title: What Can the National Broadband Map Tell Us About the Health Care Connectivity Gap?
abstract: Internet connection speeds are generally slower in rural areas, and this issue is rising in importance for health care facilities as technologies such as Electronic Health Records and Health Information Exchanges become more common. However, the extent of the rural-urban divide in terms of health care connectivity has not been fully quantified. This report uses data compiled from the National Broadband Map (NBM) to compare levels of health care facility connectivity across metropolitan and nonmetropolitan counties.
  
  
  
  The number of health and medical entries in the Community Anchor Institution (CAI) data collected as part of the NBM grew from 35,000 to 63,000 between 2010 and 2014. About one-fifth provided information on the speed of their connections in 2014. Comparisons across metro and nonmetro counties and over time provide insight into trends associated with the health care connectivity gap.
  
  
  
  The data clearly show that health-related institutions in nonmetro counties connect with lower speeds than do their more urban counterparts. At the aggregate level, over 55% of metro institutions who provided speed information had download speeds in excess of 50 megabytes per second in 2014, compared with only 12% of nonmetro institutions (P < .001). More importantly, the connectivity gap has grown significantly during 2010-2014, particularly for nonhospital facilities.
  
  
  
  The NBM CAI data are a publicly available and easy to use asset that rural health advocates should be aware of. The fact that the connectivity gap increased during 2010-2014, despite policies focusing on this issue, is a cause for concern.
authors.affiliation: Department of Agricultural Economics, Oklahoma State University, Stillwater, Oklahoma.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Whitacre
authors.affiliation: Center for Rural Health, Oklahoma State University, Tulsa, Oklahoma.
authors.forename: Denna
authors.initials: D
authors.lastname: Wheeler
authors.affiliation: Center for Rural Health, Oklahoma State University, Tulsa, Oklahoma.
authors.forename: Chad
authors.initials: C
authors.lastname: Landgraf
mesh_terms: D057286:Electronic Health Records / Q000639:trends; D062305:Geographic Mapping; D066275:Health Information Exchange / Q000639:trends*; D006801:Humans; D020407:Internet / Q000592:standards* / Q000600:supply & distribution*
keywords: broadband; connectivity; national broadband map; rural health