Implementation of Telehealth in Community Clinics

This series of reports includes case studies and financial analyses of community health organizations that have implemented telehealth and provides insights into the challenges and lessons for successful adoption.

November 2010

In 2007, the California HealthCare Foundation (CHCF) funded the Telemedicine to Improve Access & Efficiency in California Clinic Networks project to explore the role telehealth could play in improving specialty care access for patients of community health centers (CHCs). Three participating CHCs — Open Door Community Health Centers (Open Door) based in Arcata, La Clínica de La Raza (La Clínica) based in Oakland, and the Southside Coalition of Community Health Centers (Southside) in South Los Angeles — provided different settings for the programs.

  • Open Door is a rural CHC with nine sites in northwest California. Under the CHCF grant, Open Door upgraded and expanded its extensive existing telehealth infrastructure, including adding a school-based clinic and a number of specialty programs for behavioral pediatrics, diabetes education, and psychiatry.
  • La Clínica is a clinic organization with 26 sites across three urban/suburban counties. Under the CHCF project, La Clínica launched a store-and-forward teledermatology program at seven of its sites.
  • Southside is a network of seven independent clinic organizations in urban South Los Angeles, with 18 community- and school-based sites. Southside implemented a teledermatology program at several of its sites.

Each organization's telehealth experience was different, with varying degrees of success, but common themes emerged across all the clinic settings:

  • Each organization saw a reduction in wait times for patients needing specialty care.
  • There was high patient satisfaction with the telehealth process and little resistance to the use of the technology.
  • Provider satisfaction was mixed, with most Open Door and La Clínica providers strongly supportive but some Southside providers resisting implementation.
  • All sites reported challenges managing workflow and scheduling changes but were able to manage through clear protocols, procedures, and workflow charting.
  • All three organizations emphasized the importance of a robust planning phase at the outset of the project.

Several papers now report on these diverse experiences. A case study highlights and compares the experiences of each of the three CHCs as they planned and implemented their telehealth programs; this case study addresses facilitators and barriers to program implementation and operation, patient and provider satisfaction, and key lessons learned. Published simultaneously with the case study are an in-depth look at Open Door's longer-term history with telemedicine, and two papers that focus on the financial aspects of Open Door's and La Clínica's telehealth experiences. The financial analysis of Southside was published in the spring of 2011.

All reports are available under Document Downloads.