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Developing a rural telehealth workflow and strategy

Save time and avoid frustration by planning your telehealth workflow in advance.

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

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
Billboards
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.

Additional resources

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

Spotlight

HealtHIE Georgia

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.