Abstract:

In 2016, the Massachusetts Health Policy Commission (HPC) awarded grant funding to four health care organizations to expand access to behavioral healthcare (BH) through the use of telemedicine. The grantees included a range of organization types and target populations. Across this diverse group of locations and patients, HPC staff identified that all awardees had staff members playing the role of “facilitator” at the receiving (patient) site, though the value and significance of this role varied across the programs.

The use of telemedicine continues to expand as patients and providers search for new ways to connect with each other in the delivery of health care. Telemedicine is also a key tool in expanding access to needed behavioral health care services, as the U.S. faces a shortage of specialty providers. Programs should critically assess the possible benefits of including a facilitator role to increase possible locations and likelihood of success of telemedicine delivery.

Grantees submitted quarterly qualitative reports on their programs, answering questions about challenges and lessons learned during the implementation period of the grant. The HPC also convened the grantees for a structured, in-person discussion of their programs to allow the organizations to share their takeaways with each other. Qualitative experiences of the grantees provide insight into when and how facilitators could be deployed to improve the outcomes of telemedicine programs.

Telemedicine programs at non-traditional settings, e.g. schools, can benefit from having a facilitator to support patients throughout service delivery when patients are interacting with their provider remotely. Facilitators can mitigate possible operational risks to telemedicine programs by being present to correct technological or procedural issues that might arise during a session. Programs should assess the needs of their distinct target populations in determining the requirements for and specific role(s) of facilitators as the position and its scope are not universal.