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Introduction. These resources address barriers and opportunities in advancing telehealth.

Background. The COVID-19 pandemic pushed Community Health Centers to quickly accelerate the adoption of telehealth and other forms of virtual care, an opportunity that many had been contemplating for years.

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Results for: Topic Area = Telehealth

Displaying all 104 records.

Strategic Investments in Telehealth and Digital Tools for Health Centers: Maintaining Your Competitive Advantage Beyond the Pandemic (2021). Resource Type: Publication. Description: This short guide describes FQHC telehealth utilization and barriers to adoption pre and during COVID19 pandemic. The document outlines reasons for maintaining or increasing adoption relative to improving health equity through technology access and move to value based care. A checklist is provided to guide technology investment and decision making. More Details...

Fundamentals of Comprehensive Care (2021). Resource Type: Archived Webinar. Description: Join us as we discuss the core concepts of team-based care and introduce elements of team-based care that builds upon these basics to support your teams in advancing their capability to provide satisfying and effective care to complex patient populations. We are joined by Margaret Flinter, Senior Vice President/Clinical Director for Community Health Center, Inc., and both Thomas Bodenheimer, MD, Physician and Founding Director, and Rachel Willard Grace, Director, from the Center for Excellence in Primary Care. More Details...

Telehealth Office Hours: Optimizing Telehealth Workflows (2021). Resource Type: Archived Webinar. Description: Join us as we hear from the Telehealth Resource Centers as we discuss new trends in telehealth optimization, funding & reimbursement. We will review the current federal landscape as it relates to Telehealth in addition to highlighting recent trends in telehealth to include hybrid care models. More Details...

Remote Access Checklist and User Agreement (2021). Resource Type: Publication. Description: This document is a sample remote access checklist and user agreement. More Details...

Interim Lessons Learn from the Pandemic: COVID-19 & the HCH Community (2021). Resource Type: Publication. Description: COVID-19 continues to be an international pandemic and the experiences over the past 18 months have shown there are more effective ways to provide care to vulnerable people. The challenge now is to extend these improvements to all communities and make them permanent. While the pandemic is not yet over, this issue brief outlines five “lessons learned” (and related strategies) that have improved systems of care and heightened public health interventions for people experiencing homelessness. More Details...

Telehealth Office Hours: Navigating the Current Telehealth Landscape (2021). Resource Type: Archived Webinar. Description: This office hour discusses new trends in telehealth optimization, funding & reimbursement. It reviews the current federal landscape as it relates to Telehealth in addition to highlighting recent trends in telehealth to include hybrid care models. More Details...

Telehealth Optimization Quick Guide for Health Centers (April 2021) (2021). Resource Type: Publication. Description: This Resource Guide is intended to support health centers looking to advance telehealth or virtual services during covid-19 pandemic response and operational recovery. More Details...

July 2021 Telehealth Office Hour (2021). Resource Type: Archived Webinar. Description: NACHC offers monthly Telehealth Office Hours for health center, PCA, and HCCN staff who have questions or want to share information about telehealth related policy and operational activities. In addition to updates and Q&A, each session will focus on a specific topic of concern. More Details...

Community Health Centers Telehealth Promising Practices: Case Studies from the COVID-19 Pandemic (2021). Resource Type: Publication. Description: This collection of case studies highlights ten community health centers' promising practices and lessons learned in adoption or expansion of telehealth delivery in response to the covid-19 pandemic. More Details...

June 2021 Telehealth Office Hour (2021). Resource Type: Archived Webinar. Description: NACHC offers monthly Telehealth Office Hours for health center, PCA, and HCCN staff who have questions or want to share information about telehealth related policy and operational activities. In addition to updates and Q&A, each session will focus on a specific topic of concern. More Details...

Social Determinants of Health (SDOH) & Diabetes Prevention Programs Among Public Housing Residents: Infographic (2021). Resource Type: Publication. Description: This infographic provides examples of the Social Determinants of Health (SDOH) contributing to the prevalence of diabetes among public housing residents with corresponding examples of diabetes prevention promising practices provided by Public Housing Primary Care (PHPC) grantees. More Details...

Telehealth and PrEP/HIV Care Outcomes (2021). Resource Type: Archived Webinar. Description: Participants of this training will learn about the current research in telehealth and PrEP/HIV care outcomes, including PrEP @ Home and considerations for the administration and management of PrEP during COVID-19. Additionally, training participants will explore the topic of PrEP program implementation in a health center setting, including best practices for systems of care and improving adherence. More Details...

HITEQ Highlight Webinar: Level Up: Leveraging Your EHR to End the HIV Epidemic (2021). Resource Type: Archived Webinar. Description: What if we told you your electronic health record (EHR) was one of the keys to ending the HIV epidemic (EHE)? Your EHR is a powerful tool that can support increases in HIV testing, access to pre-exposure prophylaxis (PrEP) for people at risk for HIV, and so much more! View our HITEQ Highlights webinar on June 8th to learn more about leveraging your EHR through the use of digital tools and innovative strategies! More Details...

HITEQ Electronic Patient Engagement Tool Selection Rubric (2021). Resource Type: Other. Description: This Excel-based scoring rubric is intended to be used by health centers to assess electronic patient engagement tools (like automated outreach SMS platforms) to determine which tool is most likely to meet the health center\'s needs. The tool assists health centers in assessing the following areas: Patient communication features Operations features Health IT Integration Attribution and value based care features Patient generated data/ remote patient monitoring features Administration It provides guidance for weighting and scoring and provides calculated final scores for up to 5 tools. Download the Excel-based tool below. More Details...

Bridging the Digital Divide: Tactics to Address Patient Barriers to Virtual Care (2021). Resource Type: Publication. Description: Lack of Internet and broadband access prevents some patients from using telehealth and other technology that can support their own health care and getting accurate health care information. In one 2020 study, 42 million Americans lacked adequate access to broadband (high speed internet). As of 2019, about one in five people did not have smartphones, and among low income people nearly one third do not have a smartphone. Rates of computer ownership are not much better. Those patients who do have access to the technology may or may not have the capacity and willingness to use it, depending on past experiences. Some patients aren\'t comfortable with technology, while others don\'t trust it or believe that virtual care is sub-par, despite growing evidence of its benefits. This culminates in a clear digital divide that can hinder the ability for patients to fully engage in their care or take advantage of things like remote patient monitoring, telehealth, mHealth, or patient portal. More Details...

NACHC Telehealth Office Hours: State Assistive Technology Act (2021). Resource Type: Archived Webinar. Description: This session from April 8, 2021 focuses on the State Assistive Technology (AT) Act program and the services they provide. State AT programs provide information and awareness about AT, train people how to use AT, demonstrate AT that is responsive to a person’s needs related to vaccine access, testing, physical distancing, using telemedicine, enrolling in programs, and participating in virtual health and wellness and social engagement programs. More Details...

Bridging Patient Access: Best Practices for Community Health Workers (2021). Resource Type: Publication. Description: As telehealth services continue to bridge patient access to health services, it is important for health centers to focus on best practices that ensure excellent delivery of care. Thisguideincludeshelpful information about telehealth service delivery, tips for providing good virtual care, and how Community Health Workers(CHWs)can engage in telehealth. More Details...

Measuring Telehealth Success: You Can't Achieve it if You Can't Measure It: HITEQ Highlights Webinar (2021). Resource Type: Archived Webinar. Description: More than a year into the Covid-19 pandemic, it is now obvious that telehealth — in the form of a hybrid care delivery model that blends virtual and in-person care — is not a fad, but a healthcare delivery option that is here to stay. Healthcare leaders are seeking to optimize their organization\'s telehealth services for high performance and long-term sustainability. The problem is that most leaders neither know how well (or how bad) their telehealth services are performing, nor what true success can or should look like. Telehealth, when designed and implemented correctly, will engage patients to achieve positive outcomes, delight physicians, and contribute to organizational strategic objectives, including sustainable financial success. In this presentation, Christian Milaster of Ingenium Digital Health Advisors leads viewers through a series of pragmatic concepts on how to set an organization’s telehealth success targets, what and how to measure telehealth performance, the Physician Bill of Telehealth Rights, and how to leverage telehealth to achieve strategic success. This presentation is the second session of a two-part series. The first session focused on a telehealth maturity model and is available here. More Details...

The Stairway to Telehealth Sustainability: The Telehealth Maturity Model: HITEQ Highlights Webinar (2021). Resource Type: Archived Webinar. Description: In response to the COVID-19 pandemic, telehealth adoption increased significantly, supporting ongoing access to care and was critical to support healthcare operations continuity which resulted in the adoption of various modes of telehealth tools. The initial focus was applying telehealth capabilities to ordinary care to increase access to care and keep patients, providers and staff safe. What healthcare organizations are now looking for is a roadmap to make telehealth more sustainable, to integrate it into clinical operations and to leverage it more strategically. In this presentation, Christian Milaster of Ingenium Digital Health Advisors shares the 7-step Telehealth Maturity Model that guides organizations toward sustainable success with telehealth. This presentation is the first session of a two-part series. HITEQ will host a second webinar session in April -- Measuring Telehealth Success: The Why, The What, The How. More Details...

Health Center Governance & Telehealth: Current and Future Considerations for Strategy and Oversight: Gobernanza y telesalud del centro de salud: Consideraciones actuales y futuras para la estrategia y la supervisión (2021). Resource Type: Publication. Description: This article outlines various strategic and oversight considerations related to telehealth for health center boards. A list of discussion questions is included at the end of the article. More Details...

Promising Practices in Virtual Integrated Behavioral Health Care: Lessons from Community Health Centers during COVID-19; February 2021 (2021). Resource Type: Publication. Description: With the rapid shift to telehealth services propelled by the COVID-19 pandemic, many community health centers had to rapidly transition to a mechanism of care delivery previously unknown and unfamiliar. Within a matter of days and weeks, health centers creatively found ways to transform workflows and approaches to care delivery to continue to provide care even if the patient was physically distant. This resource highlights promising practices in virtual integrated behavioral health care identified from community health centers. More Details...

Clinical Quality Measures for Eligible Professionals: 2021 Update: A Crosswalk Comparison of Clinical Quality Measures from The HITEQ Center (2021). Resource Type: Publication. Description: This spreadsheet developed by the HITEQ Center provides a crosswalk of Clinical Quality Measures and their electronic specifications as defined in the 2021 update for Eligible Professionals (Clinicians). Fields include the crosswalk of measures, with related information about MIPS ID, Telehealth Eligiblity, as well as inclusion in CY2021 UDS, Million Hearts, NCQA eCQM, CMS Adult / Child Medicaid Core Measures Set, HEDIS 2021, and CPC+ eCQMs. Both a PDF and spreadsheet are available for download below. More Details...

Teledentistry During COVID-19: A promising practice (2021). Resource Type: Publication. Description: This promising practice features Petaluma Health Center in CA. The health center implemented a teledentistry program during the COVID-19 pandemic. This promising practice shares their experience in ensuring continuity of oral health care through teledentistry. More Details...

FTCA Office Hour for Clinical Leaders: January 2021 (2021). Resource Type: Archived Webinar. Description: NACHC, in collaboration with Feldesman Tucker Leifer Fidell LLP, is continuing to hold a series of Office Hours to answer health center specific COVID-19 FTCA-related questions. Topics discussed include coverage for COVID-19 related activities, navigating telehealth, coverage for virtual services, issues related to COVID-19 vaccine delivery, deeming of volunteer health professionals, preparing for a virtual site visit, and risk management. More Details...

National Financial Impact of COVID-19 on FQHCs Report: National Estimate from April 2020 - June 2021 (2021). Resource Type: Other. Description: Capital Link\'s new report provides a national picture of health center revenue loss, COVID-19-related expenses, the influx of relief funds through December 31, 2020, and the estimated gap in needed funds, based on the 15-month period from April 2020 through June 2021. More Details...

The Path Forward on Social Determinants of Health: Housing (2021). Resource Type: Archived Webinar. Description: The first of five webinars in the Weitzman Institute\'s Path Forward \"Moving from Screening to Solving for Social Needs\" series focusing on the intersection of stable housing and health outcomes with presenters Tim Shaw; Associate Director of Policy, Financial Security Program, Aspen Institute, David Rich; Executive Director of Supportive Housing Works, and Jason Shaplen; Chief Strategy and New Ventures Officer, Community Health Center, Inc. More Details...

Telehealth Office Hours: Telehealth Policy Updates (2021). Resource Type: Archived Webinar. Description: NACHC's policy team discuss federal and state level telehealth policy updates. More Details...

Strategies for Increasing HIV Screening Rates at Your Health Center (2020). Resource Type: Publication. Description: Health centers are always searching for innovative strategies to increase their HIV screening rates. This year, health centers have gotten creative by combining HIV testing with COVID-19 screening, while others are mailing at-home HIV testing kits to patients. Finding strategies to help increase HIV screening at your health center is a lesson in trial and error. We hope our latest blog will give you some ideas on improving your HIV screening rates! More Details...

Telehealth Resource Library: Curated telehealth resources for health centers (2020). Resource Type: Other. Description: HITEQ is actively compiling a telehealth resource library for health centers, which houses actionable telehealth resources in the areas of telehealth technology, patient use of telehealth, provider use of telehealth, tele-behavioral health, and operationalizing telehealth more generally. This curated set of resources aims to assist health centers in accessing those resources that directly address current telehealth needs and challenges. More Details...

Diabetes and Seasonal Influenza (Flu) During COVID-19: Protect Yourself! (2020). Resource Type: Publication. Description: This infographic addresses the importance of influenza (flu) prevention among public housing residents with diabetes during the COVID-19 pandemic. More Details...

TelePrEP and Tele-STI Care: Optimizing Safer Sex in the Pandemic (2020). Resource Type: Archived Webinar. Description: The webinar discusses what is known about sexual behavior during the pandemic and what constitutes safer sex in the COVID-19 era. The talk contextualizes PrEP as part of a sexual harm reduction strategy and discusses models for remote PrEP delivery and clinical monitoring. Practical issues, such as STI screening and reimbursement, are also discussed. More Details...

Innovating with Telepsychiatry to Improve Mental Health Care in Health Centers (2020). Resource Type: Archived Webinar. Description: This webinar will present research results comparing two different approaches to providing telepyschiatry to rural health center patients with complex psychiatric disorders. Presenters will discuss clinical outcomes for both groups of patients and implementation-related issues such as credentialing and privileging telepsychiatrists/telepsychologists, EHR access for telepsychiatrists/telepsychologists, expanding scope of practice, billing, no-shows, contracting, and indemnity. More Details...

Telehealth Office Hours: The Impact of COVID-19 on School Based Operations (2020). Resource Type: Archived Webinar. Description: Join us as we hear from the School-Based Health Alliance who will provide background information on the School-Based health center program and COVID-19 impacts on school-based operations. We will also hear directly from a School-based health center on their current operational status! More Details...

Addressing Intimate Partner Violence and Human Trafficking in the Health Center Setting: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: The coronavirus pandemic and consequent stay-at-home orders may increase danger for those at risk for or experiencing intimate partner violence and human trafficking (IPV/HT). Due to COVID-19, many health centers have shifted health encounters to virtual platforms, which offer unique opportunities to provide trauma-informed care and connect in new ways with those who may be experiencing abuse. Yet, telehealth and virtual visits also present health centers with new challenges related to privacy, safety and digital health equity. More Details...

Telehealth Office Hours: Telehealth Implementation Considerations (2020). Resource Type: Archived Webinar. Description: This Telehealth Office Hour will overview considerations that should be implemented in your telehealth implementation to ensure you are on the right track for sustainable care featuring the California Telehealth Resource Center! More Details...

Food Insecurity: The Digital Transformation in Social Determinants of Health (2020). Resource Type: Archived Webinar. Description: The fourth webinar in the Weitzman Institute's Path Forward "The Digital Transformation in Social Determinants of Health" fall series focusing on addressing food insecurity as an important public health issue. The content expert for the webinar is Sarah Carroll; Director of the Center for Care Transformation at AVIA. The following organizations served as panelists for the webinar: Jacob Luria, Co-Founder and CEO, Algorex Health; Catherine Macpherson, Vice President Product Strategy & Development, Chief Nutrition Officer, Moms Meals; and Laura Robbins, Co-Founder and COO, Advocatia Solutions. More Details...

Serving Rural Patients with Telehealth: Resources and Tips for Federally Qualified Health Centers: A HITEQ telehealth publication (2020). Resource Type: Publication. Description: With the challenges of provider shortages and lack of accessible facilities, telehealth presents an opportunity for health centers serving rural areas to expand health services, integrate primary care with subspecialty services, and improve care management.6 Telehealth provision in rural communities is particularly important and in-demand during the COVID-19 pandemic as many health centers have had to quickly transition to providing remote services. While telehealth has the potential to improve healthcare provision and access, many rural areas lack the reliable broadband connection and devices necessary for high-quality telehealth provision. More Details...

Isolation & Loneliness: The Digital Transformation in Social Determinants of Health (2020). Resource Type: Archived Webinar. Description: The third webinar in the Weitzman Institute\'s Path Forward \"The Digital Transformation in Social Determinants of Health\" fall series focusing on addressing isolation and loneliness as an important public health issue. The content expert for the webinar is Gretchen Alkema, PhD; Vice President of Policy and Communications, The SCAN Foundation. Presenters for the webinar includes: Andrew Parker, Founder & CEO of Papa; Cindy Jordan, Founder & CEO & Christina Myren; Chief Operating Officer of Pyx Health; and Ashwin Patel, Co-Founder & CEO of InquisitHealth. More Details...

Ending the HIV Epidemic Collaborative: Other EHRs (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

EnVision Centers, Jobs Plus and Health Centers Interactive Map (2020). Resource Type: Interactive Map. Description: NCHPH recently launched a new interactive map. This map shows the location of Health Centers, Envision Centers and Jobs Plus sites. EnVision Centers are centralized hubs that provide people living in public housing with resources and support needed to excel. Jobs Plus Sites. The place-based Jobs Plus Initiative program addresses poverty among public housing residents by incentivizing and enabling employment. Health Centers interested in partnering with near Envision Centers and Jobs Plus sites, visit this NCHPH resource and hover over the organization you want to partner with. Contact information will then be displayed in the information box. More Details...

Ending the HIV Epidemic Collaborative: Next Gen (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: Greenway (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: Next Gen: HITEQ Ending the HIV Epidemic Collaborative (2020). Resource Type: Learning Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Building the Plane While Flying It: Health Care for the Homeless, Telehealth and COVID-19, Part II (2020). Resource Type: Archived Webinar. Description: This Coffee Chat is the second of our series highlighting representatives from three HCH health centers featured in the Council’s recent publication on telehealth. The conversation shared information on how to engage clients through telehealth to enhance the experience and how to develop low-literacy messaging. Presenters discussed how to engage clients with limited or no access to internet or broadband services and establishing “technology hubs” can address these challenges. More Details...

Ending the HIV Epidemic Collaborative: Greenway (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Analysis of UDS Clinical Quality Measure Performance by Health Center Telehealth Use (2020). Resource Type: Publication. Description: The below analysis is based on Uniform Data System (UDS) reported by health centers (both 330 funded and Look Alikes). Performance on Clinical Quality Measures is derived from Tables 6B and 7 (with the exception of the Prenatal measure, which is not included). Telehealth Use is from Question 2 of the UDS’s Other Data Elements form, which asks Did your organization use telehealth in order to provide remote clinical care services [in referenc year]? Yes or No. More Details...

Telehealth Office Hour with NACHC: Patient comfort with technology, tips from VHA (2020). Resource Type: Archived Webinar. Description: This webinar focuses on telehealth services offered by the Veterans Health Administration (VHA) and its community care network. The discussion addresses the "continuum of care" provided by the VHA. More Details...

Ending the HIV Epidemic Collaborative: E-Clinical Works (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Ending the HIV Epidemic Collaborative: E-Clinical Works (2020). Resource Type: Collaborative. Description: Peer to peer sharing. If you are a Primary Care HIV Prevention (PCHP) funded health center that struggles with clinical decision support, tracking HIV prevention and treatment outcomes, your peers can share innovative ideas and strategies to help you find solutions. Relationship building. This is a unique opportunity for PCHP health centers to get together to share ideas around HIV screening and prevention. The EHE Collaborative is an opportunity to build relationships with other PCHPs. Improved technical assistance and training. Your participation in this roundtable helps HITEQ tailor our training and technical assistance services to serve you better. More Details...

Brief Telehealth Needs Assessment (2020). Resource Type: Publication. Description: As it becomes ever more clear that the public health emergency will last longer than initially anticipated, health centers are likely adapting telehealth services to that reality. This includes moving to a more hybrid clinic model where some visits are in the clinic, but many are still best done via telehealth. This also means refining telehealth services that may have been very rapidly adopted in early 2020 to be more sustainable and integrated going forward. More Details...

Patient Confidentiality and Telehealth Package (2020). Resource Type: Publication. Description: This packet contains guidance on immediate and long-term telehealth/patient confidentiality questions relevant to federally qualified health centers (FQHCs) across the country. The resources contained within aim to provide risk management considerations for a sustainable telehealth program. More Details...

Telehealth for Supportive Housing Providers - CSH Three Part Telehealth Series: Guidance for Providers looking to adapt and are considering Billing for themselves (2020). Resource Type: Publication. Description: In the COVID19 environment technology can be used as a complement to face-to-face services, and also as a service on its own. Technology options can be especially useful for people with depression or suffering from distress, and when there are difficulties in physically meeting with tenants. More Details...

Telehealth Basics for Supportive Housing Providers and their Health Center Partners - CSH Three Part Telehealth Series: Guidance for Providers Looking to Support Residents Getting Connected to Telehealth (2020). Resource Type: Publication. Description: The public health emergency related to the COVID-19 pandemic has required the health care sector including Community Health Centers and supportive housing providers to work in new ways to support their service participants (i.e. health center patients who are also supportive housing tenants). This brief considers the basics regarding telehealth for collaborations between health centers and the supportive housing field to consider as they adapt to provide services in a manner that protects both the client and staff. More Details...

Supporting Tenants During COVID-19 Using Technology Based Strategies - CSH Three Part Telehealth Series: Tips for Using Technology to Support Tenants in Supportive Housing Tenants (2020). Resource Type: Publication. Description: In Telehealth, the Technology can be used as a complement to face-to-face services, and also as a service on its own. Technology options can be especially useful for people with depression or suffering from distress, and when there are difficulties in physically meeting with tenants. This guide highlights the steps recommended for establishing your telehealth technology, connecting with residents and compliance with requirements such a HIPAA. More Details...

Analysis of UDS Clinical Quality Measure Performance by Health Center Telehealth Use: Updated in Sept. 2020 with CY2019 UDS Data (2020). Resource Type: Publication. Description: A brief study of how health centers who report using telehealth compare to those who do not, using data reported on 2017 UDS. This analysis suggests that the average performance on each clinical quality measure is higher among those health centers who report using telehealth than those who do not use telehealth.  The below analysis is based on 2017 Uniform Data System USD reported by health centers both 330 funded and Look Alikes.  Performance on Clinical Quality Measures is derived from Tables 6B and 7 with the exception of the Prenatal and Birthweight measures. Telehealth Use is from Question 2 of the UDS’s Other Data Elements form, which asks Did your organization use telehealth in order to provide remote clinical care services [in 2017]? Yes or No.  Considerations 1. Names used for the quality measures shown here are colloquial, and do not reflect exact names used in the 2017 UDS Manual. 2. Measures are shown in alphabetical order, not in the same order as the UDS Manual. 3. The Diabetes measure is calculated as Controlled, as opposed to Uncontrolled, as is reported in the UDS. This was done for comparison purposes, so all measures are ‘better’ if higher. Observations Health centers that report using Telehealth, on average, report slightly higher performance on all clinical quality measures than those that report that they do not use telehealth. On average, across all measures, using telehealth is correlated with a 1.18% percentage point higher performance rate per clinical quality measure. A chart showing all measures side-by-side can be seen below. Download the full analysis document at the bottom of the page for details about each measure.   More Details...

HITEQ Highlights: Preparing for Value-Based Care through Sustainable Telehealth Workflows: HITEQ Highlights Webinar (2020). Resource Type: Archived Webinar. Description: Join the HITEQ Center, in collaboration with Certintell, for a webinar on Preparing for Value-Based Care through Sustainable Telehealth Workflows. The webinar will provide an overview of how health centers can use telehealth during the current public health emergency and ensure that they are ready for the shift to Value-Based Care. We will cover sustainable telehealth services that are often underutilized and example workflows that have worked for other health centers. More Details...

Coping with COVID-19: Trauma-informed Care for Pediatric NICU Providers During the COVID-19 Pandemic (2020). Resource Type: Online Self-Paced Learning Modules. Description: This is a FREE online continuing education course that provides 1 credit to nurses, physicians, social workers, and licensed marriage and family therapists. All other professions are welcome to take the course, and will receive a Certificate of Completion. More Details...

Coping with COVID-19: Trauma-informed Care for Frontline Maternity Providers During the COVID-19 Pandemic (2020). Resource Type: Online Self-Paced Learning Modules. Description: This is a FREE online continuing education course that provides 1 credit to nurses, physicians, social workers, and licensed marriage and family therapists. All other professions are welcome to take the course, and will receive a Certificate of Completion. More Details...

Building the Plane While Flying It: Case Studies on COVID-19, Telehealth, and Health Care for the Homeless Centers (2020). Resource Type: Publication. Description: As is the case for most health centers, the COVID-19 pandemic forced Health Care for the Homeless health centers to rapidly adopt telehealth strategies to sustain client services remotely. But serving patients without homes necessitates additional innovation to reach clients in shelters, quarantine facilities, or even on the street, while attending to complex health and social needs. These case studies profile 17 HCH health centers and 2 consumers, offering a range of pragmatic, insightful perspectives on HCH telehealth in the COVID world. More Details...

Building the Plane While Flying It: Health Care for the Homeless, Telehealth, and COVID-19 (2020). Resource Type: Archived Webinar. Description: This archived webinar highlighted Health Care for the Homeless leaders who described their distinct experiences in adopting telehealth in light of the COVID-19 pandemic. The lessons learned promise to be helpful to other health centers that serve people without homes. More Details...

Telehealth Strategies and Resources for Serving Patients with Limited English Proficiency (2020). Resource Type: Publication. Description: Telehealth has the power to provide care to people in ways that were not possible before. Telehealth has removed barriers and ensured that people receive care when and where it is most convenient. Telehealth has been especially powerful during the COVID-19 pandemic, when non-emergency services such as primary care, behavioral health, and other in-person visits have been postponed to reduce the spread of the virus. However, while telehealth can remove obstacles, if not used deliberately and thoughtfully, it can exacerbate many inequalities that exist in the United States health system. One factor that is essential is language accessibility. More Details...

A Framework for Health and Housing Partnership During the COVID-19 Pandemic: Key partnership elements for successful health and housing partnerships to address crisis (2020). Resource Type: Publication. Description: Community responses to the COVID-19 pandemic like shelter-in-place, quarantine, testing, and management of strained health resources have elevated the necessity and value of effective health and housing partnerships to address the needs of vulnerable populations. This brief highlights strategies for health centers, housing, and community service providers in leveraging partnerships to address a range of health and housing needs both during, and after the COVID-19 crisis subsides. More Details...

TelePrEP for Health Centers: Telehealth Resources and Innovations for HIV Pre-Exposure Prophylaxis (PrEP), June 2020 (2020). Resource Type: Publication. Description: Pre-exposure prophylaxis, or PrEP, has long been recognized as an effective treatment in the effort to end the HIV epidemic. Prescribing PrEP should be considered as part comprehensive prevention plan that includes a discussion about adherence to PrEP, condom use, other sexually transmitted infections (STIs), and other risk reduction methods. This HITEQ brief presents an overview of how health centers can utilize telehealth for PrEP access, or TelePrEP, for comprehensive care, and includes innovations and resources that health centers can utilize to extend these services to their patient populations. More Details...

The Path Forward: Re-Imagining Primary Care During and Beyond the Pandemic (2020). Resource Type: Archived Webinar. Description: As the nation struggles with the dual pandemics of COVID-19 and racism, the moment is upon us to deeply examine and reshape the primary care delivery system for underserved communities. In this webinar, leadership of the Community Health Center, Inc. and its Weitzman Institute will lay out a road map for the new Path Forward. We invite health center and safety net providers, staff, consumer leaders and others to join the conversation and contribute their expertise, perspective and ideas. More Details...

Payment Reimbursement Tips: FQHC Requirements for Medicare Telehealth Services during the COVID-19 Public Health Emergency (PHE) (2020). Resource Type: Publication. Description: This fact sheet covers requirements for FQHC reimbursement for telehealth services during the COVID-19 Public Health Emergency. More Details...

Snapshot: FQHCs and Oral Health (2020). Resource Type: Publication. Description: n.a. More Details...

The Health Center Program and Increasing Access to Comprehensive Care Through the Use of Telehealth: An Update During COVID-19 (2020). Resource Type: Archived Webinar. Description: This fact sheet discusses how health centers are expanding their use of telehealth during COVID-19. More Details...

Telehealth Office Hours: Health Center Scope (2020). Resource Type: Archived Webinar. Description: This webinar provides a basic definition of teleheath and an overview of a Program Assistance Letter (PAL) to clarify the credentialing and privileging documentation required by health centers in response to certain declared emergencies. More Details...

Telehealth Office Hours: Focus on Sustainability (2020). Resource Type: Archived Webinar. Description: This webinar offers a broad overview of telehealth services, with a focus on sustainability. More Details...

Homelessness & COVID-19 Webinar Archives (2020). Resource Type: Archived Webinar. Description: In the peak of the emergency response to COVID-19 cases among people experiencing homelessness, the National Health Care for the Homeless Council held semiweekly webinars/forums on the most pressing issues facing health centers in April and May. View all recordings of this series now. More Details...

Telehealth.HHS.gov website (2020). Resource Type: Other. Description: The Telehealth.HHS.gov website provides information about the latest federal efforts to support and promote telehealth services. It was built by the Health Resources and Services Administration (HRSA), an agency of the U.S. Department of Health and Human Services (HHS). More Details...

Telehealth Implementation Quick Guide – COVID-19 Resource Packet / Guía rápida para la implementación de telesalud: Paquete de recursos sobre la COVID-19 (2020). Resource Type: Publication. Description: This resource packet provides a short overview of reimbursement and legal considerations for telehealth during the pandemic, operational guides compiled from health centers for implementing telemedicine and telephonic visits, and sample workflows. More Details...

Delivering Telelegal Services During COVID-19 (2020). Resource Type: n.a.. Description: This town hall featured teams from Los Angeles, Montana, and Alaska who have experience delivering remote medical-legal partnership services in urban, rural, and frontier settings More Details...

Webinar Recordings and Slides — COVID-19: Oral Health COVID-19 Webinars (2020). Resource Type: Archived Webinar. Description: This webpage includes all recordings and slides from NNOHA's live webinars related to COVID-19. The webinars include content on self-care, teledentistry, and oral health workforce. More Details...

Bridging the Digital Divide: Using Technology to Improve Access to Health Care for Public Housing Residents (2020). Resource Type: Publication. Description: The purpose of this report is to outline the digital needs and challenges of public housing residents, the risks and benefits of using technology to improve patient care, and recommendations on how to prepare health centers and patients to optimize digital tools, improve access to care, and enhance efforts through partnerships to bridge the digital divide. More Details...

Triage & Tele-Health Support Plan for Isolation Units: Strategies for engaging clients for telehealth in COVID19 environment (2020). Resource Type: Publication. Description: This step-by-step support plan is applicable to Supportive Housing Providers, Managed Care Organizations (MCOs), Health Centers, and Case Management services across the country in the early stages for addressing infectious disease. The support plan includes Triage Interview Questions and Immediate Intervention Steps for front line staff. More Details...

Telehealth Essentials (2020). Resource Type: Publication. Description: This brief guide by Mid-Atlantic Telehealth Resource Center discuss the essential aspects of telehealth, from policy to implementation. More Details...

Telehealth to Support Primary Care during COVID-19 (2020). Resource Type: Archived Webinar. Description: Sanjeev Arora, MD, discusses how the Project ECHO model is being applied to support primary care providers during this pandemic. Bob Phillips, MD reports on how primary care practitioners are applying emerging telehealth policies and the tough choices practices are making to maintain financial viability with dramatically reduced in-person visits. More Details...

Communications & Outreach Toolkit — COVID-19: Resources & Templates to help Health Centers Communicate information about services and programs during the Coronavirus Outbreak (2020). Resource Type: Toolkit. Description: Resources and templates Health Centers and PCAs can use to communicate information about services and programs to a variety of audiences, including the media, patients, prospective patients, community partners, during the Coronavirus outbreak. Resources include templates and documents like fact sheets, flyers, media relations templates, video animations, and more. More Details...

Using Non-Traditional Technology for Telehealth During COVID-19 Pandemic: Issue Brief for implementing commercial applications for telehealth consistent with March 2020 OCR Guidance (2020). Resource Type: Publication. Description: Health and Human Services’ Office of Civil Rights (OCR), the entity responsible for enforcing regulations under HIPAA, stated, effective immediately, it will exercise enforcement discretion and will not impose penalties for HIPAA violations against covered healthcare providers if patients are served on a good faith basis during the COVID-19 nationwide public health emergency. OCR has clarified that, during this public health emergency, these technologies can be used for any services, not only those specific to COVID-19. More Details...

Telehealth Policy during Coronavirus/COVID-19 Pandemic (2020). Resource Type: Publication. Description: The HITEQ Center is adding additional telehealth information, including policy and regulatory developments, relevant to coronavirus/ COVID-19 pandemic as it impacts health centers as it becomes available. More Details...

Telehealth Implications for FQHCs — COVID-19 (2020). Resource Type: Archived Webinar. Description: In this complimentary webinar, we will describe the new telehealth flexibilities in the Appropriations Act and PAL 2020-01, discuss the President's recent national emergency declaration, and explain the broader impact of each on health centers. More Details...

Telehealth Toolkit — COVID-19 (2020). Resource Type: Toolkit. Description: This toolkit outlines ways in which telehealth can be used in response to COVID-19. More Details...

Telehealth and COVID-19 (2020). Resource Type: Archived Webinar. Description: The National Consortium of Telehealth Resource Centers held a webinar exploring further uses and benefits of telehealth during the COVID-19 outbreak. More Details...

Pandemics and the Need for Telehealth: Dr. Joseph Kvedar of the American Telemedicine Association (2020). Resource Type: Other. Description: Hosts Mark Masselli and Margaret Flinter speak with Dr. Joseph Kvedar, President-Elect of the American Telemedicine Association and Sr. Advisor for Virtual Care at Partners Health Care in Boston. More Details...

Telehealth Essentials Checklist Training Event Recording (2020). Resource Type: Archived Webinar. Description: This free live training event was offered by the Mid-Atlantic Teleheath Resource Center on Wednesday March 18 from noon – 1 PM ET. MATRC walked through a checklist of the essentials health centers need to have in mind (and get into place) to get started on implementing telehealth. More Details...

The COVID-19 Pandemic Resources and Information: Spanish and English (2020). Resource Type: Other. Description: We at Migrant Clinicians Network have a priority to support both clinicians and the vulnerable patients they serve. MCN continually develops strategies and resources to support health centers, health departments, community groups, and clinicians as they reach out to communities that are often overlooked and give care to patients who might otherwise have nowhere to go. We remain highly concerned for the vulnerable populations that already encounter numerous barriers to health and to care. More Details...

Telephone and Virtual Visits: Operational Considerations (2020). Resource Type: Publication. Description: Tips and scripts for health center organizations to use in conducting telehealth visits with patients. More Details...

Telehealth Workflows (2020). Resource Type: Other. Description: Suggested diagramed workflows for any organization managing patient caseloads via telemedicine. More Details...

Telehealth Office Hours: Telehealth Etiquette (2020). Resource Type: Archived webinar. Description: This Telehealth Office Hour discusses etiquette for telehealth, from preparing for the call to utilizing video and muting best practices. This offers very practical steps to improving the quality of telehealth visits. More Details...

Telehealth Office Hours: Telehealth 101 (2020). Resource Type: Archived Webinar. Description: This webinar provides an introduction to telehealth and its various formats, as well as its benefits. It also suggest ways in which community health centers can utilize telehealth effectively. To support this endeavor, it also offers information on telehealth resource centers. More Details...

Telehealth Office Hours: Policy Updates (2020). Resource Type: Archived Webinar. Description: This webinar focuses on Medicare reimbursement for telehealth, outlining what telehealth services can be billed. It also describes opportunities and challenges for FQHCs with regards to telehealth policy. More Details...

Telehealth Office Hours: Connect Act Overview (2020). Resource Type: Archived Webinar. Description: This webinar discusses the Connect Act’s permissible exemptions to current Medicare telehealth policy, focusing on mental health and emergency medical care. It also review processes for adding additional services, exemptions for Indian health services, alternate payment models, and other key provisions. More Details...

Telehealth Office Hours: Access and Telehealth (2020). Resource Type: Archived Webinar. Description: This webinar shares how Finger Lakes Community Health in upstate New York has used telehealth for outreach to patients who need it most, including immigrant populations. Topics include eliminating geographical boundaries, reducing stigma, expanding access to care. and leveraging limited workforce resources. More Details...

Community Health Centers Meeting Rural Health Needs (2019). Resource Type: Publication. Description: This short fact sheet covers the barriers to care faced by rural communities and how Community Health Centers are helping to address those barriers: by focusing services on communities with the greatest difficulty accessing or affording care, innovating using telehealth technologies, and recruiting a wide range of health care providers to complement primary care, including dentists, pharmacists, and behavioral health professionals. Ultimately, health centers are achieving better improving outcomes for rural patients. More Details...

Telehealth Office Hours:: ADA issues in Telehealth (2019). Resource Type: Archived Webinar. Description: This presentation provides a high-level overview of accessibility considerations in telemedicine under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. We will discuss various types of services and modifications to help ensure that people with disabilities have equal access to telemedicine services. More Details...

Implementing a Pediatric Teledentistry Program: Promising Practice (2019). Resource Type: Publication. Description: Finger Lakes Community Health in New York established a successful teledentistry program. The teledentistry program focuses on providing pediatric dental care since. This promising practices will discuss lessons learned for this program. More Details...

Compendium of Telehealth Research and Publications: A Summary of Recent Research along with Takeaways for Health Centers (2019). Resource Type: Publication. Description: In early 2019, HITEQ completed a literature review of recent research and publications about telehealth. Within this compendium, HITEQ summarizes these articles and discusses possible implications or considerations for health centers. In early 2019, HITEQ completed a literature review of recent research and publications about telehealth. Within this compendium, HITEQ summarizes these articles and discusses possible implications or considerations for health centers.   Summary of Literature and Articles The Current State of Telehealth Evidence: A Rapid Review Authors: Erin Shigekawa, Margaret Fix, Garen Corbett, Dylan H. Roby, and Janet Coffman Brief Summary: In this rapid review, the authors searched for systematic reviews and meta-analyses of the use of telehealth services by patients of any age for any condition published in the period of January 2004 to May 2018. They identified 20 systematic reviews and meta-analyses that fit this criteria. These reviews and meta-analyses reported on care delivered through live video conferencing, asynchronous store and forward of data, telephone, email, text, and chat. They related to the clinical areas of: telemental health, telerehabilitation, teledermatology, teleconsultation, and other e.g., oral anticoagulation management, nutrition management, and diabetic foot ulcer treatment. The purpose of the rapid review was to determine whether the current research shows that services delivered via telehealth are equivalent to in-person services and if the use of telehealth services affects the use of other services. They found that, overall, telehealth is comparable to in-person care, however further research is needed to determine the impacts of telehealth use on other services. In other words, the question of whether telehealth can effectively substitute in-person care remains unanswered. Health Center Takeaway: In most research to date, telehealth appears to be as effective as in-person care in providing services, therefore making it a viable consideration for expanding access to care. There are mixed findings in the literature regarding the impact of telehealth use on patient services. Health centers who are looking to measure the efficacy of telehealth programs, especially from a financial investment and return perspective, should track data on patient services such as hospitalizations, repeat visits, and length of both in-person and virtual visits.   Seeing the Effect of Health Care Delivery Innovation in the Safety Net Authors:  Courtney Lyles, PhD and Urmimala Sarkar, MD, MPH Brief Summary: This article describes a large-scale telemedicine diabetic retinopathy DR screening program in the Los Angeles County Department of Health Services. The implementation of the screening program led to improvements in wait times and rates of screening for DR. The key implementation strategies used were: standardizing referral workflow, standardizing a system for optometrists to make triaging decisions about which patients should be seen, and organizing communication between clinics about screening results and scheduling. Health Center Takeaway: Effectiveness in telemedicine screening programs goes beyond just the telemedicine camera technology. Outcome of screening programs are dependent on the use of technology in the context of new team-based clinical workflows.   Implementation and Evaluation of a Large-Scale Teleretinal Diabetic Retinopathy Screening Program in the Los Angeles County Department of Health Services Author: Lauren P. Daskivich, MD, MSHS; Carolina Vasquez, BA; Carlos Martinez Jr, BA; et al Brief Summary: The Los Angeles County safety net examined whether a primary care-based teleretinal DR screening TDRS program reduces wait times for screening and improves timeliness of care. After initiation of the program, the median time to screening for DR decreased significantly 158 to 17 days and the annual screening rates for DR increased by 16.3%. Health Center Takeaway: Often, the significant wait time for patients to see optometrists leads to lengthy time between referral and screening for DR and therefore decreases overall screening rates. Building relationships with specialists who utilize telemedicine, such as optometrists, can decrease these wait times for screenings and improve screening rate.   How Is Telemedicine Being Used in Opioid and Other Substance Use Disorder Treatment? Authors: Haiden A. Huskamp, Alisa B. Busch, Jeffrey Souza, Lori Uscher-Pines, Sherri Rose, Andrew Wilcock, Bruce E. Landon, and Ateev Mehrotra Brief Summary: This article identified the characteristics of telemedicine for SUD tele-SUD users and examined how tele-SUD is being used in conjunction with in-person SUD care. Researchers found that tele-SUD visits accounted for a very small share 1.4% of telemedicine visits for any health condition reimbursed in the study period. Therefore, this finding indicates that there are regulatory and reimbursement barriers to the use of tele-SUD. Health Center Takeaway: The most common model of tele-SUD is a physician with expertise in addiction treatment providing, via telemedicine, an initial assessment or prescription of SUD medication, while local clinicians provide counseling and follow-up in person. The provision of tele-SUD depends on having primary care physicians deliver SUD treatment, especially for prescribing medications. Project ECHO Extension for Community Healthcare Outcomes uses teleconferencing to provide training from addiction medicine specialists to primary care physicians in underserved areas. Programs like this can be used by health centers to help expand the provision of tele-SUD services and lessen workforce barriers.   Telehealth in Health Centers: Key Adoption Factors, Barriers, and Opportunities Authors: Ching-Ching Claire Lin, Anne Dievler, Carolyn Robbins, Alek Sripipatana, Matt Quinn, and Suma Nair Brief Summary: This study examined factors associated with and barriers to e.g., location, patients, operation, and reimbursement policies telehealth use by federally funded health centers. Almost half of the health centers were located in rural areas and almost all of the centers were in a state where Medicaid reimbursed some form of live video. In states where Medicaid reimbursed live video or store-and-forward services, health centers had a higher probability of using telehealth. The most cited reasons by both urban and rural health centers for not using telehealth were cost, reimbursement, and technical issues such as lacking equipment and having incompatible electronic health record EHR systems. Health Center Takeaway: Despite the potential benefits e.g., potential to improve access to care in rural or urban areas with limited health care resources, telehealth has not been fully adopted by health centers. This is often due to perceived lack of need for telehealth or lack of information and training around the topic. An opportunity exists to leverage Health Center Controlled Networks HCCNs and other health center partners to increase health centers’ telehealth use through education, training, and health IT advancement.   Who isn’t Using Patient Portals and Why? Evidence and Implications from A National Sample Of US Adults Authors: Denise L. Anthony, Celeste Campos-Castillo, and Paulina S. Lim Brief Summary: The responses of 2,325 insured patients to the 2017 Health Information National Trends Survey were analyzed to characterize patient portal nonusers and reasons for nonuse. Of the patient population examined, a majority 63% reported that they did not use a portal during the prior year. Nonusers were more likely to be male, be on Medicaid, lack a regular provider, and have less than a college education, compared to users. The main reasons for non-use included the desire to speak directly to providers and privacy concerns. Health Center Takeaway: To address barriers to patient portals, efforts must be focused on more than just increasing access to technology. Patients expressed that they perceived the drawbacks to using technological tools and telehealth were concerns for their privacy and the desire for their interactions with providers to be in-person. To help facilitate the use of patient portals, it is important for providers to understand these concerns and address them. The provider-patient relationship must still be taken into account, even when communication is not face-to-face.   Are State Telehealth Policies Associated with the Use of Telehealth Services Among Underserved Populations?  Authors: Jeongyoung Park, Clese Erikson, Xinxin Han, and Preeti Iyer Brief Summary: Researchers analyzed four years of data from a nationally representative consumer survey to examine telehealth use trends and the effects of state health policy on telehealth usage. They found that the fastest growth in use of telehealth is live video communication. Usage of live video communication was found to be significantly associated with population characteristics, with age, health status, insurance type, income, and rural location among the biggest predictors. Interestingly, there was no significant association between less restrictive state telehealth policies and increased use of live video communication after controlling for population characteristics. Health Center Takeaway: This study found that more patients reported that they are willing to use live video communication than are actually using it. Therefore, creating incentives for providers and health centers to invest the time and funds needed to use telehealth can increase patients’ access to care. A method for incentivizing providers is to offer financial incentives for telehealth adoption. For example, Kaiser Permanente Medical Group provided 9,000 physicians with a complimentary iPhone and data plan to support telehealth use. Their medical group counts Telehealth visits the same as in-person visits and these visits count towards providers’ new consult targets. As a result of this program, all of the providers have participated in some video visits.    MaineHealth Care at Home: Exploring Details of the MaineHealth Telemedicine Program Author: Telehealth and Medicine Today, interview with Robert Abel Brief Summary: During this interview, Robert Abel, the Chief Nursing Officer and Director of Palliative Care for MaineHealth Care at Home, answered questions about the MaineHealth Telemedicine Program. The palliative care department telemedicine program uses virtual visits with its palliative care and heart failure patients. Nurses’ aides from the home health agency set up the equipment e.g., scales, BP cuffs in patients homes and provide education on how to use the tools. Physician treatment parameters are received for all patients in the program and protocols are triggered if patients’ vitals fall outside the parameters. When the protocol is triggered, typically a full set of vitals is taken daily and a nurse reviews the data remotely. Nursing staff use video calls on their cellphones to connect with patients. MaineHealth convenes a workgroup quarterly to assist in facilitating this telemedicine program. They are working on developing an atrial fibrillation program next. Health Center Takeaway: When working in large service areas covering states, like Maine, it is important for telemedicine devices, both for staff and patients, to be adaptable such as using multiple cell phone service providers depending on the service area. Additionally, it is helpful to use a single medical database when implementing telehealth programs, especially when the health center has many sites or covers a large service area. Another consideration is how to effectively and efficiently train patients to use the new technology. Beyond initial patient education provided by health center staff, training tutorials can be provided through the telehealth tool. Staff time spent providing hands-on training techniques can be minimized by creating built-in training protocols. Additionally, built-in training can be helpful long-term resources that patients can save and view multiple times. Additional information on Maine’s program can be found here.     Telehealth Partnerships Focus on Innovative Return on Investment ROI in Upstate NY  Author: Eric Wicklund Brief Summary: The North Country Telehealth Partnership of New York state has 33 active telehealth and telemedicine projects. This partnership works together to help collaborate and sustain telehealth projects in rural areas. In underserved areas of New York, provider and funding shortages can be a great barrier to telehealth projects, so networks are an important resource for extending clinical capacity and improving services. A network that functions in a similar capacity is the Georgia Partnership for Telehealth. Health Center Takeaway: Early provider buy-in is vital for telehealth projects to succeed. Engagement with programs can be targeted by finding telehealth programs that pique interest and have measurable success. For example, a telehealth program with local school districts could track the number of children kept in school and out of health centers or acute care so that reportable results could be seen. Additionally, telehealth programs should focus on emphasizing the ease to workflows and less crowded clinics or waiting rooms to providers as an incentive.     The growth of Telehealth Improves Continuity of Care Author: Rachel Z. Arndt Brief Summary: The University of Mississippi Medical Center Center for Telehealth utilizes SnapMD’s virtual platform for conducting visits. At UMMC, a portion of providers only do telehealth visits, though most do both virtual and in-person visits. A system is in place to send telehealth visit information to patients’ primary care providers and for providers to connect patients they meet with virtually with other practitioners in their area. At this point, certain requirements must be fulfilled for the center to receive payment from Medicare, Medicare coverage varies by state, and commercial reimbursement is even more variable. Health Center Takeaway: For telehealth delivered in healthcare facilities, webcams are most commonly used. An important lesson learned is that analog supports are needed when using this method of communication. For example when communicating numbers and measurements, it can be easy to misinterpret numbers, such as medication doses, so it is best practice for providers to write numbers on a pad of paper and hold it up to the camera for verification.   Community Health Centers and Telehealth: A Cost Analysis Report & Recommendations Author: PHI's Center for Connected Health Policy Brief Summary: The Public Health Institute's Center for Connected Health Policy CCHP conducted a study of five California community health centers to evaluate the costs and potential revenue sources for telehealth care. This financial analysis, completed with the assistance of an actuarial firm, showed that telehealth programs are not self-sustaining due to several factors: complex billing and reimbursement rules, provider shortages that lead to difficulty in securing services, data reporting issues, and inconsistent coding of telehealth-related claims and encounters. Health Center Takeaway: The current state of unsustainable telehealth programs in community health centers can be addressed by improving the tracking of telehealth-related services and costs, improving data systems and interoperability, and maintaining consistent use of modifiers for coding telehealth-related claims and encounters.    CMS Code Gives Docs a Chance to Use Store-and-Forward Telehealth Author: Eric Wicklund Brief Summary: The Centers for Medicare & Medicaid Services’ 2019 Physicians Fee Schedule and Quality Payment Program, released in the fall of 2018, defined a new code for asynchronous store-and-forward telehealth services. HCPCS Code G2010 covers “Remote Evaluation of Pre-Recorded Patient Information” and will provide some reimbursement to providers for  analyzing images submitted by an established patient and sending back a timely diagnosis. Health Center Takeaway: While there are no frequency restrictions to using this code, there are several time frame limitations that are important for providers to note. For example, if the review of the patient-submitted image and/or video originates from a related evaluation and management E/M service provided within the previous 7 days by the same physician or other qualified healthcare professional, then the service is considered bundled into that previous E/M service and would not be separately billable. Additionally, if the review of the patient-submitted image and/or video leads to an E/M service or procedure with the same physician or qualified health care professional within the next 24 hours or soonest available appointment, then the is considered bundled into the pre- or post-visit time of the associated E/M service, and will similarly not be separately billable.    CMS to Reimburse Providers for Remote Patient Monitoring Services Author: Eric Wicklund Brief Summary: The Centers for Medicare & Medicaid Services CMS issued the final 2019 Physician Fee Schedule and Quality Payment Program in November 2018. This finalized plans to reimburse healthcare providers for specific remote patient monitoring RPM and telehealth services. This program represents government support of telehealth and future expansion and reimbursement of innovative service delivery. CMS released a fact sheet that provides further information on the changes. Health Center Takeaway: In this update, CMS outlined three new CPT codes for Chronic Care Remote Physiologic Monitoring RPM. Health centers using RPM should review these CPT codes CMS 99453, 99454, 99457. CPT 99457 allows RPM services to be performed by “clinical staff” such as RNs and MAs, not just physicians or other qualified healthcare professionals. This code will make it easier for health centers to integrate RPM into their clinical workflows, especially when past barriers to use have been provider buy-in and difficulty incorporating RPM into protocols. At this time, CMS has not provided guidance on what technologies will be covered under these CPT codes.    Do Hospitals Still Make Sense? The Case for Decentralization of Health Care Author: Jennifer L. Wiler, MD, MBA, Nir J. Harish, MD, MBA & Richard D. Zane, MD, FAAEM Brief Summary: The landscape of healthcare is quickly changing. The system currently in place of hospitals being the primary providers of care will not be a sustainable method for delivery quality and efficient care in the future. We will see remote monitoring, community paramedicine, telemedicine, mHealth, large-scale EHR platforms,  and, eventually, prescriptive intelligence replace the traditional hospital-based delivery models. While hospitals will still continue to serve an important role in the healthcare system, the changing needs of consumers and developing technologies will move care-delivery into communities and patients’ homes. Health Center Takeaway: As healthcare is becoming more decentralized, health systems have developed new care delivery methods such as mobile health clinics or community paramedicine. The Geisinger Health System in Pennsylvania recently completed a pilot program in which their “Mobile Health Team” provided care to patients with congestive heart failure CHF in their homes. This program limited ED visits and hospital admissions significantly. The University of Colorado Health has also seen promising early results in rapid remote diagnosis with their mobile stroke unit MSU. The MSU is dispatched to patient homes in a specialized ambulance equipped with a small CT scanner, point-of-care testing capabilities, and virtual care access to a stroke specialist. Mobile health delivery models have shown the benefit in diversifying how care is provided. Health centers may pursue opportunities to leverage their existing expertise, combined with innovative delivery methods, to provide effective care directly to patients in the community.   YouTube Videos Telehealth & Community Health Centers: Can it Work Financially? Posted by The National Network of Telehealth Resource Centers, 9/17/2015 Brief Summary: This National Telehealth Webinar Series webinar reviewed the findings of a study commissioned by the Center for Connected Health Policy. During this study, one year of data was collected from five California health centers that represented a cross-section of the state’s health centers. The goal of the project was to assess the cost and reimbursement of telehealth, as payment policies vary by payer source, and to explore the barriers for adoption among health centers. They found that the volume of telehealth encounters varied by health center. For all of the health centers, program expenses exceeded revenue and thus multiple sources of fundings were used to cover the additional expense. Challenges health centers experienced were that volume-based reimbursement models could not be sustained, high provider contracting rates, complexity of billing and reimbursement, data management issues, EHR transitions, lack of interoperability, and inconsistent use of modifiers for coding. Potential solutions outlined were better tracking methods, develop learning collaboratives, pool telehealth volume to contract with distant providers. Health Center Takeaway: Health centers providing lower volumes of telehealth services should consider a movement from volume to value. Alternative payment methodologies would establish per member per month PMPM capitated payment that is equivalent to the PPS rate for FQHCs/RHCs and Medicare ACOs provider more flexibility in reimbursement for telehealth.    Shasta Community Health Center's Telehealth Success Story Posted by Shasta Community Health Center, 1/9/2019 Brief Summary: Shasta Community Health Center in Redding, California is using telehealth to connect patients with speciality care. The video tells the story of Maurice, a pediatric patient with cerebral palsy, who prior to taking part in Shasta’s telehealth program, had to travel several hours to the closest medical specialist in Sacramento and frequently had to be transferred by air flight to a hospital when he experienced seizures. Through Shasta’s telehealth program he was able to regularly see a pediatric neurologist at UC Davis. This led to better control of his seizures and fewer missed appointments. Health Center Takeaway: Shasta Community Health Center’s pediatrician has been working closely with the pediatric neurologist at UC Davis for several years. They have built a standardized workflow in which the pediatrician at Shasta completes the physical examination of the patient while the specialist obtains the patient’s history and views the physical exam. Despite working together from afar, they have been able to create a strong working relationship that contributes to the quality of care they provide patients.    Telehealth Brings the Dentist to Schools in El Dorado County Posted by El Dorado Community Health Center EDCHC, 12/12/2018 Brief Summary: El Dorado Community Health Center EDCHC in California has worked with partners to implement a telehealth program that provides dental care, especially preventative care, to children in local schools. In El Dorado county there are few dental clinics that accept Medi-Cal insurance and it is difficult for parents to navigate busy work schedules to get children in for dental appointments. They use a dental van equipped with telehealth technology to travel to schools to provide dental care. The van is used to provide cleanings and take x-rays, which are sent back to the health center for a dentist to review and establish care plans. Health Center Takeaway: Besides the dental care that the EDCHC dental van provides, one of the secondary goals of the program is educating children on good dental care behaviors, especially preventative care, so that positive associations around dental clinic visits can be enforced early on. This reinforcement of health behaviors aims to target overall wellness through the lifecycle and eliminate the strain placed on the healthcare system over time.    Telemedicine in Community Health Centers Posted by Northwest Regional Telehealth Resource Center, 7/28/2016 Brief Summary: During this webinar, Libbey Chuy from the Association for Utah Community Health AUCH reviewed the definition and function of primary care associations and community health centers, described Utah’s community health center network in terms of the number and location of the health centers and the population served, and the current telemedicine landscape in community health centers.  She also reviewed AUCH’s active telemedicine programs in teleophthalmology and teledermatology utilize AUCH’s Telemed Platform, telebahavioral/mental health, telepharmacy, Project ECHO provider-to-provider eConsult, and teleradiology. Health Center Takeaway: AUCH utilizes a video conference-based program for medical Spanish for healthcare professionals. This is an 8-week course that is available to providers outside of Utah. Programs such as this that provide important staff training are integral for building the adaptability of the health workforce in community health centers. Education programs for Spanish-speaking patients are extremely beneficial, however there is a lack of qualified trainers who are fluent in Spanish to teach these telehealth programs. These trainers are in high demand and there is a need for partnerships amongst health centers to collaborate on trainings and share resources.    Telemedicine—The Answer to Rural Medicine Challenges Posted by TEDxUSD Talk by Linsey Meyers, 3/29/2017 Brief Summary: This TEDxUSD talk focused on the benefits of telemedicine in spanning gaps in healthcare in rural areas. Linsey Meyers described several examples of innovative telemedicine provided by Avera Health, a regional health system based in South Dakota. One program works with aging patients to facilitate end of life care planning, long term care patient prescription reviews, and consults for long term care patients who may require ED visits. Avera Health is also working with Indian Health Services on a telehealth project that connects neonatal care specialists with rural health centers. Finally, Avera has an eICU telemedicine program that provides remote patient monitoring of critical care patients Health Center Takeaway: Rural healthcare also has the unique factor of multiple relationships between providers and patients due to small communities e.g., ED physician treats neighbor or close friend. This can lead to additional stressors on an already taxed workforce. Telemedicine can help to ease the burden on rural providers by providing specialist referrals that help make providers feel informed and supported in their decision-making, helping to counteract the rate of provider burnout and extend careers.    Remote Monitoring & Chronic Care Management: A Community Health Center Model of Care Posted by Northwest Regional Telehealth Resource Center, 7/28/2016 Brief Summary: During this recorded webinar, Kim Schwartz from Roanoke Chowan Community Health Center RCCH in North Carolina presented on remote patient monitoring RPM and chronic care management. RCCH has partnered on a bi-coastal program with Central Oregon telehealth network to develop a RPM framework for patients with chronic illnesses. According to their framework patient take their vitals at home e.g., weight, glucose levels, BP and nurse monitors their vitals remotely and if a values flag then the nurse follows up with phone call. The patient’s PCP is contacted if their vitals reach a threshold. The provider also reviews a trend report that is generated every two weeks and uses the patient portal to communicate the results of the report to their patient. They have tracked various factors including the patients’ number of PCP visits, hospital bed visits, ED visits, contact by monitoring nurse, patient satisfaction ratings, Patient Activation Measures Survey PAM results, compliance, clinical indicators, and costs. Data is collected for 6-months pre-RPM, 6-months during RPM, and 3-years post. They have found a decrease in number of hospital bed days, ED visits, and hospital charges during both 6-months of RPM and 3-years post. Health Center Takeaway: During the testing of the RPM framework, RCCH produced a blog that detailed their ongoing work on the project so that they could share important lessons learned, barriers encountered, the surveys and measurement tools utilized, and preliminary results. They found that this blog was a valuable part of their process and that it was also a beneficial resource for other health centers developing similar protocols concurrently. RCCH’s collection of baseline data, six months of data during RPM implementation, and then three years post demonstrates the longitudinal effect of RPM with measurable results. This data-tracking shows both the improvement in patients’ clinical indicators and the long-term financial implications for health centers and patients. These extensive results go far to proving to patients, health centers, potential partners, and funding opportunities the value in investing in RPM. More Details...

Barriers Encountered by Agricultural Workers Seeking Specialty Care and Potential Solutions (2018). Resource Type: Publication. Description: An issue brief for health center staff outlining the continuing challenges in providing specialty care to agricultural workers and their families. It highlights experiences of workers and provides recommendations, including opportunities for telehealth. More Details...

Increasing Access To Care thorugh Tele-Dentistry: Promising Practice (2018). Resource Type: Publication. Description: Teledentistry is an emerging trend among health centers to expand access to dental care. This promising practice will discuss the story of Ravenswood Family Health Center in California and their use of the virtual dental home model. More Details...

Telehealth Office Hours: Caring for Vulnerable Populations during COVD-19 Pandemic (2017). Resource Type: Archived Webinar. Description: This webinar features Care for the Homeless in New York City and the steps they have taken to train staff in order to streamline care virtually and to ensure care is accessible to all regardless of housing status. More Details...

Virtual Visits Fact Sheet for Consumers: What Should I Know? (2016). Resource Type: Publication. Description: Fact Sheet for consumers outlining what they should know, top reasons why people are turning to telehealth, what’s needed and how it works. The fact sheet also lays out challenges, risks and other considerations for those thinking about integrating telehealth. Two-page fact sheet for consumers outlining what telehealth is, and what they should take into consideration if thinking about integrating telehealth into their practice. The fact sheet also lays out challenges, risks and other considerations for those thinking about integrating telehealth. More Details...

Tips for Telehealth Communication (2021). Resource Type: Patient Material . Description: A tip and strategies sheet developed to help healthcare providers improve communication with patients during telehealth encounters. More Details...

Patient Telehealth Readiness Assessment Tool (2020). Resource Type: Patient Material . Description:  A tool developed to assist healthcare providers in identifying a patient’s willingness or need for resources and/or skills to engage in telehealth services. More Details...

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.