Telehealth Models for Promoting Workforce Education and Training
Telehealth can be used to help the rural health workforce overcome barriers to receiving education and training and allow providers
to meet the evolving needs of their patients. Instead of traveling for continuing education, rural providers can
access telehealth technology, such as videoconferencing, to receive face-to-face instruction and to demonstrate
the skills they have acquired through distance learning. Many distance
education courses use telehealth technology to deliver aspects of their curriculum. Providers in rural
areas can also receive tele-mentoring from specialists located elsewhere in order to build their capacity to
address complex cases.
Project ECHO is an evidence-based telehealth program based
in New Mexico that offers critical training and education opportunities to rural providers across the United
States. Project ECHO's network enables providers from university medical systems and specialty care institutions
to share information with the rural healthcare workforce. During weekly TeleECHO clinics, rural providers use
videoconferencing technology to engage in case-based learning, consult with specialists, learn from fellow rural
programs, and gain the necessary skills to meet the evolving needs of their communities. For example,
Integrated Addictions and Psychiatry TeleECHO
Clinics have provided physicians with the hours of training needed to qualify for prescribing
buprenorphine under the Comprehensive Addiction and Recovery Act. The following projects also involve Project
ECHO to train the rural workforce:
New Mexico Prison Peer Education Project (PEP) uses telehealth technology to
provide monthly continuing education sessions to peer educators at nine New Mexico prisons. PEP training
allows inmates to educate peers about the prevention of infectious disease and imparts valuable professional
skills that prepare participants for the workforce after they are released.
- The School-based Consultations for Rural
Pediatric Telehealth (SCRiPT) Network uses Project ECHO to provide training to staff at
rural school-based health centers (SBHCs) in rural locations across the country. SBHC providers submit cases
to the ECHO team, which includes a psychiatrist, psychologist, pediatrician, cardiologist, endocrinologist,
and pulmonologist. During teleECHO clinic sessions with SBHC staff, ECHO experts review the case, provide
guidance, and offer suggestions via video or teleconference.
- The University of Kansas Medical Center
is using Project ECHO as part of an initiative to address obesity and behavioral health concerns among
children living in rural Kansas. The ECHO team works with rural providers and SBHC staff to provide
teleECHO clinics on behavioral disorders, developmental concerns, learning conditions, and pediatric
obesity. The ECHO approach is unique in bringing together participants across primary care,
education, community mental health centers, and other child-serving systems. ECHO telementoring
sessions are helping to build the capacity of SBHC staff to triage cases and effectively manage the
health of students and for specialist teams to understand the resources available to families.
- The Mountain West AIDS Education and Training
Center uses Project ECHO to train rural providers in HIV patient care. Providers meet
weekly with HIV specialists via interactive videoconferencing to discuss cases and receive guidance on
- The Kansas Asthma Initiative involves an asthma
TeleECHO program that offers weekly tele-mentoring sessions to rural providers. The TeleECHO program aims to
increase the ability of rural providers to adhere to asthma management guidelines and improve asthma control
among their patients.
Other Examples of Workforce Training and Education through Telehealth
- The Virtual Infusion Project in
South Dakota trains nurses on evidence-based infusion safety standards to increase their capacity to
administer chemotherapy and address the side effects of treatment. The project offers biweekly oncology
education sessions through telehealth that allow infusion nurses to continue to build expertise.
- The TeleEmergency program at
Dartmouth-Hitchcock Medical Center offers educational training to hospital staff and
emergency medical technicians across rural New Hampshire and Vermont. For example, physicians at the
TeleEmergency center may use live video to observe nurses at a Critical Access Hospital performing a mock
code simulation. TeleEmergency staff then provide feedback to the nurses and offer suggestions to continue
to build their capacity to respond to urgent care situations. In addition, Dartmouth-Hitchcock Medical
Center helps to build the capacity of rural hospital staff through the Center for Rural Emergency Services
and Trauma (CREST), which uses telehealth to conduct case reviews and outreach rounds on topics related to
emergency and trauma care.
- The EMS Live@Nite program provides free monthly online
trainings to law enforcement, healthcare providers, EMTs, paramedics, and other volunteers in 140 rural
locations across six northwestern states. Inland Northwest Health Services delivers trainings in partnership
with Spokane County EMS through the Northwest Telehealth videoconferencing network. EMS Live@Nite has
allowed rural EMS workers to overcome barriers of distance, time, and cost that previously prevented them
from receiving continuing education.
- The Learning Exchange Reverse Demonstration (LERD) Model
is part of the Rural Nurse Initiative Program. LERD allows rural nursing students to demonstrate their
skills acquisition to instructors via telehealth. An evaluation of the model found that rural distance
students showed similar learning outcomes to non-rural students. LERD also prevented rural students from
incurring travel expenses and missing unnecessary work days, which occurs in nursing programs that require
- The U.S. Department of Agriculture's Distance
Learning and Telemedicine (DLT) Grants provide critical funding for provider education
and workforce development in rural communities. For example, the Central Michigan University College of
Medicine uses DLT funding to help fund its Comprehensive Community Clerkship, which prepares medical
students to work in underserved rural and urban areas. Students use telehealth technology to receive
instruction, share clinical experiences, and connect with their peers.
- The Healthy Eating Active
Living TeleHealth Community of Practice (HEALTH-COP) program offered a virtual learning
network to rural providers seeking to better manage the health of children who are obese or overweight.
Providers received training via videoconferencing on counseling children and their parents about topics
related to weight and nutrition. An evaluation
found an increase in the number of health and wellness topics that providers discussed during visits with
children, which likely contributed to improved behaviors related to eating and exercising among program
Project ECHO provides resources to support communities
seeking to implement their own ECHO models. For example, the planning worksheet can help interested parties
identify the key issue they want to address through ECHO and assess potential challenges to implementation.
Rural communities may also benefit from reviewing successful Medicaid financing
models and evaluation considerations.
Additional implementation considerations including licensing and reimbursement are discussed in
Module 4: Implementation and
Module 6: Funding & Sustainability.
Program Clearinghouse Examples
Resources to Learn More
Project ECHO: A Revolution in Medical Education and Care Delivery
Provides information about Project ECHO, including existing teleECHO clinics, programs, and collaborations.
Offers research on ECHO as a service delivery model and outreach and training events
supporting the model.
Organization(s): University of New Mexico School of Medicine
Southwest Telehealth Resource Center Online
Offers an extensive online video library highlighting training resources for telehealth program staff
in six languages. Access is free after taking a short survey.
Organization(s): Southwest Telehealth Resource Center