U.S. flag

An official website of the United States government

How health care providers can use telehealth to treat American Indian and Alaska Native communities.

Telehealth for American Indian and Alaska Native communities

Developing a telehealth strategy for American Indian and Alaska Native communities

Start with local priorities and partnerships before selecting your telehealth services.

On this page:

Start with community priorities and partnerships

Before developing a telehealth program, identify the community’s health care needs, existing services and resources, and gaps in care. Engage the appropriate Tribal health authority, Tribal program, and community and local leadership. You should:

  • Identify priorities. Ask which services the community wants to improve and which patients experience the greatest access barriers.
  • Design your workflow. Discuss the business and technology aspects of your program.
  • Adjust. Set a process for receiving regular feedback from patients, staff, and community partners. Ask about access, technology, and unmet needs. Review the feedback on a set schedule, share what was learned, and document changes made to the program.

Did you know?

The Indian Self-Determination and Education Assistance Act (Public Law 93-638) allows Tribes and Tribal organizations to administer certain federal programs, functions, services, or activities that would otherwise be provided by the Indian Health Services, including health programs. Work with the Tribe or Tribal organization to understand the appropriate governance, consultation, and approval process for the community your program will serve.

Define services and outcomes

Choose a small number of high-priority service areas to start. This may include:

Choose your telehealth modality

Telehealth can be used to deliver a range of services to support American Indian and Alaska Native communities. The types of telehealth that can be used to deliver this care include:

  • Synchronous telehealth. A real-time, live interaction between a provider and a patient is one of the most common types of telehealth. In some American Indian and Alaska Native communities, it can reduce travel and connect patients with specialists.
  • Asynchronous telehealth. This involves information shared between a provider and a patient that occurs at different points in time. For example, providers can review lab results and message follow-up instructions. This can help patients in areas with unreliable broadband.
  • Remote patient monitoring. Digital devices, such as wearables, can be used to monitor and transmit patient health data to a provider. This can help support patients with diabetes or other chronic diseases by tracking blood glucose, blood pressure, or weight between visits.
  • Telementoring. Virtual training and specialist support can help build local capacity. It can support health organizations by connecting local clinicians with physicians with specialist expertise.

Tip: Consider offering audio-only options when clinically appropriate, as reliable broadband remains a significant barrier for some Tribal areas.

Complete a readiness review

Before launching your telehealth program, confirm that your organization, partners, technology, and workflows are ready. Consider the following:

  • Community partnerships. Engage Tribal leadership, community members, and local organizations early. Identify existing clinical and community resources, such as Community Health Representatives, laboratories, pharmacies, behavioral health services, and other local supports, and define each partner’s role. Establish how patients will be connected back to local services for follow-up support.
  • Technology. Confirm that providers and patients have the connectivity, devices, and technical support they need. Test the telehealth platform. Determine when audio-only telehealth may be an option.
  • Privacy and security. Use a telehealth platform that supports patient privacy and security and is HIPAA compliant.
  • Legal requirements. Review licensure requirements for using telehealth.
  • Staffing and training. Define staff roles and train the care team on the telehealth technology, clinical and administrative workflows, and privacy. Consider involving Community Health Representatives or other trusted local staff to help patients use telehealth.
  • Patient training and support. Develop a plan to prepare patients for telehealth. Provider clear instructions, offer a practice session, and make audio-only services available. Some patients may need additional support before and during their first visit.
  • Emergency planning. Create a plan for emergency situations. Confirm the patient’s current phone number and physical location at each visit, identify local emergency resources, and establish procedures for urgent concerns.
  • Reimbursement. Verify coverage and requirements before providing services. Include billing staff in program planning so they can confirm payer requirements and determine whether telehealth services need to be billed differently.
  • Measurement and improvement. Select goals before launch and review them regularly. Measures may include completed appointments, access to specialty care, travel time, patient experience, and clinical outcomes. Share successes and challenges with community partners.

More information:

Getting started with telehealth — Health Resources and Services and Administration

Planning your telehealth workflow — Health Resources and Services and Administration

Privacy and security for telehealth — Health Resources and Services and Administration

Telehealth for chronic conditions — Health Resources and Services and Administration

Telehealth for rural areas — Health Resources and Services and Administration

IHS Telehealth Programs — Indian Health Service

Indian Health Service Telehealth Toolkit (PDF) — Indian Health Service

Tribal broadband and connectivity program — National Telecommunications and Information Administration

Implementation Considerations for Tribal Telehealth Programs — Rural Health Information Hub