Private stakeholders include Internet Service Providers (ISPs), patient and provider organizations such as American Medical Association (AMA) and American Nursing Association (ANA), hospital systems and their professional organizations such as the American Hospital Association (AHA), and health IT companies who design, sell, and maintain Electronic Health Records (EHRs) and online health portals. Finally, non-profit organizations involved in digital inclusion and community health are important factors as well. Universities also play an important role through their innovation, research, and evaluation activities.
Public stakeholders are mostly found at the federal level. The first pole would be Human and Health Services (HHS) and its agencies. The agencies most involved in telehealth and digital inclusion are the Agency for Healthcare Research and Quality (AHRQ), the CDC through their National Center for Chronic Disease Prevention and Health Promotion, the Centers for Medicaid and Medicare Services (CMS), and Health Resources and Services Administration (HRSA) through its Office for the Advancement of Telehealth (OAT) and Federal Office of Rural Health Policy programs (FORHP). The second is the Federal Communications Commission (FCC) through its Rural Health Care program. The NTIA State Broadband Data and Development Grant program operates a broadband technology opportunities program. Lastly, because competition issues between broadband providers are central to connectivity, the FTC's Bureau of Competition is also an important stakeholder. Because many more federal agencies support telehealth either directly, or by focusing on underserved areas, many programs are funded and managaed jointly. A federal telehealth compendium document is available and tracks all federal programs as well as their budget and financing scheme.
State-level public stakeholders have much more modest means, yet they can support broadband deployment through grants and loans to internet service providers, nonprofit utility cooperatives, and local governments. Programs focus on providing capital for “last mile” connections—the part of the network that connects directly to homes and businesses—rather than for backbone or “middle mile” infrastructure.
Digital Inclusion Trailblazers is a public inventory of local government initiatives promoting digital literacy and broadband access for underserved residents. NDIA first launched this effort in 2016 as an advocacy tool for local, state and national digital inclusion leadership, and as a handy database of examples for communities interested in taking similar steps themselves.