Center for Connected Health Policy
The Center for Connected Health Policy develops and advances telehealth policy solutions that promote improvements in health and health care systems by: serrving as a state and national resource on telehealth policy issues; identifying policy barriers through objective research; providing unbiased policy analyses and recommendations; and educating decision makers about telehealth’s optimal role in the evolving health care landscape.
Advancing Policy Options for Sustainability and Spread of eConsult
To produce and disseminate a recommended electronic consultation (eConsult) reimbursement model for California to accelerate its spread and sustainability as a means for improving access to quality specialty care for the underserved.
Analysis of Expansion of Tele-ICU in Rural Areas
The Center for Connected Health Policy will provide the New England Healthcare Institute with strategic advising and policy analysis with respect to expanding Tele-ICU in rural areas. CCHP will research and identify potential policy challenges, provide information on potential sites, and assist in the identification and assessment of available Tele-ICU technology and potential sources of public/private support.
Continued Funding of the Center for Connected Health Policy
The Center will continue leading the California Telehealth Policy Coalition, including work with the Dept. of Health Care Services on telehealth in the Medi-Cal program, the Office of Statewide Health Planning and Development and the legislature. Building on its work related to telehealth and its impact on the Triple Aim to pursue greater integration of telehealth into health care systems, with an emphasis on increasing access to quality care for the underserved, the project will identify and address emerging telehealth policy, regulatory and legal issues.
Developing a Roadmap for eConsult Sustainability
To conduct a comprehensive policy and practice scan of the eConsult model, and produce a roadmap for California to further its use and sustainability as a means for improving access to quality specialty care for the underserved.
Electronic Consult Spring Forum
To gather payers, providers, policymakers and leaders in connected health technology in a forum to discuss current eConsult and related telehealth reimbursement policies and practices, hear how successful pilot programs in California and across the country are testing payment models for eConsult, and discuss how to advance the spread of eConsult in California.
National Telehealth Policy Resource Center
CCHP continues to serve as the National Telehealth Policy Resource Center (NTRC-P) as designated by the Health Resources and Services Administration (HRSA). In this capacity, CCHP provides individualized telehealth policy assistance to 12 regional Telehealth Resource Centers (TRCs). The NTRC-P serves as a national center of excellence on telehealth policy for TRCs, HRSA grantees, and key telehealth industry constituencies across the United States.
Policy Component – VDOT for TB
This project sets out to improve the policy and reimbursement environment for using telehealth to control tuberculosis and other infectious diseases in California. Its primary focus is to assess and recommend policies governing use and reimbursement of telehealth. A companion UC San Diego funding proposal would implement asynchronous Video Direct Observational Therapy (VDOT) in 6 urban and rural counties with a high TB incidence.
State Telehealth Laws and Reimbursement Policies
Teledermatology in California & Its Role in Medi-Cal
The purpose of this project is to determine the current state of teledermatology in California assessing provider demographics, existing practice models, and perceived barriers to teledermatology practice, specifically as these issues relate to Medi-Cal financed healthcare delivery.
Telehealth and the Safety-Net: A Critical Analysis of Cost and Quality of Care
This Blue Shield of California Foundation-funded project will assess the true cost of telehealth-delivered services in federally qualified health centers (FQHCs). After gathering baseline cost data on a select group of California-based FQHCs, CCHP will partner with the California Telehealth Resource Center to develop individualized technical assistance and telehealth program optimization plans for each clinic. Clinic costs and savings, which will be tracked during a year-long implementation of the plans, will help answer key questions around telehealth, such as potential savings, cost efficiencies and other benefits.
Telehealth and Triple Aim Research Work Group and Symposium
With the help of an expert advisory panel, CCHP is creating a thorough database of telehealth research and pilot projects to date. The compiled body of knowledge, consisting of a field-wide literature search, catalog of best practice case studies and series of interviews, will be used to: identify, organize and present the current body of evidence on telehealth use; identify research gaps and best research study methods to determine telehealth’s effectiveness on the Triple Aim; and further substantiate field-tested benefits and limitations to telehealth use.
Telehealth Consulation Review
The Center for Connected Health Policy will examine whether a telehealth interaction can be considered legal and adequate to secure surgical authorization from a patient’s insurance company prior to his/her surgery.
Telehealth Legislative Staff Site Visit
CCHP will provide a forum for key policymakers and staff to increase their understanding of telehealth in California. It will highlight the potential of telehealth to increase access, quality, and efficiency; to serve low income Californians receiving care through public programs; and to improve urban and rural care delivery.
Telehealth Policy Coalition and Subcommittee
CCHP provides management and direction for the Telehealth Policy Coalition and Subcommittee, which consults with CCHP to advance telehealth policy in California.
Telehealth’s Impact on the Triple Aim Research Symposium
The Center for Connected Health Policy will conduct a symposium to collect, organize and objectively present the current body of evidence supporting telehealth's contributions to the Triple Aim in an effort to explore and eliminate the barriers that hinder the expanded use of telehealth.
The Children’s Partnership Project
The Center assists in conducting research related to children with special needs, including their health care and other service needs, the systems that serve them, and how their health care and other services are paid for, with a focus on California. The program also conducts research related to California’s telehealth reimbursement policies for services for children with special needs.
The Use of Telehealth for Serving the Undocumented; a Landscape Assessment
While there is serious interest in the use of telehealth technologies to transcend the current geo-political barriers in California and Mexico for the provision of needed primary and secondary care for the underserved undocumented Mexican immigrant population, there are a number of legal, financial, technological, and cultural questions that will need to be understood and addressed before proceeding. In addition, there are a number of potential resources on both sides of the border that can contribute to possible solutions that will need to be identified and assessed.
Over the course of six months, CCHP and its project partners will frame the dimensions of the issue and gather information that describe the degree of interest for utilizing telehealth to serve this population; identify and describe the barriers to implementation; and offer promising models that incorporate telehealth technologies along with resource opportunities for achieving desired change.
Here's How We're Making a Difference
Advancing Telehealth Policy across the Country
The Center for Connected Health Policy (CCHP) at the Public Health Institute is as a state and national leader in developing and promoting policies to lower cost of and improve access to care through broader adoption of telehealth or “connected health” technologies. As the federally designated telehealth policy resource center for the state of California, CCHP has on staff some of the most knowledgeable telehealth policy experts in the United States. CCHP Director Mario Gutierrez is a national leading expert and speaker on telehealth policy, and the CCHP has assisted in providing expert assistance to legislators in states across the country, including Nebraska, Utah, and Nevada.
Expanding Telehealth Services in California
Recommendations by PHI’s Center for Connected Health Policy became the blueprint for California’s Telehealth Advancement Act of 2011. The act removes barriers, allowing the use of digital technologies to deliver a variety of health services. This can speed treatment for patients, eliminate the need for patient travel, improve communication among providers and lead to better care at a lower cost.
Exploring Policy Options for Advancing the Sustainability and Spread of eConsult
In 2017, PHI's Center for Connected Health Policy (CCHP) produced and disseminated a recommended electronic consultation (eConsult) reimbursement model for the state of California, to support and accelerate its spread and sustainability as a means for improving access to quality specialty care for the underserved. CCHP hosted a forum of policymakers, health plans and provider organizations to disseminate and gain input on the current findings and recommendations, as well as a common baseline of understanding among diverse stakeholders.
Throughout this process, CCHP is helping to advance a recommended reimbursement model with steps to achieve legislative and regulatory changes, and/or new reimbursement policies that can account for eConsult visits, and develop and implement an impact measurement framework and participate in technical assistance and joint learning activities.
Policy Recommendations for Using Telehealth to Manage and Control TB
Recognizing the potential role that telehealth can play in effectively monitoring TB patients’ daily intake of their medication, PHI’s Center for Connected Health Policy (CCHP) is helping to improve the policy and reimbursement environment for the use of telehealth for the management and control of tuberculosis (TB) and other infectious diseases. Working with the University of California, San Diego (UCSD), which implemented a pilot program using asynchronous Video Directly Observed Therapy (VDOT) in five urban and rural counties with a high incidence of TB, CCHP explored potential barriers and opportunities to employing technology to deliver online DOT (eDOT) in treating TB in the state of California and released evidence-based policy recommendations. Read the final brief.
Prior to this project, the Centers for Disease Control and Prevention (CDC) had not updated their guidelines regarding DOT or made any inclusion for the use of telehealth in administering it. However as a direct result of this project, the CDC is now creating a toolkit that will incorporate telehealth in the administration of DOT to treat tuberculosis, and launching a New York City-based pilot project to that will look at the efficacy of using telehealth to deliver DOT. In California, the California TB Controllers Association has updated the telehealth DOT guidelines for the State to now incorporate VDOT for the first time. The California Department of Public Health has also approved the guidelines, and they are now publicly available with the joint endorsement of these two entities.
Virtually Connecting Patients to Care
Incorporating telehealth modalities of care into community health center practices can be the key to ensuring timely access to the increased demand for specialty care amongst the newly insured in California, and across the country. The Center for Connected Health Policy’s Specialty Care Safety Net Initiative (SCSNI) used telehealth to connect patients in rural and urban medically underserved communities with health specialists in six high-need disciplines.
Over the span of three years, SCSNI clinics successfully referred over 3,000 patients for specialty care in offices as far as 600 miles apart. The Center for Connected Health Policy also identified ten keys to success that help clinics to successfully establish, integrate, and use telehealth to increase patient access to specialty care.