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As of 10/04/2018, this wiki reflects the work done for the Telehealth Toolkit Workshop, 10/02/2018. It does not reflect the research and development of the Telehealth Toolkit site itself, conducted between 11/2017 - 09/2018.
Drawing on the qualitative research generated in the winter and summer of 2018, a VEO and Lab team developed the Telehealth Toolkit product for VHA's Office of Telehealth. Under the Office of Connected Care, the Office of Telehealth is responsible for providing long distance medical treatment in a variety of formats for veterans across the United States. Far outpacing its private, domestic competitors, the U.S. Department of Veterans Affairs currently operates one of the largest long distance medical services in the world. The Telehealth Toolkit development is in response to the VA agency goal of rapidly expanding the availability of the Telehealth across the final years of this decade.
To support this expansion, the number of healthcare providers practicing the telehealth modality of care will also need to be expanded. In studying how best to engage providers in this relatively new modality, however, the research team found that many providers are disinclined to practice telehealth for a vareity of reasons.
To convert providers to telehealth, the facility Telehealth staff freqently embrace the role of full-service telehealth support network: from scheduling to training to technical support, the staff are at the elbows of the providers to ensure the provider and veteran have a successful telehealth experience in each appointment. Given this reality, the research team concluded that to empower providers to use telehealth is to empower the Telehealth staff to support them. One of their major barriers: how to access guidance, support documentation, marketing materials, and subject matter experts for the entire Telehealth program.
The Telehealth Toolkit product consists of two parts:
- A peer-contributed documentation website. Prototype here: Telehealth Toolkit.
- An editorial workgroup that moderates the contributed content.
This method of content generation is practiced and validated in long-established industries such as magazine publishing and technology. The editorial workgroup draws from multiple parts of the Telehealth organization, including Program Office leaders, indidual facility Telehealth leads, and Telehealth staff.
The Toolkit's main purpose is to increase the accessbility of training and guidance documents for Telehealth staff. Its core goals include:
- Decreasing the time and energy staff spend searching for documents in the current organizational format
- Decreasing the duplicative content generation efforts across sites
- Increasing Program Office and facility-level collaboration around content generation and editing
- Increasing cross-facility knowledge sharing
- Increasing the visability and accessiblity of telehealth to facility administration and service lines
Multi-contributor content generation is practiced in long-established industries such as magazine publishing and technology. The editorial workgroup draws from multiple parts of the Telehealth organization, including Program Office leaders, indvidual facility Telehealth leads, and Telehealth staff. This workshop was the first meeting of the Editorial Workgroup for this Toolkit.
The workshops core goals included:
- Establish the workgroup and its mission
- Map out the current process for content generation
- Map out an ideal process for content generation
- Generate next steps for the workgroup in terms of editorial and technical needs
Since the Workshop pivoted around bringing together a diverse group from across the Telehealth community, the particpants started by bringing each other up to date on their individual roles and responsibilities, their main challenges, and the means by which they and their local telehealth groups were working to improve or extend telehealth within their catchment areas.
Participants Included:
- Office of Telehealth Leadership
- Quality and Training Team members (Program Office)
- Facility Telehealth Coordinators (FTCs)
- Telehealth Clinical Technicians (TCTs)
- Providers
Some of the challenges the participants expressed were:
- Lack of time for building/expanding the Telehealth program
- Communications challenges: functional formal channels versus ad hoc and personal ones
- Keeping Leadership up-to-date on the expanding abilities and needs of a Telehealth staff
- Physical Space
- Marrying metrics and care-giving
Some individual and local efforts at increasing the impact of telehealth offerings included:
- Changing providers’ attitude to telehealth
- FTCs acting as mentors to other telehealth staff
- Introducing telehealth during the onboarding process
- Embedding telehealth in PACTs
- Emphasis on Veteran experience during first visit; 60-minute visit
- Promoting access through telehealth in terms of clinical-, educational-, and outcome-based evidence
Through real-world examples, the group learned how an editorial workgroup could work to produce more useful, up-to-date, and multi-faceted documentation for the Office of Telehealth. Including how to manage submissions and grow an engaged community of contributors.
A central part of the editorial workgroup product is building a community of contributors. A vibrant community of this type relies on a reliable and open culture of communication channel through which the editorial workgroup and potential contributors can converse. Though not all contributions can be accepted, the community can be nurtured through the careful administration of critique, encouragement, and expectations-setting.
The group explored the need for and language by which article submissions in the form of abstracts, acceptances, and rejections could be vetted and communicated. The issue of reviewers was also discussed as a means by which the Workgroup could distribute its submission load and cultivate potential workgroup members as needed.
Pursuant to the development of the Telehealth Toolkit, the group prioritized the order in which the categories from the Toolkit should be developed. These categories were gathered from the field research and were based on instructional materials developed by facilities. In order of development prioritization, they are:
- Getting Providers Started Includes topics such as: Understanding Provider Needs, One-on-One Training, Talent Management System, etc.
- Telehealth Staff Training Includes topics such as: Identifying Veteran Candidates, Parameters for Telehealth Appointments
- Best Practices Includes examples of best practices
- Resources Includes topics such as: Technical Support, Forms and Templates, Contacts, etc.
- Frequently Asked Questions Includes topics such as: General Questions and Statistical Benefits
- Telehealth Experience Includes topics such as: Veteran Stories, Overcoming Challenges, Tips for Appointments, History of Telehealth
- Marketing Includes topics such as: National Announcements, Digital Posters, Print Posters and Brochures
- Telehealth Program Includes topics such as: VVC, CVT, Home Telehealth, Store and Forward and Apps
See these topics in the toolkit prototype: Telehealth Toolkit