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Resources Needed for Implementing Telehealth Programs

Rural programs may require several different kinds of resources, such as physical space, staffing, technology, and partnerships, to implement and expand telehealth services.

Physical Space

There are several considerations for establishing a physical space that is appropriate for delivering telehealth services. The ATA recommends that healthcare programs design private telehealth workspaces that maximize patient confidentiality. This could include a room where private conversations cannot be easily overheard and with a lockable door. Appropriate lighting is also critical to successful live-video telehealth encounters. Lighting can affect a provider's abilities to accurately assess the patient's state and gather diagnostic clues.

Staffing

Many rural programs designate a staff member to serve as a telehealth coordinator who can manage telehealth referrals, brief the patient on telehealth services, coordinate with the telehealth provider, facilitate the technological aspects of the visits, and schedule follow-ups as necessary. The California Telehealth Resource Center (TRC) offers free Telehealth Coordinator Online Training that provides additional information about this role.

A telehealth champion can also be critical to the success of a rural telehealth program. Champions help promote telehealth services throughout the organization and within the community, guide staff through the process of implementing or expanding new telehealth services, and help address challenges as they arise.

Technology

Common types of telehealth technology that rural programs might need include videoconferencing software, telemedicine carts equipped with cameras and screens, and remote patient monitoring devices. The National Telehealth Technology Assessment Resource Center can help rural communities select the most appropriate telehealth technology for their program. Rural communities may need to apply for grant funding to support initial costly investments in technology or the addition of new technologies. For example, telehealth programs seeking to implement a program that uses mHealth may need to pay for smartphones or tablets for participants in rural areas, where mobile device ownership lags behind that of urban areas.

Partnerships

Many rural programs rely on partnerships to implement, expand, and sustain telehealth services. Some communities build affiliations with partner organizations in order to receive access to telehealth technologies and resources. For example, affiliates of the Finger Lakes Community Health Telehealth Network pay a subscription fee to receive discounts for broadband services. Other communities partner with academic medical centers or larger regional hospitals in order to receive access to specialty care services through telehealth. Rural communities should consider how partnerships will contribute to or create challenges for sustainability. For example, some partners can support sustainability by sharing their telehealth experiences; helping demonstrate a return on investment; and contributing in-kind services, including telementoring and training. However, rural telehealth programs may need to consider where partners are located and whether they can support the costs of licensing and credentialing additional providers, particularly those located in different states.

Telehealth Resource Centers (TRCs) provide comprehensive guides and toolkits that can help rural communities to better understand the kinds of resources that contribute to successful telehealth programs. The California TRC's Telehealth Program Developer Kit includes checklists, instructions, templates, and activities to guide communities from inception to evaluation of a telehealth program, and a video library provides further instruction about program implementation. The Northeast TRC also created the Roadmap for Planning Development of Clinical Telemedicine Services, which offers a collection of tools and framing questions for implementation.

Resources to Learn More

National Compendium of Best Practices in Telehealth Services: As You Begin….Lessons from the Field
Website
Reviews 25 best practices and associated lessons learned for telehealth implementation, collected from field experience and discussions with telehealth experts.
Organization(s): California Telehealth Resource Center

Telemedicine Implementation Guide
Document
Provides guidance from the perspective of a rural telehealth partnership regarding telemedicine implementation. Includes step-by-step considerations, needs assessments, equipment acquisition and preparations, and other helpful resources.
Author(s): Johnson, D.C. & Cook, K.L.
Organization(s): North Country Telehealth Partnership, Fort Drum Regional Health Planning Organization, Adirondack Health Institute
Date: 6/2015

Telemedicine Workplace Environments: Designing for Success
Document
Describes considerations for designing telemedicine facilities. Includes examples of both clinical and non-clinic-based teleconsultations.
Author(s): Krupinski, E.A.
Citation: Healthcare, 2(1), 155-122
Date: 3/2014