Rural Technology Access: Paper Session Summary
In an effort to share ideas beyond the limited time we have during the annual conference, the Community Building Committee asked Graduate Students attending TPRC54 to take notes of paper sessions to be made available to the community. The following is a summary of the paper session entitled “Equity and AI” that was presented on Friday, September 25, 2026 at 2:00pm. The session was moderated by Avijit Sarkar, University of the Redlands. The following is an edited summary based on the notes provided by Christopher Lawson, North Carolina Central University. Full papers can be accessed through ConfTool.
Paper 1: “Can Telecommunications Save Rural Hospitals? - The Potential and Limitations of TeleHealth and Hospital-at-Home to Providing Remote Healthcare”
Presenter: William Yurcik, Centers for Medicare & Medicaid Services
Additional Authors: Gregory Pluta, University of Illinois at Urbana-Champaign; Scott Kruse, University of Texas at El Paso; Diane Dolezel, Texas State University
The presentation examined the significant healthcare challenges facing rural communities. Approximately 20% of the U.S. population, or about 60 million people, lives in non-urban areas where access to healthcare can be limited.
Rural hospitals face numerous financial and operational challenges, including unfavorable payer mixes, lower reimbursement rates, Medicaid dependence, demographic changes, and increasing hospital closures. In some communities, patients must travel two to three hours to receive specialized or higher-quality care.
The presentation introduced the concept of Distant-Independent Healthcare, which combines healthcare delivery models, delivery methods, and enabling technologies to extend care beyond traditional clinical settings.
One example was the Hospital at Home model, where eligible patients receive acute-care services in their homes through remote monitoring and telehealth technologies. These approaches can provide comparable treatment while improving convenience and patient outcomes.
The major takeaway was that healthcare access is foundational. Without access to healthcare, it becomes difficult for individuals and communities to address other aspects of well-being and quality of life.
Paper 2: “Broken Backbones: Fibre Cuts, Power Failures, and a Socio-Economic View of Connectivity Resilience in Nigeria”
Presenter: Theophilus Benson, Carnegie Mellon University
This presentation explored telecommunications infrastructure challenges in Nigeria. The research emphasized that connectivity problems cannot be attributed to a single telecommunications operator because the internet ecosystem is much more complex.
The ecosystem includes:
End users
Terrestrial infrastructure
Internet Exchange Points (IXPs)
Cloud services
Content and cache servers
The research examined where outages occur, how outage patterns are changing, whether outages can be detected externally, and the social and economic effects of connectivity disruptions.
Network failures were analyzed according to location, affected operator, duration, and cause. The presentation emphasized that connectivity resilience requires consideration of both technical infrastructure and regulatory environments.
A major goal of the project is to use regulatory data and research findings to identify connectivity trends, potential policy interventions, and the real-world effects of outages on users and communities.
Presenter: Moinul Zaber, Institute of Development Studies (IDS)
Additional Authors: Eity Modhu, Data and Design Lab; Tariqul Islam, Data and Design Lab; Bulbul Ahmed, Data and Design Lab; Sarker Rumee, University of Dhaka
The third presentation examined how AI governance is being implemented in practice and whether government institutions are prepared to oversee the increasing adoption of AI.
AI readiness varies significantly across countries, with an important divide between the Global North and Global South. The presentation identified five major building blocks of AI readiness:
Infrastructure
Workforce skills
Data
Governance and rules
Oversight and accountability
One of the most significant findings was that AI adoption and institutional readiness do not always progress at the same pace. Organizations may adopt AI quickly while governance frameworks remain underdeveloped.
The research used a convergent mixed-methods approach that combined quantitative and qualitative data. The findings showed that low AI readiness is not necessarily caused by a lack of technical capacity. In some cases, infrastructure and individual capabilities may be relatively strong while governance mechanisms remain weak.
Where formal AI governance is lacking, public officials may become an informal control layer between AI systems and decision-making. This highlights the need for stronger governance frameworks and accountability structures.
Session Reflection
“I really enjoyed the way all three presentations connected technology to real-world challenges rather than focusing solely on the technology itself. Each speaker highlighted how access, governance, and infrastructure ultimately determine whether innovations can create meaningful outcomes for people and communities. From Author 1's presentation, I learned more about the growing healthcare challenges facing rural communities and the potential of Telehealth and Hospital-at-Home models to address care gaps. I was particularly struck by the reality that some patients must travel for hours to access quality healthcare and by the idea that healthcare access is a foundational need that affects all other aspects of life. From Author 2's presentation, I gained a better understanding of how complex internet connectivity and telecommunication ecosystems are. The discussion reinforced that outages are rarely caused by a single point of failure and that technical, regulatory, and socioeconomic factors all play a role in shaping connectivity outcomes. I found the focus on understanding the user-level impacts of outages especially valuable. From Author 3's presentation, I learned that AI adoption and AI governance often develop at different rates, particularly across regions worldwide. The finding that governance capacity can lag behind technology adoption was compelling, as was the observation that public officials often act as informal oversight mechanisms when formal governance structures are lacking.
One question I am left with is how policymakers and organizations can keep governance frameworks evolving at the same pace as technological innovation. Whether in healthcare, telecommunications, or AI, the presentations suggested that technology is advancing rapidly, but institutions often struggle to adapt quickly enough. I am also curious about what specific policies or investment strategies have been most successful in closing these gaps, particularly in underserved communities and developing regions.”