As a member of the IEEE-USA Medical Technology Policy Committee I have
helped work on the position statement below, recently approved by our
policy board.  Given the extensive discussion on CLICK4HP on this topic,
I am including the summary statement (The entire statement is available,
but a bit long for general list-serv distribution .... let me know if
you'd like the whole shabang).  It is interesting to me that the most
extensive online debate within this group of engineers (i.e., IEEE) who
are all leaders in medical technology was on the subject of social
equity.
Paul Lee

UNIVERSAL ACCESS
The ability for an authorized user to access secure information from
anywhere within the United States via high capacity telecommunications
network is called "universal access."  This access should be available
ubiquitously to facilitate multi-media broadband services for optimizing
the delivery of public services, such as health care.

The Institute of Electrical and Electronics Engineers-United States
Activities (IEEE-USA) recommends that:

1)      The Federal Communications Commission and state public service
commissions identify incentives or subsidies which will promote
infrastructure development and encourage broadband network access by
under-served populations and the deployment of high-speed advanced
networks to serve low income segments of the population, persons with
disabilities, as well as communities where the high cost of network
development delivery have discouraged investments;

2)      The Federal Communications Commission and state public service
commissions cooperate with local governmental and private-sector
entities to identify applications in health-care, education, library,
economic development, corrections and other areas of public concern to
enable communities and network providers to aggregate demand for
telecommunications networks and services;

3)      Contributions to universal service support mechanisms be open,
explicit and competitively neutral; and all service providers in a
particular area should contribute;

4)      The private and non-profit sectors promote development of
educational and training programs that would overcome fears of using new
technologies and enhance public understanding of the value of advanced
networks in specific applications such as education and health-care; and

5)      Universal access policies be flexible and subject to frequent
review. Technology changes extremely rapidly and regulation has not been
able to keep pace.

The 1996 Telecommunications Act charges the Federal Communications
Commission with establishing policies for ensuring universal access in
the new competitive environment.  IEEE-USA recognizes that the Federal
government, in conjunction with state governments, is required to
continue to promote and encourage universal access for all the people of
the United States, regardless of location, disability or economic



IEEE United States Activities Board                             February
1997

        - 2 -

status.  Interactive telecommunications access points should include
schools, facilities of primary care providers, government offices,
libraries, post offices, community-based organizations, and, ultimately,
homes.

In order to support the development of universal service, we offer the
following observations:

1)      Historically, universal service has meant availability of
telephone services at reasonable cost.  In the information age, this
definition needs modification from the model of voice-grade
communication, to include the availability at reasonable cost of both
access to multi-media information services as well as networks that
transport these information and
multi-media services.

        The universal service debate must also address the need to
ensure that citizens receive the education, training and services they
will require in order to have realistic access to these networks and
services.  A high degree of computer literacy will be required for
members of the next
generation to be functioning citizens and participants in the economy.

2)      Different applications may have different technical
requirements.  For some, two-way voice and text will suffice; for
others, two-way video will be necessary.

        Medical applications (involving patients, health-care providers
and diagnostic consultants) will require high bandwidth two-way
communication.

3)      Enhanced privacy, security and reliability must be part of the
infrastructure if the national information highway is to fulfill its
potential.  These are especially critical and immediate needs in medical
services.

4)      Legal and technical standards are essential.  The Federal
government needs to enact a comprehensive privacy law to supersede
conflicting state laws, so as to ensure that authorized users and
consumers can safely send and receive sensitive personal information.
In addition, minimal standards for system security should be defined.

This statement was developed by the Medical Technology Policy Committee
of IEEE-USA and represents the considered judgment of a group of U.S.
IEEE members with expertise in the subject field.  IEEE-USA promotes the
career and technology policy interests of the more than 220,000
electrical, electronics and computer engineers who are U.S. members of
the IEEE.