Evidence-based Telehealth Network Program – Texas A&M Telehealth Institute
The Georgia Health Policy Center recently spoke to Carly E. McCord, Ph.D., a licensed psychologist and executive director, and Whitney Garney, Ph.D., research director, at the Texas A&M Telehealth Institute about plans to ensure a solid data foundation for measurement-based telecare and outcome monitoring.
To date, what has been the biggest accomplishment or win in your telehealth program?
Carly: What I am proud of is how we have built on the last evidence-based grant that was specifically focused on behavioral health and have been able to unite our primary care here at Texas A&M Health with our behavioral health.
Whitney: I am most proud of our ability to capture data within this grant that will tell us about the impact of service delivery via telehealth. This is something which we are not always offered the opportunity to do within service-based grants that are focused on providing telehealth-related care. The data collection component is added work, especially for clinicians used to filling out electronic health records (EHRs) for care, but not necessarily for data collection purposes. We are focused on developing processes and platforms to collect that data efficiently and extract it from traditional EHRs. This program’s end goal will be to compare our in-person and telehealth services across different primary care and mental health outcomes. Right now, we are focused on developing the right structures and processes to collect quality data.
What is a tip or early learning that you would share with an organization launching a similar telehealth program?
Carly: One of the big lessons learned is investing upfront in buy-in. There is often a divide between the practitioners and providers, and the data and the research that can come out of it. So, it is important to take time to make sure the fields are standardized and that you can pull that data, and that providers are actually going to put that information where you would like them to. It is about not waiting until it is time to do the first data poll but doing it in small clusters and improving in increments and having some kind of tracking and quality improvement along the way. This starts with identifying who the key stakeholders are, both from a leadership perspective and the clinic management side.
Whitney: Capacity is absolutely a thing and it should not be undervalued. One of our challenges was that one of the community sites that we were going to originally work with felt like they did not have the data collection capacity. Once we got into the weeds, they stepped back, and I am glad that we respected that decision and did not push them to do something they did not feel like they could handle. It is a big burden, and not all clinics necessarily can participate in this type of project.
How do you see participation in the Office for the Advancement of Telehealth’s Evidence-Based Telehealth Network Grant Program impacting your broader telehealth or health improvement efforts?
Carly: When COVID ended and restrictions and regulations all changed, it had a trickle-down effect, especially for our medical residents, not being able to count hours towards their time and residency if they were done by telehealth. This project has kept at the forefront some positive pressure to keep telehealth availability happening in our system. You have to work at it — both ‘big P’ policy and ‘little p’ policy — to keep it moving forward. We are committed to this project and we are committed to telehealth efforts moving forward in a way that might not be happening if we did not have this project.
Whitney: This program is part of an existing research and service agenda, but it will inform future activities. Carly has done a wonderful job of launching a telehealth training program for our counseling doctoral students. This grant has allowed us to transfer into primary care, as well. So now at this point, people are being trained in telehealth across many disciplines: counseling, psychology, medical residents, psychiatry residents, and social work. I see this as being the preface of a lot of good things that are happening.
Carly: This will help expand the workforce and make sure that they are equipped for this next generation of service delivery. We know telehealth is not going away. We want them to be competent and confident in telepractice, so that wherever they go on to work, they will be happy to include telehealth as part of their offerings.
What is next on the horizon for your grant-funded program?
Carly: I think we need to transition our research questions and ideas and funding from non-inferiority type questions to understanding for whom, at what “dose,” and with what technology tools does care actually get better with telehealth?
Whitney: This grant and the other HRSA grants that we have been lucky enough to receive have really positioned us to make telehealth a priority across our whole system at Texas A&M, which is why we now have a telehealth institute. It is a recent edition, and we hope to engage faculty across all sorts of disciplines in telehealth-related research and services. That is another broad next step that this project absolutely has laid the foundation for.