Behavioral Health Integrator

Health center utilization of telehealth advanced in leaps and bounds since the start of the COVID-19 pandemic in March 2020. In 2019, fewer than 500,000 visits in health centers nationwide were provided via telehealth, and in 2020, over 28 million visits were conducted virtually as reported in the Uniform Data System (UDS).¹
Massachusetts leadership and learning in telehealth have been a collaborative effort between Community Care Cooperative (C3) and the Massachusetts League of Community Health Centers that together formed the FQHC Telehealth Consortium. In April 2020, the FQHC Telehealth Consortium began leadership calls with participating health centers to make progress on long-term telehealth strategy, with an initial focus on patient access and health center revenue. The FQHC Telehealth Consortium worked with Massachusetts health centers to develop a vision of telehealth maturity advancement and measurement specific to health centers, which, in turn, led to the development of a telehealth maturity model assessment tool to be applied across five domains.² This tool was used to conduct interviews in telehealth maturity in summer/fall 2020 and again in summer/fall 2021. The key objectives of measuring telehealth maturity were to:

1. Understand successes in implementation over the 18-month period from March 2020 through September 2021.
2. Identify areas for continued development and refinement of telehealth models in health centers in order to sustain telehealth past the pandemic.

In 2021, interviews, using the maturity assessment tool, were conducted with health center leaders from each of 34 Masssachusetts health centers. The tool assesses telehealth advancement across the domains of strategy and leadership, clinical integration, people, technology, and reimbursement and policy. During the 34 interviews, themes emerged as to where health centers need to focus their efforts to advance, as well as best practices and recommendations. This resource summarizes those themes, organized by experience, what to do now, and next steps, within each of the five domains. The intent is for the experiences of Massachusetts health centers to inform others across the country.

¹Health Center Program Uniform Data System (UDS) Data Overview 

² HITEQ Center - Assessing Telehealth Maturity in Health Centers: A report out on the progress of Massachusetts health centers in advancing telehealth during a pandemic

Download the resource in the Documents to Download Section below.

With the onset of the COVID-19 State of Emergency, in March 2020, Community Care Cooperative (C3) and the Mass League of Community Health Centers (League) both identified the critical need to support health centers to pivot to telehealth and COVID-19 care, in order to continue to meet the needs of the low income, diverse communities they serve and to remain in sound financial position. A grant from the Patrick J. McGovern Foundation provided the opportunity to form the MA FQHC Telehealth Consortium, providing support to FQHCs across Massachusetts. With the involvement of the CEOs and CMOs of the Consortium health centers, the League and C3 have designed a “Maturity Model” that provides a holistic roadmap for building a telehealth platform that is fully integrated into the primary care team, enhancing providers’ ability to address the physical, behavioral, and social needs of the complex, diverse patients served.

This webinar gave participants the opportunity to learn about the successes and ongoing work to advance telehealth in Massachusetts and critical areas for continued focus and resources to enable equitable access to telehealth.

In response to the COVID-19 pandemic, telehealth adoption increased significantly, supporting ongoing access to care and was critical to support healthcare operations continuity which resulted in the adoption of various modes of telehealth tools.

The initial focus was applying telehealth capabilities to ordinary care to increase access to care and keep patients, providers and staff safe. What healthcare organizations are now looking for is a roadmap to make telehealth more sustainable, to integrate it into clinical operations and to leverage it more strategically.

In this presentation, Christian Milaster of Ingenium Digital Health Advisors shares the 7-step Telehealth Maturity Model that guides organizations toward sustainable success with telehealth. This presentation is the first session of a two-part series. HITEQ hosted a second webinar session in April -- Measuring Telehealth Success: The Why, The What, The How -- that can be viewed here.

The coronavirus pandemic and consequent stay-at-home orders may increase danger for those at risk for or experiencing intimate partner violence and human trafficking (IPV/HT). Due to COVID-19, many health centers have shifted health encounters to virtual platforms, which offer unique opportunities to provide trauma-informed care and connect in new ways with those who may be experiencing abuse. Yet, telehealth and virtual visits also present health centers with new challenges related to privacy, safety and digital health equity. Given these changes in care delivery — and the inclusion of new Uniform Data System (UDS) data elements to capture IPV/HT diagnoses and services — health centers need information about how to identify and support patients at risk for or experiencing IPV/HT and leverage their health IT to provide and document care appropriately. In this webinar, presenters from the HITEQ Center and Futures Without Violence:

--Describe how health centers can implement an evidence-based, trauma-informed intervention for IPV/HT called CUES during virtual or in-person visits

--Review the newly included UDS data elements designed to capture IPV/HT diagnoses and services taking place within health centers

--Outline key considerations around privacy, safety, and equity for providing care through virtual platforms to patients at risk for or experiencing IPV/HT

--Feature promising strategies from health centers that have explored how to utilize health IT to support quality clinical care and data collection for IPV/HT