On December 10-11, 2021, a series of major tornadoes ravaged the southern and lower Midwest. A tornado destroyed 200 miles in Kentucky in one fell swoop. The total death toll is at least 90.

Dawson Springs, Kentucky is a town of about 2,700 people. The original missing list was about eight pages, single-spaced.

Communities face an increasing number of destructive unnatural disasters — catastrophic forest fires and earthquake fears on the West Coast, tornadoes in the Midwest, hurricanes and flooding in the Gulf of Mexico and East Coast, and the occasional New England deep freeze.

At first glance, some may think that discussing telehealth here is illogical. But what is telemedicine? More than just video chatting with doctors, it uses Internet and Intranet technologies to facilitate many medical activities related to healthcare and physical and mental health. Telemedicine is either real-time appointments, some variant of store-and-forward data exchange, or digitized medical knowledge.

Clearly, telemedicine disaster solutions are an imprecise science, but there are many components that can provide powerful solutions. Next year, the federal government will release billions of dollars for broadband, telemedicine, and healthcare, so now is a good time to develop some telemedicine and broadband-driven disaster recovery strategies while having the funds, even as a pilot test.

Generally speaking, natural disasters have at least three stages: 1) initial impact that is often unpredictable when everyone is fleeing or fleeing, 2) immediate aftershocks and assessment of human losses, and 3) slow recovery paths to normal. Many changes in telehealth will affect these phases.

Expand the reach of first responders

When disaster strikes, first responders have the largest share of immediate medical response. They have equipment that helps first responders communicate with hospitals, clinics, etc., so they can triage and manage injuries. Healthcare vehicles are equipped with more powerful wireless technology to facilitate patient care en route to the hospital.

In many parts of the country, cities are customizing RVs, vans, buses and ambulances with telehealth tools, expanded medical capabilities and wireless connectivity to bring health care directly to underserved populations and segments of the public.

For example, Flagstaff, Arizona has a program called “Big Orange Bus“Visit homeless shelters, schools and businesses.

One benefit of these tools is that trust is built between communities and participants, making personnel and medical management easier during disasters. Additionally, these telehealth-specific programs are more general, and people may receive extensive treatment and counseling in residential or sheltered settings. The community may wish to add these mobile units.

Create an emergency telemedicine center

There are many places in the U.S., both urban and rural, where a major disaster can cause power outages for a week or two, while highways and streets are out of service for a month. As of this writing, in Bowling Green, Kentucky, 12,000 homes were without power, and more than 500 homes and dozens of businesses were destroyed.

Before a disaster strikes, consider designating various buildings (libraries, auditoriums, gyms) across the city as “generator and telehealth zones” where you can move appropriate equipment and telehealth kiosks. Use these for store-and-forward telemedicine applications for people without home, power, and/or internet access. Introducing telehealth kiosks for real-time therapy and mental health sessions.

Arrangements are made in advance with hotels, university residence halls, warehouses and other facilities that can carry generators, computers, telemedicine equipment and wireless intranet (private) networks. If the buildings survive the disaster, they could accommodate the elderly displaced by health problems, the chronically ill, and those who suffered minor injuries from the disaster if those residents do not have easy access to other residences or medical facilities.

When disaster strikes, urban low-income residents seem to be easily forgotten. When Hurricane Katrina hit New Orleans in 2005, killing more than 1,800 people, it was one of the worst public health failures in U.S. history, as these pictures show. It will take months for poor communities to get broadband back, if they ever do.

Lessons learned, cities should leverage broadband and health care funding to build emergency health care capacity in public housing facilities during times of disaster and leverage the technology during normal times.

Broadband Basics

Let’s accept the obvious: If homes and buildings are destroyed, telemedicine will become uncertain, depending on how long the batteries on computing devices and cellphones last, as well as the infrastructure that drives the electricity. If you have a broadband network in your community, quality and speed can have a major impact on your technology’s ability to survive a disaster and get back up and running quickly.

Our network provides broadband and dedicated connectivity to multiple 911 centers in North Georgia,” said David Little, vice president of network operations for North Georgia Networks. Community broadband built by electric cooperatives or public utilities like Lafayette and Chattanooga Flooding or other damage is designed to both data and power instantly re-routed anywhere in the entire network. Despite disasters, these networks rarely experience downtime.

Communities must be responsible for their digital destiny. More towns have a chance to build the best. Telehealth stakeholders should be involved in broadband or digitization efforts in their cities, or at least community broadband initiatives that support telehealth and disaster response.

Grayson, Kentucky has a population of 4,217. They’re using their federal American Rescue Program Act funds to build a massive 100-gigabit-per-second network — upload and download speeds — to serve every household. It is estimated that this is 100,000 written novels. every second!

Grayson and many other communities in Kentucky and elsewhere dodged a serious bullet. Some are working feverishly to tidy up their broadband and digital homes. Innovations such as continuous monitoring of medical devices and artificial intelligence “health coaches” are taking off, which will help communities get through this difficult time.

“The public will have access to telehealth in our community years earlier,” said Grayson City Clerk Duane Suttles. “In the event of a natural disaster, once emergency power has been established, 1 Gb fiber can be used in every building, which will allow emergency responders to greatly enhance on-site and home connectivity in the event of traffic delays due to road and bridge closures. medical treatment.”

Craig Settles, relieved from his stroke through telemedicine, pays for the cost through a telemedicine-broadband integration program that unites community broadband teams and healthcare stakeholders.follow him on twitter @cjsettles101.