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.

As health centers have newly established, scaled and/or enhanced their telehealth services during the pandemic year, they have navigated a variety of challenges, including policy and practice changes, logistics of implementation, privacy and security considerations, connectivity issues, ensuring quality services and patient and provider satisfaction. As health centers continue to refine their telehealth services amidst a changing context, the HITEQ Center is pleased to offer a panel of telehealth experts to address health center questions.  Panelists offer expertise in: set up and implementation of telehealth; clinical workflows, roles and training; hybrid care; patient-centered services; remote patient monitoring; telebehavioral health; telehealth optimization, maturity and performance management.

View the HITEQ Center's Telehealth Operations and Quality: Ask Anything  session. The session,  moderated by HITEQ’s Training and Technical Assistance Advisor, Natalie Truesdell, will provide an open forum for health centers to ask panelists their most pressing questions about telehealth services in the health center setting, such as:

• How can we fully integrate telehealth into our overall care delivery model?
• What are the ways in which telehealth may alleviate and/or add to provider burden?
•  Can you describe other health centers’ experiences with the unintended consequences of transitioning to telehealth?
• How do we ensure health equity when refining our telehealth and in-person care?
• What recommendations do you have for patients with limited digital proficiency?
• What might be the best approach to optimizing care for patients with chronic conditions?
• How can we improve our care team communication when so many staff are working remotely?
• What recommendations do you have for quick training of providers on patient interaction through telehealth?
• How can telehealth be more than a ‘transactional’ interaction?
• Can it be used to provide more touchpoints through different levels of care?
• What's the best way to assess telehealth success?

Please note: This session will be focused on telehealth operational and quality questions, and will not cover questions related to telehealth reimbursement, financing or policy changes at the state or federal level.

The session features the following panelists:

• Emma Ansara,  RN, MS, MA, FNP-C, Integrated Care Expert at the HITEQ Center
• Samantha Lippolis, MPA, Physician Practices Telemedicine Advisor & Consultant with Ingenium Digital Health Advisors
• Shane McBride, MBA, Founder & CEO of Chiron Strategy Group
• Christian Milaster, MS, Founder & CEO, Digital Health Transformation Advisor & Consultant with Ingenium Digital Health Advisors

The  60 minute session will start with panelists answering questions submitted by health centers during registration for the event.

Objectives

• Provide information and guidance to health centers across a variety of telehealth topics.
• Share ideas, tactics, and resources for implementing and optimizing telehealth services and virtual care

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.

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.

Although telemedicine use has grown exponentially during the COVID-19 pandemic, many ambulatory providers still lack the knowledge and skills needed to implement video-based telemedicine into their practices. To support wide adoption of telemedicine, the U.S. Department of Health and Human Services (HHS), Assistant Secretary for Preparedness and Response partnered with the ECHO Institute at the University of New Mexico and the Public Health Foundation’s TRAIN Learning Network to deliver a 10-week, virtual peer-to-peer learning community called Telemedicine Hack.

For many, telehealth has removed barriers and ensured that people receive care when and where it is most convenient. However, while telehealth can remove obstacles, if not used deliberately and thoughtfully, it can exacerbate many inequalities that exist in the United States. One factor that is essential to account for is language accessibility, which, if not provided, limits the number of patients who are able to utilize telehealth services. 

We are adding additional telehealth policy information relevant to coronavirus/ COVID-19 pandemic as it impacts health centers as it becomes available.

Participants of this Primary Care Development Corporation webinar will learn to: 

• Define telehealth and telemedicine
• Discuss telehealth effectiveness
• Discuss applications of telehealth  
• Explore communication styles conducive to telehealth

Participants of this Primary Care Development Corporation webinar can expect to learn to:
1. Define telehealth vs telemedicine
2. Clarify patient and provider eligibility for telemedicine encounters
3. Discuss types of telehealth encounters and telehealth solutions
4. Outline changes to telemedicine billing codes and documentation requirements
5. Discuss motivational interviewing strategies specific to telehealth

Presenters: Nicki Andrews, MPH, Maia Morse, MPH, CPC, Sarahjane Rath, MPH, CHES

Health centers are having to dramatically change approaches to patient care as the COVID-19 public health emergency keeps patients at home and ramps up the demands of telehealth and other remote care modalities. This resource is a quick start guide for health centers making this change.