Starting a Telehealth Program in Rural Hospital and Clinics

HTS3 Executive and Interim Recruiting is a recognized consultancy with a solid, reputable and longstanding track record of aligning only the best qualified leaders to healthcare organizations. This includes the placement of executive leaders into rural hospitals and clinics, where in-depth knowledge of telehealth technology solutions is critical often due to limited local resources. Telehealth is identified as a highly valued resource for outlying organizations and their patients.

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Introduction to Robert Thorn MBA, FACHE

Robert Thorn is one of our registered interim CEO/COO executives; with vast strategic and operations experience across hospitals (acute and CAH), medical practice and large scale construction and telehealth projects.

As a strategist and accomplished leader, Robert has written many articles, one of which is – Starting a Telehealth Program in Rural Hospitals and Clinics: A 10-Point Primer.

Telehealth can be a valued resource for a rural community, often bridging distances and improving access between patients and providers. As technology advancements now offer a variety of options for people to consider, it is best for rural hospitals and clinics to identify where and how telehealth technology solutions can provide their greatest benefits. The following points are offered to help organizations navigate entry into this exciting and dynamic arena.

  1. Before looking for any technology-based solutions, first identify the needs. 
    Defining the needs of your community through a formalized assessment can help clarify the needs for a remote presence of specialists and services.
  2. Let the needs and solutions drive the technology.
    Before offering a solution, identify a specific need and make sure the solution fits. Be cautious, as there are a number of technology solutions in the market looking for needs to address.
  3. Look at current referral patterns. 
    Consider approaching referral-bound specialists to explore a more active involvement in the coordination of care, and how data/information can travel rather than asking that of patients or providers.
  4. If the specialists with whom you work are not interested in a greater involvement in the coordination of care, including the use of telehealth, find those who are.
    If your referral volume is too low to keep specialists’ attention, consider collaboration with other rural providers to create some efficiencies.
  5. Check regulatory and reimbursement policies in your state.
    Is telehealth encouraged and supported by payers?  What does CMS require, and is it different than what Medicaid and private insurers require? If using specialists from out-of-state, what are the licensing requirements for telehealth in your state?
  6. Think about the long-term needs of patients with chronic conditions.
    What is your role in the care and management of patients with chronic conditions? Is your organization at risk for readmissions? What can you do to proactively fend off acute episodes rather than react to unplanned acute episodes?
  7. Look for solutions that help you manage and mitigate risk as healthcare moves from a volume based to a value based model.
    Technology solutions should support the goals of the Triple Aim, which are to simultaneously:
     Improve the patient experience of care (including quality and satisfaction)
     Improve the health of populations
     Reduce the per capita cost of health care
  8. Look for services that can be offered in your community, supported by specialists in other communities.
    Testing that can be performed locally and read remotely is not limited to just radiology. There are office-based tests that can be administered in a primary care setting and read by specialists elsewhere (e.g., dermatology, post-surgical wound checks, etc.).
  9. If considering televideo services for (virtual) clinic visits, what will the specialists do to help engage patients at the local level?
    Having an established relationship between providers and patients makes for optimal care. Additionally, it is incumbent upon you to set the expectations, and develop policies around these expectations, for remotely-based and visiting specialists, as members of your medical staff, to follow.
  10. Skype and FaceTime are not HIPAA-Compliant.
    NEVER conduct televideo sessions in any format that is not secure. Video and data are considered Protected Health Information under HIPAA and as such, are required to be secure, so Business Associate Agreements are needed with your technology provider.

If you are interested in learning more about your organization’s readiness to leverage technology through telehealth, please contact Robert Thorn at