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.

Designed to engage providers seeking knowledge and skills to implement the delivery of PrEP via telehealth (known as "telePrEP") in their practices, the session showcased models of practice and the role of clinicians and navigators within a PrEP care team. Speaker presentations were followed by a facilitated question and answer session.

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.

The Streamlining IT Infrastructure for a Successful Telehealth Program learning collaborative series focuses on best practices, common solutions, key considerations, and other strategies for success when implementing telehealth technologies in a health center. Apply to join this health center learning collaborative here.  

Health centers will participate in four structured virtual sessions where they will engage with subject matter expert, Rachel Dixon, President and Executive Director of Prime Health, and in didactic learning and peer sharing and discussion. Session topics will include: assessing technology and identifying best practices for streamlining telehealth workflows,  aligning telehealth technology with financial sustainability, telehealth technology vendor considerations, and operationalizing telehealth technology strategies.

This series is particular to health centers and oriented to:

• Health centers that may have started a telehealth program, but pulled back and are not sure how to go forward, or

• Health centers that have started telehealth implementation, have some experience and are ready to take a step back and reassess the technology you are using, and

• Health centers that are ready to think about alignment of their telehealth strategy with long term financial stability.

Learning Collaborative Structure and Expectations: 

• All sessions will be hosted by HITEQ using Zoom Meeting and start at 12:00 ET.  The sessions will last about 90 minutes.

• The learning collaborative is open to staff of health center organizations across the nation. Primary Care Associations and Health Center Controlled Networks are welcome to attend with a health center in their network.

• It is ideal for health centers to identify a team of 2 – 3 multidisciplinary staff to attend each session. Teams may include staff in leadership, IT, quality improvement, and/or clinical roles.

• Sessions will be interactive and engaging. Participants are encouraged to join by video.

• Health center teams will have homework following sessions 1, 2 and 3.  

All sessions are scheduled to begin at 12:00 ET and will last 90 minutes. The session schedule is:

<

The Streamlining IT Infrastructure for a Successful Telehealth Program learning collaborative series focused on best practices, common solutions, key considerations, and other strategies for success when implementing telehealth technologies in a health center. 

Health centers participated in four structured virtual sessions where they engaged with subject matter expert, Rachel Dixon, President and Executive Director of Prime Health, and in didactic learning and peer sharing and discussion. Session topics included: assessing technology and identifying best practices for streamlining telehealth workflows, aligning telehealth technology with financial sustainability, telehealth technology vendor considerations, and operationalizing telehealth technology strategies.

This series was particular to health centers and oriented to:

• Health centers that may have started a telehealth program, but pulled back and are not sure how to go forward, or

• Health centers that have started telehealth implementation, have some experience and are ready to take a step back and reassess the technology you are using, and

• Health centers that are ready to think about alignment of their telehealth strategy with long term financial stability.

The Streamlining IT Infrastructure for a Successful Telehealth Program learning collaborative series focused on best practices, common solutions, key considerations, and other strategies for success when implementing telehealth technologies in a health center. 

Health centers participated in four structured virtual sessions where they engaged with subject matter expert, Rachel Dixon, President and Executive Director of Prime Health, and in didactic learning and peer sharing and discussion. Session topics included: assessing technology and identifying best practices for streamlining telehealth workflows, aligning telehealth technology with financial sustainability, telehealth technology vendor considerations, and operationalizing telehealth technology strategies.

This series is particular to health centers and oriented to:

• Health centers that may have started a telehealth program, but pulled back and are not sure how to go forward, or

• Health centers that have started telehealth implementation, have some experience and are ready to take a step back and reassess the technology you are using, and

• Health centers that are ready to think about alignment of their telehealth strategy with long term financial stability.

The Streamlining IT Infrastructure for a Successful Telehealth Program learning collaborative series focused on best practices, common solutions, key considerations, and other strategies for success when implementing telehealth technologies in a health center. 

Health centers participated in four structured virtual sessions where they engaged with subject matter expert, Rachel Dixon, President and Executive Director of Prime Health, and in didactic learning and peer sharing and discussion. Session topics included: assessing technology and identifying best practices for streamlining telehealth workflows, aligning telehealth technology with financial sustainability, telehealth technology vendor considerations, and operationalizing telehealth technology strategies.

With the onset of the COVID-19 State of Emergency, in March 2020, Community Care Cooperative (C3) and the Mass League of Community Health Centers (League) both identified the critical need to support health centers to pivot to telehealth and COVID-19 care, in order to continue to meet the needs of the low income, diverse communities they serve and to remain in sound financial position. A grant from the Patrick J. McGovern Foundation provided the opportunity to form the MA FQHC Telehealth Consortium, providing support to FQHCs across Massachusetts. With the involvement of the CEOs and CMOs of the Consortium health centers, the League and C3 have designed a “Maturity Model” that provides a holistic roadmap for building a telehealth platform that is fully integrated into the primary care team, enhancing providers’ ability to address the physical, behavioral, and social needs of the complex, diverse patients served.

This webinar gave participants the opportunity to learn about the successes and ongoing work to advance telehealth in Massachusetts and critical areas for continued focus and resources to enable equitable access to telehealth.

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.

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