AMHCP defines telehealth as the remote delivery of health care services and clinical information via telecommunications technology. Telehealth services provided to families include appointments with health care providers, family education, and peer-to-peer support. Telehealth can be “synchronous” (real-time), such as a video or phone call between an individual and their provider, or “asynchronous” (store-and-forward), such as a case consultation between two providers through secure file exchange. Telehealth also includes remote patient monitoring, in which families use internet- or Bluetooth-enabled devices to send health data such as blood pressure, blood glucose, or weight to their provider.
Telehealth has the potential to expand access and increase equity within public health systems by reducing the burden on families associated with receiving care, such as geographic distance, travel costs, childcare needs, or language interpretation. Telehealth can be utilized across MCH focus areas to help ensure that individuals and families receive safe, timely, and high-quality care when and where they need it.
Children & Youth with Special Health Care Needs
For Children and Youth with Special Health Care Needs (CYSHCN) and their families, telehealth can improve access to safe, timely care and care coordination. For many individuals and families, there is not a provider specializing in their health care needs in the community. Without telehealth, these families may travel long distances to a provider elsewhere in their state or wait until a rotating public health clinic arrives in their community to receive care. In either case, families of CYSHCN often incur large costs associated with travel or go without critical care until they are able to find it nearby.
Telehealth is a tool to reduce these burdens and improve the family experience by providing families with timely access to providers, often through video or phone calls. In addition addressing barriers such as distance or cost, telehealth in CYSHCN can address other concerns with receiving in-person care, such as exposing a child to possible illness or an adolescent without transportation having autonomy over their care. Telehealth can also improve care coordination by connecting multiple providers in a care team to discuss progress or decisions virtually, when it may not be possible to gather everyone in an office setting due to distance or scheduling.
Telehealth can be utilized in newborn screening to ensure that families of infants identified through newborn bloodspot screening and screening for critical congenital heart disease have timely access to providers such as specialists and genetic counselors following an out-of-range screening result to coordinate care and provide education or resources. Telehealth can also be utilized to connect parents with relevant family networks and ensure they feel supported following a diagnosis and as they navigate treatment or early intervention.
Early Hearing Detection & Intervention
For Early Hearing Detection and Intervention (EHDI) programs, telehealth can help overcome distance and provider shortages to connect families with remote hearing screening and diagnosis services. For many families, especially those living in rural communities, there may not be an audiologist nearby. Without telehealth, these families may have to travel long distances with their infant to receive additional hearing testing and diagnosis. By utilizing telehealth, families can instead visit a health care location in their community and connect with an outside audiologist to perform the testing and interpret the results using telehealth equipment. In addition to improving the family experience, telehealth in EHDI also ensures that families have access to timely diagnosis and referrals to critical early intervention services, if needed. In many cases, early intervention services like parent support and American Sign Language (ASL) instruction can also be provided using telehealth.
AMCHP partners with the National Center for Hearing Assessment and Management (NCHAM) to support MCH programs utilizing telehealth in EHDI.
Home visiting programs can utilize telehealth in a variety of ways to provide continued support to families in a virtual setting, rather than in their home. Telehealth in home visiting can include conducting regular visits with families via phone or video calls, connecting with families through a messaging service to provide real-support, or delivering education and resources online with social media or other online content. The coronavirus pandemic prevented home visitors from connecting with families in the traditional way and relaxed telehealth restrictions for home visiting programs. However, beyond the pandemic, telehealth has the potential to improve access to care for home visiting families and enable home visitors to provide continuous support regardless of weather, illness, or other obstacles that may prevent or delay home visiting services.
AMCHP partners with the Rapid Response-Virtual Home Visiting Collaborative (RR-VHV) to support MCH programs utilizing telehealth in home visiting.
Title V programs can utilize telehealth in a variety of ways to best meet the needs of the populations they serve through programming and direct services. Video and phone calls can make it easier for individuals and families to access all that Title V has to offer, such as receiving virtual lactation support, mental health care, or nutrition education. Other telehealth functions, such as remote patient monitoring and store-and-forward can be used in similar settings to ensure families have access to safe, timely, and high-quality care, either when it is not possible to provide services in-person or in cases where the family prefers the virtual setting.
Like many, Title V programs quickly adapted operations to telehealth during the coronavirus pandemic and continue to explore the utility and feasibility of telehealth to improve access to care and the family experience long-term.
Family Support & Leadership
Telehealth can be a powerful tool to connect families and provide virtual support and engagement, especially during times when gathering together is not possible, such as the coronavirus pandemic, and for families who do not have access to a support network nearby, such as those living in remote or rural communities. Offerings like one-on-one peer support or support groups for families are easily adapted to a virtual setting and can provide critical social, emotional, and educational support to participants. Telehealth can also improve the quality of support services a family receives by ensuring families have access to others who understand and share their experiences, spoken language, or culture, regardless of location. Similarly, by engaging families in shared decision-making virtually, MCH programs can reduce barriers to participation and be more inclusive of family leaders who may not have access to in-person meetings or events.
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