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Telehealth coordinators in hospital based telehealth services: Who are they and what do they do?
Abstract
Many studies have identified the importance of ‘telehealth coordinators’ for successful telehealth implementation and operation. However, little is known about the telehealth coordinators’ functions, the skills and competencies required and the reasons for their influence. This study aimed to examine the key functions of telehealth coordinators in the Queensland public health system, their perceptions about their role, and the level of competencies to support this role. All telehealth coordinators within Queensland Health Telehealth Services were invited to complete a questionnaire. We collected: (i) demographic information; (ii) details of their telehealth work; and (iii) information about knowledge and skills relevant to their telehealth coordinator role. Eighteen of 20 (90%) participants completed and submitted the survey. Telehealth coordinators were responsible for a range of tasks relating to telehealth consultations, technical assistance, administration, research, promotion and marketing. Nearly all telehealth coordinators (n = 17, 94%) were confident in carrying out the tasks of their job. The majority of telehealth coordinators (n = 13, 72%) thought education and training relating to telehealth would help improve their job. The top three topics that telehealth coordinators were keen to learn about were: (i) examples of clinical use of telehealth; (ii) types of technologies used; and (iii) telehealth clinical and business models. Our participants were all hospital-based; as the use of telehealth is growing outside of the traditional hospital settings, the role of telehealth coordinators is likely to change.
... así como a la capacidad para utilizarlas para proporcionar atención de salud de manera efectiva [17,20,[29][30][31]33,35,36], y para solucionar problemas relacionados con su uso en tiempo real [13,37]. Entre los usos identificados destaca el trabajo con registros electrónicos de salud [16,21,26,28,36,[38][39][40][41], la participación en videoconferencias para telemedicina [26,28,35,41] y la utilización de monitoreo remoto [26,28]. ...
... las necesidades de salud de los usuarios, junto con administrar los recursos disponibles para brindar una atención integral [14,15,17,18,20,21,26,27,31,32,35,37,[42][43][44]. Además, se menciona la gestión como parte importante de esta área, donde se consideran el manejo del tiempo [27] y la carga de trabajo [27,43]; gerencia de proyectos y del cambio en el área de la salud [22]; la administración de datos, esto es, la recolección, evaluación y análisis de datos para la toma de decisiones [15,32,33]. ...
... En cuanto a la investigación, se refiere a la capacidad y habilidad para desarrollar investigaciones sobre servicios de telesalud, recopilando y analizando datos de salud electrónicos [15,22,30,37]. Estos datos posibilitan la toma de decisiones clínicas informadas y la generación de nuevo conocimiento a partir de los datos analizados [30,47]. ...
Introduction Telehealth and telemedicine have proven to be useful in complementing face-to-face care, especially when long distances exist or when it is difficult to access specialists. New competencies are required to implement telehealth and telemedicine, not only in the use of technologies, but also in areas such as communication and ethics. Objective To identify the dimensions associated with competencies in telemedicine and telehealth from the perspective of professionals in the area based on research developed in the last ten years. Methods A Scoping Review was carried out by reviewing the WoS, Scopus, PubMed, and Scielo databases. The selection of publications included only original articles in both Spanish and English available under Open Access between the years 2013 and 2023. Results The review identified twelve key dimensions in telemedicine and telehealth, highlighting “Technological knowledge in general and in telehealth technologies”, present in 25 papers. Seventeen papers addressed the dimensions of “coordination, cooperation and management”, highlighting the effective integration of multidisciplinary teams. Ethical competencies, professionalism and legal aspects, essential to guarantee privacy, informed consent and safety in telehealth, were also highlighted. Professionalism includes effective communication, technical skills and clinical reasoning, while safety encompasses data protection, promoting ethical and patient-centered care. Interpretation The dimensions identified can guide researchers to better understand the competencies needed in the field of telehealth. Moreover, they can provide key elements for the development of a contextualized training framework leading to quality, flexible and more equitable remote care, responding to the needs of a society that is changing and adapting daily.
... This role is critical in expanding access to care, particularly in remote and underserved areas. [15,16] Medical software developer: Medical software developers design and build applications tailored to the needs of the healthcare industry. These applications range from EHR systems and telehealth platforms to mobile health apps and diagnostic tools powered by artificial intelligence (AI). ...
The integration of digital technology into the healthcare sector is revolutionizing the way medical services are delivered and experienced. This transformation is driven by advancements in artificial intelligence, telemedicine, wearable devices, and electronic health records, among others. These innovations are enhancing diagnostic accuracy, improving patient outcomes, and increasing the efficiency of healthcare systems. Telemedicine is breaking geographical barriers, providing access to medical care for remote and underserved populations. Wearable devices and mobile health applications are empowering patients with real-time health monitoring and personalized health insights. Meanwhile, electronic health records and data analytics are streamlining administrative processes and enabling data-driven decision-making. This article explores the multifaceted impact of digital technology on healthcare, highlighting its potential to foster a more responsive, patient-centred, and efficient healthcare ecosystem. As these technologies continue to evolve, they promise to shape the future of medicine by making healthcare more accessible, equitable, and effective. Introduction: The digital revolution has permeated almost every aspect of our lives, and the field of healthcare is no exception. Over the past few decades, digital technology has been transforming medicine in unprecedented ways, leading to significant improvements in the quality, accessibility, and efficiency of healthcare services. From electronic health records and telemedicine to wearable devices and artificial intelligence, digital innovations are reshaping the medical landscape, offering new tools and capabilities that were once the stuff of science fiction. The digital health landscapes Digital health encompasses a wide range of technologies designed to improve patient care, streamline clinical processes, and enhance the overall healthcare experience. These technologies include electronic health records (EHRs), telemedicine platforms, mobile health applications, wearable devices, and sophisticated data analytics tools. Together, they are creating a more connected, informed, and patient-centric healthcare system. [1,2]
... Our findings point to the need for one or more "champions" who can successfully and rapidly determine the needs of students, clinical educators, and clients, and coordinate a teletherapy practical, especially in emergency circumstances. These persons might be a version of what Edirippulige et al. (2016) refer to as "telehealth coordinators" or people working in a teletherapy practice who can provide technical assistance, assist with teletherapy preparation, and liaise with clients and clinicians about teletherapy related issues. ...
Students and clinical educators have had to adapt to emergency telepractice during the COVID-19 pandemic without much preparation. We sought the experiences of clinical educators and students (n = 11) regarding a pediatric teletherapy practical at a university speech-language therapy clinic in South Africa, a Global South context, via qualitative surveys and a reflective focus group. Findings highlight several challenges experienced when engaging in telepractice, including allocating clients for telepractice, preparing for telepractice sessions, managing caregiver involvement in telepractice, promoting connection with clients online, and adapting supervision style for telepractice. We discuss several implications and considerations for student teletherapy practicals going forward.
... The telehealth co-ordinator role is important to the success of both the telehealth clinics and ad hoc telehealth consultations, enabling the clinicians to concentrate on clinical issues, especially for the specialist DNE who has an overloaded role. 17 Clinic reminders via text or email were felt to be helpful by parents. It appeared that with the convenience of coming to a local site, clinic attendance was better with fewer cancellations or non-attendance than if asked to come to a central site, which has been noted previously. ...
Aim
To evaluate rural paediatric diabetic telehealth clinics including whether they meet clinical standards, provide equivalent care to central clinics, families were satisfied and difficulties were encountered.
Methods
An audit of a telehealth service for children and adolescents with type 1 diabetes mellitus at four rural sites was conducted. The case notes for each patient for 2019 were reviewed to determine if standards of paediatric diabetic care were met. Interviews were conducted at a clinic at each site with the child, parent(s) and staff attending the clinics. A retrospective review of difficulties in service provision was undertaken with staff.
Results
Nineteen children and adolescents were seen in the telehealth clinics over the year. Eighteen (95%) were seen four times with point‐of‐care measurement of glycosylated haemoglobin (HbA1c) and growth by the consultant paediatrician and diabetic nurse educator. Complication screening was achieved on time for 15 (78%) patients, with the remaining patients having had the tests ordered. Eleven (56%) patients were reviewed by a dietician, six (33%) by social worker and five (27%) by psychologist. All patients and parents reported receiving good support for their diabetes without any preferring to attend the central clinic. There were no significant technical difficulties.
Conclusion
Providing paediatric diabetic care through a telehealth service at rural hospitals meets standards of care and was provided without technical difficulties. It is preferred by patients and their parents to attending a central clinic. A model of service is presented that may be replicated elsewhere in Australia.
... Telemedicine coordinators can be integral to the success of daily program operations, ensuring coordination between patients and providers so that visits run smoothly. They also might conduct data analysis and quality improvement, troubleshoot technology, coordinate referrals, or maintain electronic health records (Edirippulige et al., 2016). Coordinators often serve as telemedicine "champions," promoting the use of services (Wade and Eliott, 2012). ...
Objective
Telehealth and patient travel cost subsidisation are two strategies used to reduce the effects of healthcare access inequity. Despite this shared goal, these programs are usually run independently, and their effects are infrequently compared in evaluation. Understanding how these programs are used helps ensure services are delivered efficiently.
Methods
Counts of telehealth outpatient service events (TH) (n = 250171) and patient travel subsidy scheme claims (PTSS) (n = 270933) for the 2022-23 financial year were captured. Comparisons of PTSS and TH activity were made by postcode, rurality (The Accessibility/Remoteness Index of Australia (ARIA)) and health jurisdiction (Hospital and Health Service (HHS)).
Results
Correlation analysis conducted on PTSS and TH activity revealed a statistically significant, moderate positive correlation (r = 0.449, p < 0.01). TH (coefficient = 0.650, p < 0.001) and rurality (coefficient = 26.208, p = 0.686) also retained their significance.
Conclusions
This study established that increases in TH activity is correlated with increases in PTSS, with both programs reporting greater activity as rurality increases.
The Princess Margaret Hospital Burns Telehealth Service provides a multidisciplinary service for paediatric burn outpatients living in rural and remote areas of Western Australia. In the two years since its establishment in August 2005, 164 patients have been referred to the service, with 297 clinical reviews undertaken via videoconference. An evaluation of the service was undertaken by surveying all families who had been reviewed by the service in a two-month period. Thirty survey forms were returned (a response rate of 51%). The majority of respondents felt that the telehealth service saved them money (82%), time (86%) and stress (79%) compared with conventional face-to-face outpatient clinic attendance in Perth. Ninety-three percent of responders were satisfied with the service. The estimated cost-saving in avoided travel was Aus1 is is an element of 0.64, US$0.88). The success of the Burns Telehealth Service is reflected in its place as an integrated part of service delivery for Western Australian paediatric burn patients.
An interactive audio and video telemedicine feasibility program was established to provide counseling on breast cancer risk-reducing strategies for underserved, high-risk Alaskan native women through a collaboration among the Alaska Native Medical Center, the Mayo Clinic Breast Clinic, Mayo's Center for Innovation, and the Alaska Federal Health Care Access Network. The telemedicine model included a navigator to facilitate patient encounters (referrals, electronic records, and scheduling) and a subscription billing contract. Between January 1 and December 31, 2011, 60 consultations were provided to the Alaska Native Medical Center. A survey of a sample of 15 women demonstrated overall patient satisfaction of 98% pertaining to the experience, technology, and medical consultation. The referring physician satisfaction, from 11 visit surveys and 8 referring physicians, revealed 99% satisfaction with the service. In this telemedicine pilot study, we demonstrated the feasibility of a telemedicine program to provide integrated specialty care that resulted in a positive effect on patient satisfaction. This program has a sustainable business model, thus creating a new modality for health care delivery.
Telehealth coordinators practising in Canada were invited to respond to an online survey and participate in a telephone interview. For the present study, the definition of 'telehealth' was limited to the use of videoconferencing. The coordinators were recruited with the assistance of the Ontario Telemedicine Network (OTN) and the Canadian Telehealth Forum (CTF). The response rate to the online survey from the OTN cohort was 4% (n = 13) and from the CTF cohort was 36% (n = 34). Of the 47 people who completed the survey, 16 also participated in a telephone interview. Most respondents were female; their mean age was 40 years. Most telehealth coordinators had some form of post-secondary education. Most, 66% (n = 31) coordinated both clinical and educational videoconferences. About half of the telehealth coordinators (55%, n = 26) indicated that their job was dedicated solely to telehealth, although 32% (n = 15) reported that their jobs involved responsibilities outside telehealth. About half of the respondents worked full-time (51%, n = 24). Most respondents either strongly agreed or agreed with the statement that 'If a telehealth coordinator's role involves patient care then that individual should be a member of a regulated health profession'. The need for organizations to more clearly define the role, better recognize and support telehealth coordinators and develop mechanisms for continuing professional education and certification were recurrent themes in the interviews.
A literature review was carried out to identify the key challenges in the implementation of telehealth. This was followed by a survey of organisations in England involved in telehealth projects in order to understand the challenges they faced. Ten of the 13 health or local authority organisations surveyed had telehealth projects and three were at the planning stage. The analysis revealed seven key challenges facing implementers of telehealth in England. Based on the findings from the literature review and the survey, a model was constructed and a checklist drawn up. The model contained the following elements: identifying issues, needs and partners; producing a strategy; securing funding; implementing changes; and monitoring and evaluating a telehealth project. The checklist was validated by using key informants from the organisations originally surveyed. The checklist may be useful to guide telehealth development and implementation in the future.
As telehealth networks develop across Canada, new professional roles start to emerge. A university healthcare center part of an integrated health network has identified the need to introduce a clinical coordinator for specialized telehealth programs. However, very little is found in the current literature about the description or core competencies that such a professional should possess as well as the ways to implement this role. The objective of this study was to explore how healthcare professionals (HCPs) involved in a specialized teleoncology program perceive a new clinical telehealth coordinator (CTC) role within a university integrated healthcare network (UIHN) in a metropolitan area in Québec, Canada.
A descriptive qualitative design was used and a purposive sample of nine HCPs, including physicians, nurses, and pharmacists who were members of a UIHN teleoncology committee, was recruited.
The HCPs identified that the CTC was a multifaceted role. The core competencies identified by the HCPs included knowledge, expertise, and experience. Participants identified three key factors in the implementation of this role, namely, the structural support, having a common language, and making the implementation of this role relevant.
The results suggest that this CTC role may be more complex than originally expected and that the diverse competencies suggest an expanded nature to this role. This has important implications for administrative strategies when addressing the key factors in the implementation of this role.
A feasibility study was carried out to test the hypothesis that, for an effective telehealth service, a full-time coordinator is required to act as a single point of contact for consultation requests. By shifting the responsibility for telepaediatrics from the referrer to the provider, the telehealth process becomes equally (or more) attractive as the conventional alternative. Preliminary results showed that, within six months, telepaediatric activity increased to an average of 8 h per month. Not only did certain health services become more accessible to children and their families in remote areas of Queensland, but significant savings were also made. At least 12 patient transfers were avoided to and from the tertiary facility, with an estimated minimum saving of $18,000 to the health-care provider.
Today's ¿virtually¿ and vertically integrated health systems increasingly are much better positioned than the multihospital systems of the 1980s to respond to the healthcare challenges of the twenty-first century. The authors argue that the control of the health services ¿value chain¿ will devolve naturally to those market players who have the comparative advantage in coordinating the flows of information, human, and physical resources along the continuum of services required to improve and maintain the health of populations. Available evidence does not render a clear verdict on whether superior performance is generated by the virtual integration of strategic alliances and affiliations or the vertical integration represented by unified single ownership of all system components. While inertia, acute care-based ¿mental models,¿ weak incentives, and insufficiently developed information systems represent important barriers to the creation and sustainability of integrated systems, the authors argue that system evolution is occurring and offers promise of enhanced efficiency and patient benefit. However, the full potential of these systems will only be realized as they accept explicit accountability for meeting the health needs of their local communities. The transition from ¿covered lives¿ to accountability for the community population is crucial.
We performed a feasibility study to test the validity of conducting two standard cognitive assessments via videoconferencing. There was a high correlation between the scores from a face-to-face assessment and those from a videoconference. A second trial was conducted with patients living in a rural community, examined both face to face and via videoconferencing. Again, the validity and reliability of the assessment tools were demonstrated for videoconferencing. The acceptability of the technology to patients and clinicians was also shown. As a result of the trials and at the request of rural participants, geriatric telehealth services are now being provided to a rural aged care assessment team (ACAT) on a fee-for-service basis. The success of this project is reflected in its senior clinical and academic 'champions', the establishment of a dedicated telehealth resource and the development of protocols.
A telepsychology and telepsychiatry service, using ISDN interactive video H.320, providing psychological consultations for the Family Resource Center in Farmington, New Mexico, was evaluated. During the first year of service, 56 individuals participated including University of New Mexico staff, Family Resource Center staff and clients. Consultations involved children from families referred by the Children, Youth and Family Department (CYFD) in New Mexico. Telemedicine was used in some child abuse cases. This study investigated whether the quality and acceptance of telemedicine consultations were comparable to face-to-face interactions in a group referred by a state child welfare agency. Participants received formal written consultation reports after the video conferencing sessions, which included a number of recommendations. Participants were asked to complete an anonymous questionnaire to rate various aspects of videoconferencing. The participants rated the university staff as involved, enjoyed the Family Resource Center staff's presence, felt the procedure was useful for evaluation purposes, found the format allowed for discussions of problems, and felt that the format was useful when compared to face-to-face consultations. The participants also said they had followed up on many of the recommendations. Videoconferencing appears to be a viable approach for providing consultation for families referred by a state child welfare agency. Several participants rated the session as both educational and consultative compared to simply therapeutic.
We formulated policies and procedures for allied health professionals (AHPs) who provide services using telehealth in Nunavut, Canada's newest Arctic territory. These are a supplement to the clinical policies and procedures already established for Nunavut physicians and nurses. The services were in the areas of audiology, dietetics/nutrition, midwifery, occupational therapy, ophthalmic services, pharmacy, physiotherapy, psychology, respiratory therapy, social work and speech therapy. Documents specific to each of the services were developed, drawing on information from Government of Nunavut data, Nunavut healthcare providers and links made through the Internet. Topics included the scope and limitations of telehealth services, staff responsibilities, training and reporting, professional standards and cultural considerations. We also considered generic policies covering common issues such as jurisdiction, licensing and liability. The policies and procedures for AHPs will enhance and expand the successes already achieved with telehealth in Nunavut. The challenges are to balance the preferred approaches to service provision with the realities of health care and communications in an Arctic setting.
However attractive the idea of telehealth may appear to them, clinicians in regional hospitals will be preoccupied with clinical matters and are unlikely to have either the time or the expertise necessary to address the infrastructure and organizational aspects of establishing a telehealth service. Our experience of telepaediatrics in Queensland has shown that the support of the central service and coordinator has been essential in overcoming initial difficulties and has freed us as clinicians to concentrate on appropriate clinical referrals and consultation via telehealth. The central service is also able to assist in data collection, and in the analysis and interpretation of telehealth activity, for example in measuring cost-effectiveness. We have found that consolidating most consultations into planned clinics creates efficiency. The central coordinator can teach and support those new to telehealth in the regional and primary care setting, thus relieving the local clinician of this responsibility. As telehealth services expand in a regional centre, having a dedicated local telehealth coordinator may become appropriate. A central telehealth support service, which is clinically focused and responsive to clinicians' needs, is an essential foundation for successful telehealth.
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