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Technology and Telehealth Model

Services integration programs in rural communities can involve various forms of technology, including telehealth services. Telehealth is the use of telecommunications and information technology to provide access to:

  • Health assessments
  • Diagnoses
  • Interventions
  • Education
  • Consultations
  • Information across distance

Telehealth can be a key component of integrated care in rural communities because it connects patients to a range of providers and makes it possible for patients to receive screenings, education, and other services without traveling to a provider’s office. Telehealth has been used in school settings in rural communities to increase access to oral health and specialty care.

Acute care facilities are increasingly using telehealth as a tool to manage patient care. There is also growing evidence to support the use of virtual technologies to improve access to care and quality services in behavioral health and social services, particularly with respect to substance abuse and addiction. By using telehealth for counseling and support, mental health providers are able to expand the reach of their services to different populations living in areas where there are limited mental health services. Additionally, populations such as children may feel more comfortable when participating in virtual therapy sessions from their own homes rather than in a medical setting.

Telehealth is also a promising approach for creating virtual health homes and team-based approaches to care where mental health, human services, nutrition, and healthcare services are integrated. Further, there are opportunities to use telehealth to integrate behavioral health and social services for children living in poverty.

Other common forms of technology include electronic health records (EHR) systems, which help service providers easily share patient information in a secure format. Common data standards can also help providers track basic demographic information and facilitate collaboration between service providers. In addition, many aspects of services integration require the support of system-wide computerized information systems that allow data management and effective tracking of utilization and outcomes. EHRs can also be used to determine eligibility for and help enroll people in human services programs such as:

  • Temporary Assistance for Needy Families (TANF)
  • The Low Income Home Energy Assistance Program (LIHEAP)
  • Housing subsidies
  • Special Supplemental Nutrition Program for Women, Infants and Children (WIC)

Examples of Rural Programs that use Technology and Telehealth

  • The South Georgia Regional Prevention Coalition has used telehealth to address the issues related to transportation and lack of local specialists. Using telehealth technology, rural providers are able to set up consultations with specialists in cities located long distances away. These consultations help providers to determine if patients need to make the long distance trips in order to see a specialist. Telehealth also assists with follow up care if procedures need to be performed out of town.
  • The Rural Child Poverty Telehealth Network Grant Program is a three-year pilot program that funds existing telehealth networks to develop innovative ways to address health challenges affecting children living in impoverished rural areas. In some cases, grantees will expand access to healthcare services by integrating human and social service providers in their telehealth networks, including early childhood development, food and nutrition support, and economic support programs.
  • The Annie E. Casey Foundation developed an application called Casebook that uses social networking and web-based technologies to build a family-centric, child welfare case management tool. This tool helps service providers collect and report data across organizations as well as develop information on the patient’s health, education performance, mental state, and social relationships.

Considerations for Implementation

A critical component in the use of telehealth is access to high-speed broadband. Though the majority of communities in the U.S. has access, some rural communities may not have access. Wireless technology is also effective, but may not be as dependable in rural areas. In addition, the telehealth field is growing quickly and changing dramatically. Understanding new developments in the technology is critical. In order to use telehealth as an integrative tool, participating providers and organizations need to adopt the same technology. Implementing new technology and data recording systems can be very expensive and labor intensive. If the entire network cannot support the technology, it may not be possible to fully integrate health and human services. There are 12 regional telehealth technical assistance centers and two national centers that provide toolkits, guidance, and consultation.

Finally, telehealth enables the patient to be at the center of care, as opposed to the institution or provider. Therefore, it is important to think outside the box about how to integrate services; it may be possible to provide care within a patient’s home, school, or health center.

Resources to Learn More

Consortium of Telehealth Resource Centers
Website
Telehealth Resource Centers (TRCs) provide assistance, education, and resources to those providing or seeking to provide healthcare services to underserved populations at a distance.

Gaining Ground: A Guide to Facilitating Technology Innovation in Human Services
Document
This report describes how human services can benefit by successfully leveraging technology innovation.
Author(s): Freedman Consulting
Organization(s): Data-Smart City Solutions, Harvard University
Date: 5/2014

State Innovations in Horizontal Integration: Leveraging Technology for Health and Human Services
Document
This report provides examples of innovations in technology and services being implemented at the state level to integrate health and human service programs. Highlights common themes across findings.
Author(s): Shaw, T., & Streett, L.
Organization(s): Social Interest Solutions and The Center on Budget and Policy Priorities
Date: 3/2015

Telehealth
Website
This website provides a background on the use of telehealth in rural communities, a list of relevant telehealth publications, a resource toolbox, and a list of funding opportunities in an effort to promote and improve telehealth services in rural areas.
Organization(s): Health Resources and Services Administration

Telehealth Start-Up and Resource Guide
Document
Guides implementation of telehealth services in Critical Access Hospitals and offers resources for learning about telehealth and organizations that use the technology.
Organization(s): Telligen, Great Plains Telehealth Resource & Assistance Center
Date: 10/2014