What is Telehealth and Digital Inclusion?
OeHI’s Telehealth and Digital Inclusion Initiative develops and supports approaches that lead to increased adoption of telehealth through a framework of digital inclusion, with the goal of digital equity in Colorado. Telehealth is an important avenue to support health care reform, and has the potential to be a tool for addressing long-standing health inequities. OeHI is working with partners across agencies, sectors, and throughout the state to support equitable access to telehealth and to advance programs that work towards all individuals and communities having the information technology capacity needed for full participation in society.
Supporting Health Equity
Creating digital health equity using health IT and digital health solutions requires intentional efforts to build digital inclusion, and this means ensuring that all individuals and communities have access to technologies and the support and skills to use them. In order for telehealth to truly benefit those most burdened by inequities and challenges in accessing healthcare, broadband access needs to be ubiquitous, and access to educational opportunities for digital skill development and internet-enabled devices must be equitably accessible. Otherwise, telehealth runs the risk of increasing inequalities rather than closing them by only benefiting those who have the broadband access, skills, and devices required for a telehealth visit.
Telehealth and Digital Inclusion Projects at OeHI
2022 Colorado Telehealth Provider Survey Report
Following up on the 2021 Colorado Telehealth Provider survey, OeHI and Prime Health conducted a follow-up survey to look at how the telehealth landscape in Colorado has evolved in the last year. Key findings include:
- Patient access to telehealth services remains an issue, with broadband/internet access and digital literacy the top two barriers to patient access identified by telehealth providers;
- Training remains the top resource need identified by all providers (those currently utilizing telehealth and those who are not)
- Sentiments and utilization of telehealth remain positive.
The published report can be found below:
Non-Governmental Funding for Health IT in Colorado
OeHI worked with students from UC Denver to conduct a landscape analysis of private and nonprofit funding opportunities to support health IT, specifically telehealth, electronic health records, and cybersecurity in order to understand gaps in funding and potential partnership opportunities.
2021 Colorado Telehealth Provider Survey Report
OeHI and Prime Health conducted a survey to healthcare providers and staff in 2021 to better understand what is needed to expand and support telehealth services in Colorado. The analysis includes respondents’ demographics, barriers to and overall sentiments on telehealth, behavioral health and substance use disorder (SUD) services, direct-to-consumer telehealth, safety net providers, and more. The report provides context for decision-making and policy that will shape how we approach telehealth in Colorado, and how we set priorities for expanding and bolstering this crucial network of providers. The published report can be found below:
Effects of Remote Patient Monitoring
OeHI and the Department of Health Care Policy & Financing's Health Programs Office partnered with the Colorado Health Institute (CHI) to examine the effect of remote patient monitoring (RPM) on health outcomes, potential cost savings from RPM, and operational considerations for providers considering implementing RPM. CHI reviewed information from peer-reviewed literature, white papers, and industry publications, and spoke with a telemedicine expert and the Colorado Rural Health Center (CRHC) to inform this memo. Their published findings can be found below:
Three Publications on the Value of Telemedicine During the COVID-19 Response
OeHI partnered with the Colorado Health Institute (CHI) to examine the value proposition of telehealth services in light of the COVID-19 pandemic and Colorado’s rapid transition to virtual care delivery. CHI developed an analysis plan that utilized key informant interviews and electronic health record data from the Colorado Health Observation Regional Data Service (CHORDS) network to answer key questions related to utilization and access, outcomes and quality, and provider and patient experience. Their published findings can be found below:
Value of Telemedicine through the Eyes of Three Colorado Providers
In collaboration with OeHI, the Colorado Health Institute (CHI) examined the impact of utilizing telemedicine during the COVID-19 pandemic. Over the course of July and August, CHI conducted interviews with both patients and providers at Axis Health System, Family Practice of Holyoke, and The Mental Health Center of Denver. CHI documented these conversations and created the following reports to illustrate the value of continuing to promote telehealth efforts across the state of Colorado. These reports dive into the incredible use of telemedicine at these clinics during COVID-19, challenges faced, sustainability, and the path forward. CHI's provider profiles are now published and available using the links below:
Telehealth + Broadband RFA
HB21-1289 directed the Colorado Broadband Office to award grants to providers of telehealth services. In partnership with OeHI, 10 projects were funded in 2022 to support providers lacking quality internet access, availability of patient devices for telehealth, and technical assistance to behavioral health practices in delivering services via telehealth, totaling roughly $4 million.
Colorado Health Innovation Resource Platform
The 2021 Colorado Health IT Roadmap prioritized the creation of a Colorado Innovation Resource Center (now the Colorado Health Innovation Resource Platform, or CHIRP) for healthcare providers to access trusted information, resources, and support for health IT, virtual and remote health services and other digital health solutions. This platform would streamline and coordinate access to existing resources, such as information, technical assistance, training, workforce support, and more. OeHI is working with Prime Health to gather stakeholder input and plan the logistics of creating and implementing the Innovation Resource Platform.
Expanding Telemedicine Capabilities
In support of Medicaid providers throughout the state, OeHI, in partnership with Colorado Regional Health Information Organization (CORHIO) and Quality Health Network (QHN), funded 34 projects in 2020 to support infrastructure and technology to expand telemedicine capabilities, totaling $2 million. To find a full list of the telemedicine projects, visit OeHI’s website. These projects focused on:
- Narrowing the digital divide between rural and urban providers
- Mental and physical health providers
- Advancing health equity to vulnerable populations
State Digital Equity Plan
As the Broadband Office coordinates broadband efforts to create more access to high-speed internet they have partnered with the Office of Future of Work (OFOW) and the Office of eHealth Innovation (OeHI) to lead activities related to digital literacy and inclusion. OFOW and OeHI are leading the implementation of the State Digital Equity Planning grant, with the goal of creating a Digital Equity Plan for the State of Colorado. For more information on this and digital literacy and inclusion efforts, visit the OFOW’s Digital Equity, Literacy, and Inclusion Initiative webpage.
To learn more about the work happening at the Colorado Broadband Office and how to get involved in their initiatives, visit their webpage.
State Funded Telehealth Project Dashboard
Through a collaborative partnership between OeHI and HCPF, a state-funded telehealth project dashboard was developed to provide information on state-funded telehealth activities and interventions occurring throughout Colorado. The intention of this dashboard is to support state agency coordination and collaboration on telehealth funding and programs. This tool is meant to help track, analyze, and plan state telehealth programs/projects, with an overarching goal of equitable distribution of resources and support across Colorado. To visit the dashboard, visit this web address.For definitions, data elements, and a brief background on this dashboard, check out this resource.
Telehealth is a broad term that encompasses a variety of telecommunications technologies and tactics to provide health services from a distance. It is not a specific clinical service, but rather a collection of means to enhance care and education delivery.
Digital inclusion refers to activities necessary to ensure that all individuals and communities have access to information and communication technologies, and the skills and resilience to use them. Digital inclusion ultimately leads to digital equity.
Digital equity is a condition in which all individuals and communities have the information technology capacity needed for full participation in society, democracy and economy. The three components of digital equity include access to affordable, high-speed internet, access to affordable, web-enabled technology, and access to relevant and high quality, effective training and support for digital skill development and use.
Through a collaborative partnership between OeHI and Health Care Policy and Financing (HCPF), a state-funded telehealth project dashboard was developed to provide information on state-funded telehealth activities and interventions occurring throughout Colorado. For definitions, data elements, and a brief background on this dashboard, check out the Dashboard Overview.