Developing a rural telehealth workflow and strategy
Save time and avoid frustration by planning your telehealth workflow in advance.
A successful and sustainable telehealth practice in a rural area needs careful planning from the early research through implementation. We can help you get started.
Get to know your community
If you already live and work in the area you want to serve through telehealth, you may already know a lot about your patient population. If you are in a more populated area and looking to expand your telehealth program to rural and frontier areas, getting to know your community’s provider and patient needs is critical.
Here are several considerations before you get started:
- The percentage of households that have internet access
- Specific medical services or specialties that are lacking in the coverage area
- Whether or not there is a local health clinic within a short driving distance for most residents
- The specific medical needs of your patient population
- The general receptiveness of patients to telehealth
There are several ways to get to know your community. You can read local reports, research any health or Census data that’s available, and you can reach out to potential patients.
You may consider doing an informal survey of potential patients, either online, by phone, or in person to gauge their interest in rural telehealth care.
Create a business plan
Carefully planning your workflow will help your telehealth practice launch on solid footing. Many rural healthcare providers struggle financially. Contributing factors include high overhead costs and lower patient volumes. Your business plan should account for these factors so telehealth makes financial sense for rural providers.
Determine what kind of services you will offer
Examples of telehealth services include:
- Appointments for follow-up care
- Sick care
- Phone call appointments for patients who do not have the technology or internet access for video chats
- Remote patient monitoring
- Mental health services
- Maternal telehealth care
- Coordination with tertiary centers in local hospitals for certain diagnostic testing and imaging
- Coordination with rural or tribal medical clinics
- Specialty care or coordination with specialists
- School-based telehealth for students with chronic conditions
Consider the type of staffing you may need
Your staffing needs will depend on several factors such as whether you are expanding your existing telehealth program to include rural locations or starting a new program in a rural location.
You may also choose to keep the existing number of staff members and reorganize their job duties based on need and skill level. If your colleagues and staff members have not worked with telehealth before, they may need additional training.
Examples of staff you may need include:
- Front-desk staff to book telehealth appointments over the phone and answer telehealth-related questions
- Someone to handle telehealth billing and reimbursement
- Tech support to handle in-office issues as well as patient troubleshooting
- Additional healthcare providers to see telehealth patients, including physicians, physicians assistants, nurse practitioners, or nurses
Tip: Online health equity training is a great way to ensure you, your staff, and your colleagues are providing the best, most accessible care possible.
Advancing Health Equity at Every Point of Contact — from the U.S. Department of Health and Human Services (HHS)
Consider your technology needs
Internet and technology infrastructure can be among the toughest, most pervasive challenges when it comes to rural telehealth. Here are the basics you will need:
- Reliable internet service, preferably broadband
- A mobile hotspot with a strong signal for when internet service is spotty
- A computer, laptop, tablet, or smartphone for video chats
- A landline to communicate with patients and other providers if your internet signal goes down
- Computers and software to handle patient portals, electronic health records, data from remote patient monitoring devices, and other resources
Read more about internet access and other telehealth resources.
Market and advertise your telehealth services
You will need to let patients and other providers know that you are preparing to launch rural telehealth services. Word of mouth is often a great way to spread the news, but you will need to make more of an investment in a rural or frontier area.
Keep in mind that your patient population may not know all the different types of care they can receive via telehealth.
Advertising methods include:
- Printed signage near your office
- Brochures and handouts in multiple languages for your waiting room and local community groups
- An email or phone call to your current patients
- Social media posts
- An ad in your local newspaper or magazine
- Radio ads
- Letters or postcards mailed to the community
- A booth or stand at community events such as health fairs or town celebrations
Evaluate your telehealth program
A sustainable telehealth program is successful for patients and providers alike. There are several ways to evaluate your telehealth program after it launches so that you can make adjustments along the way.
Get feedback from your patients and the community
Your best measure of success is often the satisfaction of the patients you are serving. There are several ways to get feedback and suggestions about the type of telehealth care you are offering, as well as their perceptions on quality, cost, and availability.
- Patient surveys
- Feedback solicitations
- Options for patients to provide suggestions
Set and then measure known performance indicators
This type of business model measurement will help you measure your return on investment, or ROI. Profits vs loss is one simple, but effective measurement of ROI. You could also look at trends in scheduling, types of appointments booked, patient outcomes, and the number of new vs existing patients.
Mapping Workflow of Telehealth Programs — Rural Health Information Hub
Sustainability Planning Tools — Rural Health Information Hub
Evidence-Based and Promising Models for Telehealth Programs — Rural Health Information Hub
Marketing Considerations for Telehealth Programs — Rural Health Information Hub
Telehealth Campaign — from the National Rural Health Resource Center
Evaluation Measures for Rural Telehealth Programs — Rural Health Information Hub
HealtHIE Georgia is a non-profit network of rural Georgia hospitals working together to coordinate healthcare in some of Georgia’s most rural, underserved communities. A grant award from the Health Services & Resources Administration (HRSA) has allowed HealtHIE Georgia to build an outreach program using telehealth to connect rural providers and clinics with resources from larger healthcare institutions and universities.
This program aims to lower the cost of care coordination for providers in rural areas while also improving telehealth access and patient care for residents. The targeted telehealth healthcare services include primary and acute care and behavioral telehealth. HealtHIE Georgia will also collaborate using the Community Outreach Intervention Network Services model (COINS) to provide critical support services to rural patients. These services include Spanish-language translation and pharmacy delivery.