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5G4PGH Ep. 2: Crown Castle and UPMC


Renee Morales, Public Affairs Manager at Crown Castle, and Carla Dehmer, Director of Telemedicine at UPMC, join TechVibe Radio's Jonathan Kersting for a discussion 5G's impact on on telemedicine.

We live in a world where connectivity is an absolute necessity, and as broadband and mobile data demands increase, our communications infrastructure is critical in meeting these increasing demands. Learn how 5G adoption in Pittsburgh is setting the stage for this and more robust telemedicine capabilities.



This is Jonathan Kersting with the Pittsburgh Technology Council and Techvibe Radio bringing you our 5G4PGH initiative. We kick this off almost a year ago really excited to explore all the opportunities happening in Pittsburgh, around 5Gand today we're hanging out with Crown Castle who is the leader in connecting people. 5G is their thing that is for sure. And really, when you think of 5G and how it's going to enable just better connectivity, faster connectivity, just really increase the quality of our lives, especially now we've all become so reliant on having good solid connections at home during COVID. And of course COVID also bringing out the advent of bring telemedicine right to the forefront and very fast way. And that's what we're going to explore today because we are talking to Renee Morales, who is a public affairs manager at Crown Castle and with her is Carla Dehmer, who's a director of telemedicine at UPMC. Carla, you must be like breathing some sighs of relief right now gotten this bar? Oh, yeah, he's been telling us as fast as you guys did at UPMC. And me having used the UPMC telling us and it works very well.

Always happy to hear that. Thank you for sharing Jonathan.

It's kind of cool to meet the people behind the stuff that goes on. And so welcome both of you today. I really appreciate you taking the time. So Renee, let's start with you in crown castle, and let's get it because we need the foundation for making telemedicine happen, right. And that's going to be 5G, and everything like that. So just quickly, what's your background background real quick, and then just give us an overview of 5G. And really what Crown Castle is all about when it comes to all things 5G.

Sounds good. Well, thanks for having us today, Jonathan, excited to talk about this. So number one, again, my name is Renee metallus. I am a public errors manager with crown castle, I cover about 18 states for the company in my role. So I have a fairly good overview of what's going on across the nation. Kind of a good regional overview, if you will. But let me let me give you a foundation about what crown castle is what we do and what we do across the nation. So crown castle owns the nation's largest portfolio of shared communications infrastructure. We have 40,000 cell towers, those are the ones you see off in the horizon, they create coverage in a geographic area, right? We have 70,000 small cells, either on air or under contract, they create capacity on a network, and I would flag small cells is the thing to remember today. Okay. And we have about 80,000 route miles of fiber across the nation. Now, all of this works together in a very holistic way. And hopefully, you'll get a better grasp of this by the end of the podcast. Now here in Pittsburgh, and Pittsburgh proper, I should say we have 30 towers, and then 95 small cells, and 350 route miles of fiber, you know, all working together to create connectivity. So you know, we really live in a world where connectivity is an absolute necessity. Oh, yeah. And as broadband. Yeah. And, and as broadband and mobile data demands increase. Our communications infrastructure is critical in meeting these demands. So the average consumer uses about seven gigs per month of mobile data, but is expected to be at 22 gigs by 2022.

Yeah, that's a huge increase. So they say that by between 2016 and 2018, we increased our usage by 238%. On the data you should side. So in everything we talked about today, and I think especially when Carla starts to give us some insight. Remember, it's consumer usage that drives demand, right? So small cell networks underpinned by fiber have become the preferred way of really expanding the coverage and the network capacity. And it's easy to see why. So small cells, as their name implies, are smaller than traditional towers, or rooftop installation.

You seem like on like utility poles sometimes and exactly things and they're, you know, a couple feet tall and so forth.

Yeah. Yeah. And that's kind of by design. We like to say if we're doing our job, right, they're hidden in plain sight when, yes, small cell infrastructure it can serve as the backbone for 5g. So think of the small cells as the backbone and the fiber as like the lifeblood, and these combined really are going to provide like a major economic engine, really for any municipality, any city state CTIA, one of the trade organizations, they say that 3 million new jobs will come about because the five g 500 billion in new GDP 270 5 billion in investments. And just on the construction side alone, $93 billion is expected to be spent spent to create this 5g network.

That's amazing. I mean, those are some serious numbers you're talking about right there?

Yes, yes. And think of all of the job creation that comes along with that from, you know, from Erie, to Pittsburgh, to Philly, it's all across the map in the Commonwealth. So you know, but we're committed partner into all of these communities, Jonathan, we understand that if it's Hershey, or, again, if it's Pittsburgh, if it's Canonsburg, where we're one of our major campuses sits, you know, we need to be a committed partner, because all of these communities, they really have a unique character. And it's our job to help them figure out what the need is for the aesthetic part of the design.

But not only that, making them look like artwork sometimes as well. Yes, I mean, like modern art.

Yeah, that's what we try to do. But look, we do more than just connect people, with the communities with our infrastructure, we connect with the community. So our corporate social responsibility program called connected by good, where we give back and volunteer, we enhance communities, we serve by improving public spaces. So with parks, and really promoting public safety and advancing access to education and technology. And that's just a bit of an overview, Jonathan happy to get into more detail.

Of course, that's one thing I do know, new crown is very just a keystone in the tech industry here in Pittsburgh and in the community in general, just because, I mean, without these foundational pieces, tech is not working, and it can be you guys want to be part of the community. So I've been part of many, many things where you guys have done some great work, getting back into the community, everything like using like 412 Food Rescue on some projects, and taking some of the cafeteria food and getting it to people, you know, all the way to making sure that students have the proper broadband and everything like that in order to do their learning and so forth. So Karla big question here, and how is we saw this massive, massive, massive increase for NEET and telemedicine? Right, is COVID going to see doctors? And how are you going to do it? So something that we thought was still on the horizon? All the sudden he became your top priority? Are you are you still recovering?

A little bit, you know, but it's, it's been it's been, you know, we hit our peak, I'd say in the April timeframe, and we're able to bring some of our patients back into our facility now. And the UPMC team has done an amazing job about putting the right efforts in place to help keep our patients safe, that are coming back in. But telemedicine still is a substantial part of what we do and how we provide our care to patients. So they're still keeping me on my toes, I would believe so.

Just think about how if this, this pandemic were to happen, you can just five years ago, we would not have been able to keep up I think as well as we've been able to keep up but we would not have been seeing doctors with telemedicine, I don't think that would have been happening. Like, we would not have been on a zoom call like this. Now, effectively, you know, with a million other way, using the zoom calls the same time, and getting some great results, being able to just do something as simple as recording a podcast. So yes, so tell me like, like, what were the first steps to me, obviously, as we move forward to how to getting up and making sure that we could visit our doctors that we knew the technology was there, you knew the foundations for connectivity that the crown and so forth is providing How did you guys get this thing started? A few minutes ago.

There was a big the big ask. Um, well, let me talk a little bit about kind of what I consider the definition of telemedicine. And I can talk about kind of from there, what, what we really did and what Luckily, we UPMC had a great foundation in place to kind of build from Okay, yeah, so we use a broad definition of the medical exchange of healthcare information from one site to another via electronic communications to improve the patient's health status. So that allows us to talk about not just a video connection, but a way to even asynchronously talk with your provider or even provider to provider. So we've got, you know, situations at UPMC where providers can connect with one another asynchronously and maybe a PCP with a specialist who has questions about a patient and can get a return response on that patient within a certain number of days.

That's interesting. I wasn't even thinking about that aspect. I'm just thinking about patients coming with dogs we forget doctors need to talk to other doctors.

Exactly right.

Yeah, he Gotta do it securely, because he said the stuff going on there for crying out, you know, so demand pressures on.

I know, right, right. So there's, there's so many tools out there. Of course a provider can also be with a patient of particular facility. So in our senior living communities, this was extremely key given the high risk for those patients during COVID. And being able to have a nurse or someone facilitate the visit with a specialist who's remote. And we've we have things like Bluetooth stethoscopes that we can use for our RNs or advanced practice providers. And that patient or that provider, who's remote is able to hear those heart and lung sounds even if they're not physically within that location.

Oh, my goodness, that's craziness. It's the future is here, right?

I know, we're gonna have the remote blood pressure tests.

Oh, my gosh, yes, my practice. Yeah, I hear you. I know he's on the screen. And I'll give you your blood.

Future is coming. I'm sure someone's actively working on that right now. And then, of course, we have, you know, what we all think of when we think of telemedicine, which is our ability to contact our provider either on a scheduled visit or an on demand visit via our own devices, whether it be our computers or smartphones to connect with our providers. So and then there's remote patient monitoring, which, you know, there's a facilitated visit where you could have a nurse or we could send you home a kit or mail you a kit with with blood pressure cuffs or items that could allow you to be remotely monitored over a period of time with specialists who are remote from you so and UPMC. We do all of those forms of telemedicine. And luckily, we were doing every form of that prior to COVID. So we were set up to succeed. Luckily, we had already been deploying cameras and microphones to all of our providers across the system. We had a good training platform put together for our providers, we had patient facing information that we could send directly to a patient once they scheduled for a particular type of telemedicine visit. So when it was time to turn on, we were really ready to turn it on. We we were doing about 100 to 200 patients a day for telemedicine pre COVID, which we were pretty proud of. Yeah. And then then come April, we exceeded 10,000, telemedicine visits a day, we back up 10,000 in a day that was in Okay, so now I'm getting this whole capacity thing that Renee was talking about here.

Yes, yes, it's key, of course, you know, patients need that broadband strands strength to be able to connect to us. But that as that increases, you know, having that network capacity is is key. So it was it was quite the increase. I can't say enough about all of the various teams that came together to make this possible in the expansion of our capacity that we needed on the network to allow for that to happen. And yeah, it just seems like it was you know, one day we were in one place in one day, we were in another and luckily we were prepared to take all of that on.

That's an amazing story. It just goes to show you the ingenuity that goes on people's commitment to providing great healthcare and then having Of course, the the infrastructure to do that as far as that goes. So Renee, tell me like what are your thoughts like on as 5g begins to proliferate? how that's going to impact telling us and obviously, it's more capacity, but I'm assuming I'm assuming it's gonna allow us to have better visits, and for doctors to be able to share to share really pertinent files and results a lot quicker and things like that. What are your thoughts on this, Rene?

Yeah, so so I think Carla kind of touched on it there and what you're saying Jonathan was so so we understand that we need the small cells to create capacity on a network, and we need the speed associated with 5g, right? So look, I think on a phone call, for the for the human mind, we don't understand the difference, right, between a millisecond and half a millisecond. But I think when it comes to what telemedicine holds for the future, millisecond and a half a millisecond might make the difference in remote surgery. And I think that look, when I think about their something called a five g powered ambulance that they're trying to develop, and you think about Yeah, yeah. And you think about a five g powered ambulance that could be on a city of Pittsburgh Street, trying to send information to a medical professional at UPMC. Right. And they're trying to send possibly CT scans and x rays and high def video and trying to communicate, you need ultra high speed and ultra low latency and ultra low latency is the handoff of the packet. Right? And so I just think that you need it right now. Right for the capacity. What Carla said the 10,000 calls a day To help the network, but we cannot begin to figure out what's going to happen in the future, the tech council probably can innovate. Right. And the entrepreneurs and the innovators that are listening to this podcast that are developing software and platforms and things that I can't wrap my mind around, that's really talking about to begin this initiative was the fact that this is going to create a whole new level of companies, I think about the fact that Uber was created because of a 4g network, right. So 5g network, maybe that does allow remote surgery. It's Oh, yeah, we're able to get it's a we're only gonna be able to, we don't know, until we started seeing it until we have this innovation unleashed upon us.

Yeah, I think the other thing that's important is one the speed, the ultra low latency that then then just the innovation that can come out of what 5g will allow. But, you know, we can't also forget the simple things, right. So we know that 50% of homes don't have a landline. And we know that 80% of homes, I'm sorry, 80% of 911 calls are made from a wireless device.

Point. So holes cannot be dropped.

Right? So the critical illness of you know, me needing to to call 911 if I went into labor, right? I mean, I don't even take it down the negative road, I take it down the positive road, if I'm right. But you know, I think that that is a aspect where you need capacity on a network to reach out to emergency services. And sometimes they are the only lifeline for a caller. And then that that emfs to the hospital. And so I think that can't be forgotten the benefit at the capacity point, I wasn't thinking that way. I mean, when it comes to the ultimate health care, it's that first call, it gets you the health care, right? So right. So it becomes that basic of a need, and just shows you how tied we are to having connectivity. And so that's why I'm this I'm so proud of Rome, five G, especially when I think about all the gig be doing around telemedicine. And so Carla, I mean, like, so what's what's UPMC doing to meet the future demand, this is where your job gets to be a lot of fun, because you can now start thinking about ways to make this bigger in depth.

Yes, yeah, exactly. You know, we, we had that time where things were wild and crazy. And you're putting everything together to make it work. And now it's time to reflect and say, Okay, yeah, how can we even take this up a notch? And so a couple of the things that we're thinking about is how can we continue to think about the technology and make it easier for both our patients and providers to use? You know, as, as we might take advantage of how easy it might be to download an app for us might not be the easiest thing to do for all of our patient population. So how can we consider you know, all demographics, all all areas where people may live, that we can make sure that we're supporting them? Things like how do you have Ada capabilities within telemedicine? How do you allow an interpreter for someone who needs sign language? Or someone who maybe is non English speaking? How can we allow for them to be accommodated into the room? So we're making sure that all patients you know, regardless of what they, you know, may have and what they may be working with and battling with that you can take advantage of telemedicine no matter what. And we want to accommodate all patient populations, including those that work that live and work in rural populations. So how can we you know, work with people that don't necessarily have the debases that they need to connect at home? How can we, you know, help those that have low broadband strength and can't connect with telemedicine. And so some of the things that you can see is obviously, looking into and actively working on all of those technologies to make it easier creating the ADA capabilities, the non English speaking interpreter, invitations into those rooms. But we're also actively and what we've done for some time, is that we have sites set up in rural communities where patients can take a 10 minute drive versus a three hour drive to Pittsburgh, and they can go to a provider or a specialty care clinic that they're familiar with the location, they could go into a room and they could have a telemedicine visit with a sub specialist that they would have had to travel. Oh, that's a that's a really cool way to go about it. Yeah. So that way you go 10 minutes, because the three hours to get that same level of care, you can then from there Connect, right, the people that you need to very great, exactly. And you might have someone there like a nurse or someone who could help facilitate the visit for you as well. So how can we you know, better accommodate those patients. Of course, we'd like them in the era of COVID to not have to go into any facility. But I think in in a situation like this to still be able to accommodate those patients is is key and something that we're taking seriously and working with all of our hospitals and rural people. To make sure that we're accommodating them appropriately with the specialist that their patients need, makes a ton of sense. Now to make this all happen, we got to roll this 5g network out. And that is no easy task. There's barriers, there's hurdles all over the place. And oh, that, you know, crowns working diligently around this day. What's going on? What What is it really going to take to make sure that 5G's rolling out in Pittsburgh? I know Pittsburgh has been a little bit late to the game. There's been some obstacles here and there. And what can we what can we do to make sure that, you know, Carly here has the best network to roll this cool future stuff out on?

Yeah, that's great, Jonathan. I think that Carla, Carla kind of touched on it there when she said, You know, it's not just the urban patients, it's rural, it's suburban. So I think when we think about it across the state, you know, there are 2500, over 2500 municipalities in the Commonwealth. And really 5g deployment is dependent upon the rules and procedures set forth by each individual municipality, you can talk and how do you to get approval for like, for sale?

Yes. So imagine if Imagine if we had to, if we were wanted to employ 20 small cells, for, you know, one of our customers bill, we had to talk to three different municipalities and their three different sets of procedures. I mean, it can take up to 187 days on average, to get something done. Imagine if it took you in your home to get permits, you would maybe Forget it. Know, so we really think that there should be one uniform, predictable statewide process, right, that wins. But since stop talking, right. And here's the thing, we we think that the Commonwealth typically leads in innovation and really making its mark on things, but really, to date 29 states, as well as Puerto Rico and the District of Columbia have already adopted small cell legislation, and 5g investment is happening in those states, really, where you start building because you know what you can build?

Yes, and you know, it's predictable. But Pennsylvania is missing out on this connectivity, the jobs, the economic growth, that comes with building small cell infrastructure. You know, deploying the world's first 5g network will require a partnership between between everybody carriers, the government, the communications infrastructure providers. So legislation is currently pending in the legislature, the small wireless facilities deployment act, and this would put Pennsylvania on a level playing field with surrounding states, you know, like, let's say, Ohio, Delaware, and West Virginia. So the legislation would help streamline the process and allows for consistency. You know, we realized a few years ago, there were some hurdles to clear in Pennsylvania. And so crown castle founded the PA partnership for five G. And the partnership was formed and has grown to nearly 50 organizations. So businesses, nonprofits, trade organizations, and all of these companies groups have come together to recognize the positive impact on 5g technology will have on their industry, clients and customers. Okay, really coming together to advocate and educate around 5g, I don't think that there is a geography or an industry that we can talk about that 5g won't touch. And to be honest, we're really excited to have you can see as our newest member, and you can just hear from Carla everything that the infrastructure and 5g will do for them. And in health care. But really, when I think of the tech Council, I think of the innovators and the entrepreneurs what I was saying earlier, who are going to create these software platforms that rely on wireless devices, right? And, and we really think that this is a moment in time that they can also get involved in the coalition. And they could be a part of this to push the message, right? The Commonwealth should not be the last one to sign up for that's gonna be embarrassing.

Like, if we're the last sign up for this, it's like it's gonna happen and you want to be last to the game like,

right, though we need the investment in the state. So So I think, you know, people always ask me, Well, what should we do? What's the call to action? And I say a couple of things. One, join the partnership. There's no cost and you can either be super involved or just read the newsletter every month. And and I would also encourage everybody that's part of the tech Council and listens to the podcast, to you know, reach out to state representatives. To your state senators, and ask them to support support this legislation. Because Listen, right now, we're still in the middle of a pandemic. And connectivity is critical. There's no reason not to pass this. This is private industry investing in Pennsylvania.

Yeah, we give these numbers I mean, just just from an infrastructure standpoint, that's why why would we not start doing this? And then from the connectivity standpoint, to have awesome telemedicine and so many other things. Let's make this happen. You know, I keep saying myself, you know, back in the day, we just say I want my MTV now I say, I want my five G.

Think we need to make that our slogan or something like I love it.

And that's why we got to have these types of conversations as far as that goes. That's why it's been so much fun talking to both of you today. I just love hearing about the infrastructure and the potential and that love talking to Carla Harris about what they've been able to do so far, and what they want to be able to do with telemedicine. As we have better connectivity that's going to be powered by 5g. It's going to be happening here. It's just a matter of when so let's not be the last of the game. It's no place to be embarrassed. We won't let that happen. And so people want to learn more about the 5g partnership, where can they go and check that stuff out? Yeah, so I would I would one just google pa partnership for five The the Pittsburgh tech Council is a part of the partnership as well. Or they can email me also. I don't know if you do show notes, Jonathan, but we can show notes. Yeah, yeah, let's put in the show notes. All the ways to connect happy to do that happy to share some more through their great stuff. Once again, can't thank you guys enough for being part of our 5g Pittsburgh initiative, putting all the weight on what's happening five g wise, it's not enough. We need more happening and we're gonna make that happen. So this is Jonathan Kersting with the Pittsburgh tech Council and TechVibe Radio.

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