librarians are not comfortable yet with the concept of helping patrons to search for data and resources to help them meet urgent healthcare needs. 

Peter Caplan, managing consultant at eHealth Systems & Solutions has been in the telehealth business for 15 years. 

“There is great potential for libraries to serve as a community telehealth ‘spoke,’ augmented by barber shops/hair salons, grocery stores’ in-store pharmacies, community centers, and churches within neighborhoods,”Caplan said. “Most of these sites could be eligible for equipment and broadband funding with well designed and deployed programs.”

This is an opportunity for community partnerships between employers, physicians/clinics, economic development organizations, churches, banks, and others to fill the void.

“Libraries as avenues for delivering telehealth is a long overdue model in rural communities,” Caplan said. “It just takes organization and commitment from many key stakeholders. When you’re searching for partners, don’t forget civic interest groups such as Lions, Shriners, Masons, Kiwana Clubs, and VFW outposts.”

Craig Settles, saved from a stroke by telehealth, pays it forward by uniting community broadband teams and healthcare stakeholders through telehealth initiatives.