Before the FEDERAL COMMUNICATIONS COMMISSION Washington, DC ) ) ) ) ) ) ) REPLY COMMENTS OF THE WMTS COALITION

TABLE OF CONTENTS EXECUTIVE SUMMARY... i I. THE INITIAL COMMENTS DEMONSTRATE STRONG SUPPORT FOR RETAINING CHANNEL 37 FOR WMTS AND RADIO ASTRONOMY...1 II. THE ADVERSE IMPACT ON HOSPITALS OF ANY RELOCATION OF CHANNEL 37 WMTS WOULD BE HUGE...5 III. THE FCC SHOULD NOT ALLOW ADDITIONAL UNLICENSED OPERATIONS IN CHANNEL 37...8 IV. THE ADOPTED BAND PLAN SHOULD NOT INCREASE THE RISK OF ADJACENT CHANNEL INTERFERENCE TO CHANNEL 37 LICENSEES...14 V. CONCLUSION...17

EXECUTIVE SUMMARY A large majority of the parties filing initial comments joined the WMTS Coalition in favoring a band plan that retains Channel 37 for Radio Astronomy and the Wireless Medical Telemetry Service ( WMTS. The latest data show that 2,277 health care facilities have now registered Channel 37 WMTS equipment, representing more than 118,000 WMTS devices. This demonstrates that the number of health care facilities potentially affected by relocation is large and that any attempt to transition them out of Channel 37 would significantly stress the nation s health care industry. The pure dollar costs of relocating WMTS out of Channel 37 would far exceed the statutory limits imposed by the Middle Class Tax Relief and Job Creation Act of 2012, even without regard to the potential costs of relocating Radio Astronomy Service licensees. The disruption to the health care community from any relocation also needs to be considered. Many of the wireless telecommunications parties actually see significant benefit in adopting a band plan that retains Channel 37 for its current uses. For example, Channel 37 s placement at the boundary between mobile and broadcast operations might be useful as part of the guard band between mobile and broadcast operations. The WMTS Coalition strongly disagrees with those parties proposing that the Commission create a system of registration and coordination to allow unlicensed or secondary users to operate in Channel 37. There is simply no reasonably reliable way to protect WMTS devices involved in critical care patient safety from harmful interference if unlicensed devices, especially mobiles, are allowed to operate on a co-channel basis. The allocations for channels adjacent to Channel 37 could have a seriously adverse impact on the use of Channel 37 for WMTS licensees. A few parties may have misconstrued the level of protection from interference that the WMTS currently receives as a co-primary service in Channel 37. While it is true that, for historical reasons, WMTS licensees are not afforded protection from Part 73 DTV stations operating adjacent to Channel 37, it is simply not true as the Coalition stressed in its initial comments that interference is not suffered by WMTS licensees from adjacent channel DTV stations operating at the out of band emissions ( OOBE and power limitations imposed in the FCC s rules. To date, WMTS licensees engineer around any OOBE interference from DTV operations on adjacent channels in such a way that a significant amount of WMTS capacity becomes unusable. Increasing the number of DTV stations on Channels 36 and 38 would greatly exacerbate the amount of Channel 37 WMTS capacity that becomes unusable. The FCC, therefore, should heed the concerns of WMTS manufacturers GE Healthcare and Philips Healthcare when formulating its band plan for the spectrum adjacent to Channel 37 WMTS.

Before the FEDERAL COMMUNICATIONS COMMISSION Washington, DC 20554 In the Matter of Expanding the Economic and Innovation Opportunities of Spectrum Through Incentive Auctions GN Docket No. 12-268 To: The Commission REPLY COMMENTSOF THE WMTS COALITION The WMTS Coalition, whose members are listed on Exhibit A attached hereto, hereby submits reply comments with regard to certain comments filed in response to the Commission s Notice of Proposed Rulemaking in the above-referenced proceeding. 1 I. THE INITIAL COMMENTS DEMONSTRATE STRONG SUPPORT FOR RETAINING CHANNEL 37 FOR WMTS AND RADIO ASTRONOMY In the NPRM, the Commission initiated the complex process of developing rules for a new incentive auction by which spectrum can be made available for future wireless telecommunications services in the so-called 600 MHz Band (between 470 MHz and 698 MHz, while also assuring that incumbent uses of the band are not unduly harmed. Included among those incumbent uses is the Wireless Medical Telemetry Service (the WMTS which operates on a co-primary basis in the 608-614 MHz band ( Channel 37. In its favored band 1 FCC 12-118, 27 FCC Rcd 12357, released October 2, 2012 (the NPRM. These comments represent the general consensus positions of the Coalition; however, individual members of the Coalition may file their own comments discussing other issues arising out of the NPRM, or even differing with the Coalition s view on a particular issue addressed in these Comments.

plan, the so-called 600 MHz Plan, the Commission concluded that it would be difficult to relocate WMTS without significant cost and disruption to this critical radio service. As a result, the 600 MHz Band Plan anticipated that the allocation for Channel 37 would remain primary for Radio Astronomy and the WMTS. An overwhelming majority of commenters joined the Coalition in favoring a band plan that retains Channel 37 for Radio Astronomy and the WMTS. 2 A few commenters did, however, suggest that the WMTS can, and should, be relocated to another band, or that other secondary uses of Channel 37 can and should be authorized. As demonstrated below, however, the record in this proceeding would not justify such actions. This Commission has consistently recognized the importance of wireless telemetry to, and its value in, the nation s healthcare infrastructure. 3 In creating WMTS, the Commission noted that [a] specific allocation [to WMTS] is necessary in this case to protect the public safety by providing spectrum where medical telemetry equipment can operate without interference. 4 The Commission also said that it did not anticipate providing any further allocations for medical telemetry devices, urging the health care community to assure that the newly allocated spectrum was used efficiently to meet long-term needs. 5 As the Coalition demonstrated in its Initial Comments, the creation of the WMTS has allowed for the significant expansion of wireless medical telemetry, and generally improved 2 In fact, although commenting parties suggested a number of variables for the allocation of broadcasting and wireless telecommunications, almost all of these plans retain Channel 37 for its current primary uses. 3 See Amendment of Parts 2 and 95 of the Commission s Rules to Create a Wireless Medical Telemetry Service, Report and Order, ET Docket 99-255, 15 FCC Rcd 11206 (2000 (WMTS Report and Order. 4 Id., at para. 11, emphasis added. 5 Id. 2

patient care and safety. 6 Indeed, as the Coalition noted, over 2,200 health care facilities have registered Channel 37 WMTS equipment, representing more than 117,000 separate WMTS devices, while almost 1400 health care facilities have registered nearly 160,000 separate WMTS devices operating in the 1.4 GHz WMTS allocation. 7 And based on a survey of sales by manufacturers of Channel 37 WMTS systems, the Coalition suspects that the number of WMTS devices currently operating on Channel 37 likely may exceed 200,000. 8 In short, the creation of the WMTS and the allocation of Channel 37 on a primary basis for WMTS licensees has been a resounding success. But as a result, the number of health care facilities potentially affected by relocation is large; and any attempt to transition them out of Channel 37 would significantly stress the nation s health care industry. The Coalition therefore urged the Commission to reject any band plan that would require relocation of incumbent WMTS users out of Channel 37. It was joined in this conclusion by a substantial diversity of parties, ranging from Coalition members GE Healthcare and Philips 6 There have been some reported incidents of interference from adjacent channel DTV stations, see, e.g., http://www.fda.gov/medicaldevices/safety/medsunmedicalproduct SafetyNetwork/ucm127780.htm. However, as discussed in more detail below, manufacturers and system designers have learned how to accommodate the existence of adjacent channel DTV broadcast signals through filtering and other means that generally reduce the bandwidth available for WMTS capacity. 7 We note that since these statistics were compiled, 2277 health care facilities have now registered Channel 37 WMTS equipment, representing more than 118,000 WMTS devices, while almost 1435 health care facilities have registered over 166,000 separate WMTS devices operating in the 1.4 GHz WMTS allocation. This is roughly a 10% increase across the board. We also note that the average number of deployments per month in Channel 37 since June 2012 has increased by more than 650% over the average number of deployments since January 2010. The average number of deployments per month in the 1.4 GHz band has increased by more than 240% over the same period. 8 ASHE and the Coalition members continue their efforts to encourage all hospitals employing wireless medical telemetry systems to register with the WMTS database, so it is certain that the number of Channel 37 systems that would be required to relocate will be much larger than the number registered in the WMTS database today. 3

Healthcare, to parties more focused on assuring that the adopted band plan efficiently allocated spectrum for the wireless telecommunications industry s use, including Alcatel Lucent, AT&T, CTIA, the Computer & Communications Industry Association (CCIA, Verizon, Sprint PCS, and Nokia Siemens. The CCIA, for example, recognized that [t]he relocation process is arduous and disruptive, and would be particularly out of step with the Commission s recent commitment to aiding the provision of healthcare through use of broadband services. 9 AT&T also acknowledged that it would likely be cost-prohibitive to relocate wireless medical telemetry devices from Channel 37 and that, therefore, the channel will likely remain unavailable for assignment to mobile broadband providers. These devices are used in hospitals and other health care facilities to transmit patient data (such as pulse to a nearby receiver. It would be challenging to relocate this large installed base of wireless medical telemetry devices that currently use Channel 37. 10 Many of the wireless telecommunications parties actually see significant benefit in adopting a band plan that retains Channel 37 for its current uses. Verizon, for example, notes that under its proposed band plan the so-called down from Channel 51 plan that has garnered significant favor among a diverse set of commenting parties -- it, like the NPRM s principal plan, avoids the need to relocate the numerous operations that currently use the spectrum designated as Channel 37. Under some configurations, Channel 37 s placement at the boundary between mobile and broadcast operations would be useful as part of the guard band between 9 Comments of the Computer & Communications Industry Association at 13. 10 Comments of AT&T Inc. at 39. 4

mobile and broadcast operations. 11 Alcatel-Lucent similarly suggests that Channel 37, on which incumbent radio astronomy and medical telemetry services may continue, can serve as a natural break between additional unpaired downlink or uplink spectrum to form additional pairs, or TDD spectrum depending on which brings greater market demand (i.e., which would raise maximum funds to meet the financial obligations set forth by Congress in the Spectrum Act. 12 In sum, there is strong indeed, overwhelming support for retaining the allocation of Channel 37 primarily to Radio Astronomy and WMTS. II. THE ADVERSE IMPACT ON HOSPITALS OF ANY RELOCATION OF CHANNEL 37 WMTS WOULD BE HUGE Only a very few commenters even suggest that the Commission should give consideration to relocating WMTS licensees from Channel 37. Motorola Mobility suggests that [f]rom a spectrum engineering perspective, it would be highly preferable for the radio astronomy and medical device allocation to be removed from TV channel 37 [since] [t]hese services will find the operating environment far more severe as they become sandwiched between advanced mobile networks and high-powered broadcast facilities. 13 Similarly, the Wireless Internet Service Providers Association ( WISPA insisted that the Commission should initiat[e] a rulemaking proceeding seeking comment on issues such as the timing of the transition to other spectrum, the suitability of alternative spectrum and the costs involved. 14 11 Comments of Verizon at 14-15. 12 Comments of Alcatel-Lucent at 4. 13 Comments of Motorola Mobility at 12. 14 Comments of WISPA at 14. It is noteworthy that neither Motorola Mobility nor WISPA suggest what other spectrum could be re-allocated to WMTS. 5

While the Coalition acknowledges that the future operating environment for WMTS in Channel 37 may become more challenging, the Commission must consider the direct and intangible costs as well as the adverse consequences for incumbent WMTS health care facility licensees. And contrary to the suggestion in the WISPA comments, this proceeding has already provided an adequate record that demonstrates that the public interest would be ill-served by requiring relocation of incumbent WMTS users from Channel 37. For example, in its Initial Comments, the Coalition provided substantial evidence that the costs and burdens associated with any relocation of existing WMTS systems to any other frequency band would be overwhelming. 15 The pure dollar costs (not to mention the significant adverse intangible impacts would far exceed the statutory limits imposed by the Middle Class Tax Relief and Job Creation Act of 2012, 16 even without regard to the potential costs of relocating Radio Astronomy Service licensees. The Coalition calculated that relocation of existing WMTS systems would require almost $2 billion for equipment changes alone, without even considering the administrative, engineering, taxes, installation, and other costs that would have to be incurred by a hospital that was required to relocate to a new band. 17 As the Coalition also noted, the intangible expenses that would be incurred by the health care industry in attempting to relocate incumbent WMTS systems are no less daunting 15 Comments of WMTS Coalition at 12-20. 16 Pub. L. No. 112-96, 125 Stat. 156 (the Spectrum Act indicates in Section 6403(b(4(A(iii that the total relocation costs available for reimbursement of Channel 37 incumbents may not exceed $300 million. 17 Comments of WMTS Coalition at 13-14. The Coalition believes that these costs are likely to add 20-30% to the relocation costs, bringing the potential out of pocket expenses that would be incurred by the health care industry for relocation of WMTS licensees out of Channel 37 to more than $2.4 billion. Id. at n. 27. 6

than the out-of-pocket costs. 18 Affected hospitals would need to devote considerable resources to planning and executing any change to the telemetry system without disrupting patient care. 19 As discussed in the Coalition s initial comments (at pages 13-20, in responding to a poll conducted by Coalition member the Association for the Advancement of Medical Instrumentation ( AAMI, the Methodist Hospital of Houston, Texas, and others noted that they are running at nearly full capacity in their use of their wireless telemetry systems. 20 The potential down time of systems while any mandated relocation from Channel 37 was accomplished would create a significant adverse impact on the delivery of patient care. Given the scarcity of resources available for such tasks now, redirecting them to a transition in the WMTS telemetry system would certainly deny health care facilities the benefits of other priority activities or projects. GE Healthcare echoed the Coalition s concerns in stating that: [e]ven if the tangible and financial costs described above could be reimbursed through auction proceeds, an involuntary WMTS relocation would be highly disruptive to hospital operations and jeopardize the safety of patients across the country. Although such costs may be more difficult to quantify than the direct costs described above, they are likely to be far more significant, in both the short- and long-term. 21 GE Healthcare further noted that: [m]inimizing customer disruption is a key consideration in this proceeding. Likewise, one of the core principles of the Commission s Emerging Technologies relocation policies through which the Commission requires new entrants to fully compensate incumbents upon a service displacement 18 Comments of WMTS Coalition at 18. 19 It should be noted that WMTS hospitals include many Veterans Administration hospitals. The FCC would be ill-advised to undertake the radical step of requiring these hospitals to transition to different spectrum without an analysis of the impact on the federal budget. 20 Comments of WMTS Coalition at 18. 21 Comments of GE Healthcare at 15-16. 7

is to minimize disruption to incumbent operations used to provide service to customers during the transition. In light of the critical nature that WMTS systems play in patient monitoring and public safety, that principle should assume an even greater role in this proceeding. 22 The Coalition also demonstrated that any effort to require relocation of WMTS from Channel 37 would have a severe impact on manufacturers, which would be required to engage in a wholesale redesign of their product lines, disrupting current product development and resource allocations. 23 In fact, the most aggressive estimates for re-design and FDA clearance suggest that the industry would need at least two years from any decision by the Commission to relocate Channel 37 WMTS incumbents, followed by at least a 2 to 4 year period before manufacturers would be able to produce and begin to install new equipment. This would be a period extending well beyond the three years after the relevant auctions have ended deadline imposed by the Spectrum Act for completing all reimbursements. The Coalition does not believe that there is any reasonable path by which relocation of incumbent Channel 37 licensees could be implemented in the timeframes established by the Spectrum Act. In sum, the record created by the commenting parties fully supports the conclusion that, whatever band plan the FCC may finally adopt in this proceeding, it must retain the current primary allocation of Channel 37 for the WMTS. III. THE FCC SHOULD NOT ALLOW ADDITIONAL UNLICENSED OPERATIONS IN CHANNEL 37 While there was broad support for allowing the WMTS to remain in Channel 37, several commenters did suggest that the Commission should create a system of registration and coordination that, in their view, would allow unlicensed users to operate in Channel 37 without 22 Id. at 17. 23 Comments of WMTS Coalition at 18-20. 8

creating interference to the incumbent licensed services. The Coalition strongly disagrees with these commenting parties. There is simply no reasonably reliable way to protect WMTS devices involved in critical care patient safety from harmful interference if unlicensed devices, especially mobiles, are allowed to operate on a co-channel basis. The principal premise of virtually all of the proponents of expanded sharing of Channel 37 is that the inclusion of WMTS and Radio Astronomy licensees in the existing white spaces databases will allow the creation of geographic protection zones within which unlicensed devices would not operate. Assuming that technology within the unlicensed devices would restrict their operation within these geographic protection zones, the proponents of expanded sharing of Channel 37 conclude that there will be significant geographic areas in which protection is not required. For example, Kate Harrison and Anant Sahai of Wireless Foundations argue that since WMTS registered locations (or at least locations which tend to use such devices are predictable and relatively static over time [i]t would be no harder to accommodate WMTS devices than it is to accommodate TV stations. 24 Although acknowledging that they have neither the locations nor protection criteria needed to avoid harmful interference to WMTS devices, these academics nevertheless speculate that the impact [of sharing] would be relatively small compared to the benefit derived from allowing TVBDs to transmit on channel 37. 25 Boeing similarly believes that, by establishing well-considered protection areas, the Commission can feasibly make 24 Comments of Kate Harrison and Anant Sahai at 3. 25 Id. 9

Channel 37 available for unlicensed use without increasing the risk of interference to existing [WMTS] and radio astronomy service operations. 26 Clearly missing from these comments is any much less a realistic -- assessment of the risk to patient safety that would exist if unlicensed devices were able to operate in Channel 37. Given the potential impact on patient safety that could result from interference from an unlicensed device that may find its way into a hospital and transmit, the FCC should not allow unlicensed devices in this band. As GE Healthcare pointed out, this is not a matter of first impression for the Commission. 27 Barely six years ago, the Commission considered the wisdom of allowing TV Band devices to operate in Channel 37 using the same type of geo-location database and sensing technologies that were designed to protect broadcast services from interference from such unlicensed devices. In its 2004 NPRM, the Commission said, [W]e are proposing not to allow unlicensed devices to operate on TV channel 37, due to the special interference concerns associated with the sensitive nature of radio astronomy reception and the critical safety function of medical telemetry equipment. 28 In adopting rules governing the use of white spaces two 26 Comments of The Boeing Company at 3. See, also, IEEE 802 (at 14 Channel 37 should be made available for unlicensed use, while putting the Radio Astronomy and Wireless Medical Telemetry Systems in the database service where they can be protected [by] enforced exclusions in geographic regions. WISPA also argues that the Commission can make Channel 37 available for unlicensed use in areas where existing RAS and registered WMTS operations can be protected from harmful interference... through inclusion in the existing geo-location database with protection zones to be determined based on realistic propagation models. Comments of WISPA at 15. 27 Comments of GE Healthcare at 31. 28 Unlicensed Operation in the TV Broadcast Bands; Additional Spectrum for Unlicensed Devices Below 900 MHz and in the 3 GHz Band, Notice of Proposed Rulemaking, 19 FCC Rcd 10018, 34 (2004. 10

years later, the Commission declared, To minimize the risk of interference to certain authorized services in the TV bands, we will not permit operation of TV band devices on TV channel 37. 29 On further consideration, the Commission reaffirmed its earlier decision with regard to the use of Channel 37 by unlicensed TV Band devices: We believe it is important that TV band devices be allowed to operate on the largest practicable number of television channels. This will maximize the opportunities for operation of unlicensed devices in all areas, and will be particularly important for the successful implementation of unlicensed devices in areas where the TV bands are congested with other services. As discussed throughout this proceeding, however, there are certain channels that are not suitable or appropriate for use by unlicensed by TV band devices. We reaffirm our decision not to allow TVBDs to operate on channel 37 in order to protect radio astronomy and WMTS operations. 30 Certainly the parties supporting unlicensed use in Channel 37 have made no effort to balance the risks previously identified by the Commission against the claimed potential benefits of allowing such operations in the Swiss cheese environment that would exist even if some form of geographic (and spectral protection zones around WMTS licensed facilities could be created. As GE Healthcare convincingly demonstrated in the Appendix to its Comments, an unlicensed device transmitting at the fixed/access TV band device EIRP limit of 18.6 dbm/100 khz would cause significant desensitization to WMTS facilities located within 21 kilometers. 29 Unlicensed Operation in the TV Broadcast Bands, Additional Spectrum for Unlicensed Devices Below 900 MHz and in the 3 GHz Band, First Report and Order and Further Notice of Proposed Rule Making, 21 FCC Rcd 12266, 12267, 2 (2006. 30 Unlicensed Operation in the TV Broadcast Bands, Additional Spectrum for Unlicensed Devices Below 900 MHz and in the 3 GHz Band, Second Report and Order and Memorandum Opinion and Order, 23 FCC Rcd 16807, 16859, 16861 148, 155 (2008. ( Second Report and Order. 11

An unlicensed device transmitting at the personal/portable TVBD EIRP limit of 2.6 dbm/100 khz would cause significant desensitization to WMTS facilities within 3.3 kilometers. 31 With this co-channel interference potential, any geographic exclusion zones would have to be very large to prevent the fundamental emissions of unlicensed devices in Channel 37 from causing harmful interference to WMTS operations. Basing these exclusion zones off the more than 2200 hospitals already registered with WMTS systems operating in Channel 37 (a number that is growing rapidly as the Commission s activities in this proceeding become better known to the health care community, vast areas within virtually all urban centers of the country would be excluded from use by unlicensed devices -- making the benefit of sharing Channel 37 small at best, and illusory at worst. GE Healthcare also shared the Coalition s concern that a geolocation-based strategy would require that all WMTS and unlicensed device locations be known, registered, and/or capable of being identified. 32 Unlike the relatively static DTV broadcast contours that are currently tracked in the White Spaces database, tracking the many thousands of WMTS systems operating on Channel 37 across the country would almost certainly prove more daunting. 33 31 Comments of GE Healthcare at 32, Technical Appendix at 44. 32 Id. at 32. 33 The Commission must also be protective of those hospitals who have not, and may not, register with the WMTS database coordinator. While today the penalty for non-registration may be potential interference from another hospital, if Channel 37 is shared with unlicensed lowpower devices the penalty could be much more severe. As GE Healthcare notes, the penalty for failing to register the WMTS system would have the draconian effect of creating potential interference with life-critical services an inappropriate penalty that would threaten patient safety throughout the country and be anathema to the public interest. Id. at 33. While the Coalition does not mean to endorse non-registration by any WMTS operating health care facility, assuming that some non-compliance is inevitable, the Commission should nevertheless be concerned if its decision to allow other users to share Channel 37 could adversely affect patient safety. The Coalition also notes the possible similarities between WMTS devices and wireless 12

And GE Healthcare also noted, as did the Coalition, that location information for WMTS locations is rarely determined from measurements by highly qualified engineers, but rather by reference to street addresses of the hospital s location (often then translated by mapping software. 34 Because the registered geographic coordinates are not necessarily the locations of the actual deployments, the protection zones to be determined from the WMTS registration must necessarily be larger to take these inaccuracies into account. This is particularly important issue since the potential penalty for inaccuracies in the WMTS location database is interference with life-critical services. What the parties urging use of Channel 37 for unlicensed devices fail to recognize is the Commission s inability to guarantee that any exclusion zone approach will be fool-proof. As Philips noted in its comments, [n]o matter what power unlicensed devices might utilize, there is no doubt that patients and hospital visitors bringing uncontrolled co-channel transmitting devices into close proximity to wireless monitors would disrupt wireless monitor transmissions. This would be a totally unnecessary and unacceptable risk. 35 Simply stated, when patient safety is involved, even a very effective (e.g., 99.9999% scheme, applied to millions of devices, would still result in a multitude of cases of interference. This would not be the mere annoyance of noise on a television screen, but the potential to disrupt the readings of a monitored patient and cause significant health-related impacts. The conclusion reached in the White Spaces Device proceeding several years ago remains just as true today: [T]here are certain channels that are microphones. However, we also note that WMTS devices and systems are engineered to more exacting design criteria than typical wireless microphone systems, and that interference into WMTS systems is a matter of patient safety, which is certainly not the case for wireless microphones. 34 Id. at 32; Comments of WMTS Coalition at 22. 35 Comments of Philips Healthcare at 4. 13

not suitable or appropriate for use by unlicensed TV band devices. 36 The Commission simply should not allow unlicensed devices to operate in Channel 37 as part of any band plan adopted in this proceeding. IV. THE ADOPTED BAND PLAN SHOULD NOT INCREASE THE RISK OF ADJACENT CHANNEL INTERFERENCE TO CHANNEL 37 LICENSEES As the Coalition noted in our Comments, changes to the allocations for channels adjacent to Channel 37 could have a seriously adverse impact on the use of Channel 37 for WMTS licensees. Both GE Healthcare and Philips raised similar concerns. As GE Healthcare noted, the Commission... fail[s] to recognize, by proposing to provide no guard band between new mobile broadband operations and WMTS operations on Channel 37, the material risk of interference that wireless base stations and mobile devices would pose for the more sensitive WMTS devices operating in Channel 37. 37 Philips, too, voiced concern that [n]ew high-power operations in adjacent spectrum also would pose substantial risks to hospital WMTS systems unless out-of-band emissions are carefully regulated and separation distances observed. 38 Each of these manufacturers proposed specific technical requirements that could be used to mitigate the potential for harmful interference to WMTS devices from adjacent channel operations, the need for which would depend upon what services (and applicable technical requirements are allocated to Channels 36 and 38 in the final band plan. The comments in this proceeding have propounded a number of alternative band plans designed to maximize the efficient use of the band by wireless telecommunications carriers and broadcasters after re-packing. With these various plans including those initially proposed in 36 Second Report and Order at 16859, 148. 37 Comments of GE Healthcare at 19. 38 Comments of Philips Healthcare at 4. 14

the NPRM under consideration, the Coalition recognizes that it may still be too early in this proceeding to favor a particular approach for protecting Channel 37 from adjacent channel interference throughout the nation. It is note-worthy, however, that many plans are designed to minimize the impact of adjacent channel interference on Channel 37 licensees. For example, the down from 51 plan could have very little impact on Channel 37 unless the Commission was particularly successful in regaining more than 84 MHz of spectrum for wireless telecommunications services. For the Coalition, it is most important that the Commission remain sensitive to the concerns raised by GE Healthcare, Philips, and the Coalition as it proceeds to a final band plan and to technical rules that will govern the use of Channels 36 and 38 (or at the very least the portions of those channels immediately adjacent to Channel 37. In that regard, a few commenting parties have misconstrued the level of protection from interference that the WMTS appropriately enjoys as a co-primary service in Channel 37. 39 While it is true that, for historical reasons, WMTS licensees are not afforded protection from any interference that may be created by incumbent DTV stations operating adjacent to Channel 37, it is simply not true as the Coalition stressed in its comments that interference is not suffered from adjacent channel DTV stations operating at the out of band emissions ( OOBE and power limitations imposed in the FCC s rules. To the contrary, because of the historical priority given to these DTV stations and only to such DTV stations WMTS licensees engineer around any OOBE interference identified. But the Commission s rules and policies are specific to Part 73 DTV licensees; no other licensed or unlicensed service operating in Channels 36 or 38 have such priority. To the 39 See, e.g., Comments of Public Interest Spectrum Coalition at 27-29. 15

contrary, as noted above, in the White Spaces Report and Order, the Commission took great pains to impose a tight emissions mask on TV Band Devices expressly to protect WMTS (and Radio Astronomy licensees from adjacent channel interference. The Coalition would hope and expect that identical concerns for the effective use of Channel 37 in these patient-critical services would result in similar protections in any rules and allocations adopted in this proceeding. As the Coalition noted in our comments, finding the right balance that allows for the robust use of adjacent spectrum without adversely impacting patient care is a goal that all affected parties should pursue. The commenting parties, without regard to the band plan they may favor, should recognize that no licensee would benefit from rules that result in numerous instances of harmful interference to patient monitoring devices. It is therefore important to assure that the debate over the best band plan also considers avoidance of risk to patient safety in the WMTS bands. 16

V. CONCLUSION The WMTS Coalition urges the Commission to take actions consistent with the views expressed herein: retain Channel 37 for WMTS and Radio Astronomy, do not allow unlicensed devices in Channel 37, and do not increase the risk of adjacent-channel interference to Channel 37 licensees. Respectfully submitted, THE WMTS COALITION March 12, 2013 /s/ Dale Woodin By: Dale Woodin Executive Director The American Society for Healthcare Engineering of the American Hospital Association 155 North Wacker Drive Suite 400 Chicago, IL 60606 17

EXHIBIT A MEMBERS OF THE WMTS COALITION (Listed Alphabetically 1. The American College of Clinical Engineering 2. The American Society for Healthcare Engineering of the American Hospital Association 3. The Association for the Advancement of Medical Instrumentation 4. Cardiac Science 5. ECRI Institute 6. GE Healthcare 7. Mindray North America 8. Nihon Kohden America, Inc. 9. Philips Healthcare 10. ScottCare Corporation 11. Spacelabs Healthcare, LLC 12. VHA Center for Engineering & Occupational Safety and Health (CEOSH 18