Health center utilization of telehealth advanced in leaps and bounds since the start of the COVID-19 pandemic in March 2020. In 2019, fewer than 500,000 visits in health centers nationwide were provided via telehealth, and in 2020, over 28 million visits were conducted virtually as reported in the Uniform Data System (UDS).¹
Massachusetts leadership and learning in telehealth have been a collaborative effort between Community Care Cooperative (C3) and the Massachusetts League of Community Health Centers that together formed the FQHC Telehealth Consortium. In April 2020, the FQHC Telehealth Consortium began leadership calls with participating health centers to make progress on long-term telehealth strategy, with an initial focus on patient access and health center revenue. The FQHC Telehealth Consortium worked with Massachusetts health centers to develop a vision of telehealth maturity advancement and measurement specific to health centers, which, in turn, led to the development of a telehealth maturity model assessment tool to be applied across five domains.² This tool was used to conduct interviews in telehealth maturity in summer/fall 2020 and again in summer/fall 2021. The key objectives of measuring telehealth maturity were to:

1. Understand successes in implementation over the 18-month period from March 2020 through September 2021.
2. Identify areas for continued development and refinement of telehealth models in health centers in order to sustain telehealth past the pandemic.

In 2021, interviews, using the maturity assessment tool, were conducted with health center leaders from each of 34 Masssachusetts health centers. The tool assesses telehealth advancement across the domains of strategy and leadership, clinical integration, people, technology, and reimbursement and policy. During the 34 interviews, themes emerged as to where health centers need to focus their efforts to advance, as well as best practices and recommendations. This resource summarizes those themes, organized by experience, what to do now, and next steps, within each of the five domains. The intent is for the experiences of Massachusetts health centers to inform others across the country.

¹Health Center Program Uniform Data System (UDS) Data Overview 

² HITEQ Center - Assessing Telehealth Maturity in Health Centers: A report out on the progress of Massachusetts health centers in advancing telehealth during a pandemic

Download the resource in the Documents to Download Section below.

Under-resourced organizations that adopt telehealth platforms or other patient-facing digital tools rapidly, but not comprehensively, have the potential to increase safety vulnerabilities and decrease access for the most marginalized patients. This brief assessment contains questions that health centers can ask potential vendors to ensure their tools support equitable access and address the needs of the health center's population.

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.

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.
This resource provides an overview and some tips for assessing a patient's ability to engage with technology for virtual care, and and interventions that can be used to bridge gaps that are uncovered.