So I’ve been following up more since initial post yesterday. As a general matter, I recommend interested readers start with this piece from the FDA’s website, followed by the FCC’s Office of Engineering and Technology (OET) FAQ on wireless medical telemetry devices and the digital transition. OET does not see this as likely to cause a big deal because there’s plenty of empty “white spaces” out there after the digital transition and users can adjust their devices as digital televisions come online.

Well, I hope they are right about that, although I’d feel a lot better if someone were responsible for actually keeping track of this and making sure that users get informed. Under the rules, there are notification requirements for when a station goes live with its digital signal so hospitals can make changes. That works as long as folks are paying attention, of course. In any event, in case OET is looking for more work (or someone on the Hill wants to step up), I would suggest that it would be awfully nice to know what the state of the industry is. But I suspect the right place to do that is really the FDA not the FCC, or perhaps the U.S. Department of Health and Human Services.

But there is a broader lesson here. As with wireless microphones and a host of other specific low power applications, the real problem is not capacity. The problem is that we have a legacy system that slices spectrum uses into these discrete little services rather than allowing general low power unlicensed use and using cognitive radios to avoid interference.

Hospitals provide a particularly useful environment for smart devices, because they have so many noisy devices, sensitive devices, and such an expanding need for wireless devices for medical telemetry. Imagine a device that works equally well in all locations of the hospital without putting other systems at risk because it senses and adjusts for its radio frequency environment in a real-time basis. If another doctor starts up a device in a neighboring bed that is noise generator, the device monitoring my patient will move to a clear frequency. Devices and systems could even be tagged for priority, so that a mobile monitor attached to a patient knows that it must give the “right of way” to the cardiac ward systems if they come into conflict.

But more specifically here, there is nothing that existing wireless medical telemetry devices authorized in the band do that could not be replicated more flexibly and at lower cost by authorizing generic low-power white spaces devices. This is essentially the same problem as with wireless microphones. If wireless microphones had never received a special dispensation to function in the broadcast white spaces as a licensed ancillary service, you could replicate these systems with unlicensed white spaces devices. But, like the QWERTY typewriter, they are an embedded technology. And they have a constituency that, quite logically, resists change and argues that it plays an important role that generic devices could not replicate.

We thus have the irony of everybody agreeing there is “plenty of white space” for existing secondary users like wireless microphones and medical telemetry, but supposedly no room for the next generation of devices that could do the job of both technologies and bring us a host of other applications besides. We could cure this with more powerful cognitive radios, but the same natural conservatism by incumbents against any intrusion in “their” spectrum makes any movement in that direction politically difficult (as demonstrated by the FCC terminating two promising proceedings last year).

We therefore have the classic political and collective action result of fixing the wrong problem, at least from a public policy perspective. Rather than expanding wireless use generally, we make the new, more useful generic technology subordinate to the existing stakeholders. It is rather like what would have happened if harness makers and farriers had been able to demand that automobiles must protect their industries before being allowed to share the road with the horse and buggy.

Hardly a new problem or an original observation, I recognize. This has been the lament of spectrum reformers since five minutes after the first licenses were issued and the rest of us got cut off. Still, I keep hoping that this time around we’ll manage to get the right result and not let the embedded old technology trump the next generation of users.

Stay tuned . . . .