Lessons on delivering telehealth in the safety net: Results from evaluation of the Connected Care Accelerator

Before the COVID-19 pandemic, many health centers established some form of telehealth as technology grew to meet the interest in health care services delivered remotely.

After the onset of the pandemic, the need for social distancing prompted an expansion of telehealth capacities on a massive scale—completely transforming how health care was delivered. This transformation to telehealth was challenging in all settings. These challenges were compounded in safety net health centers because of the barriers experienced by low-income, uninsured, and underinsured people seeking access to health care virtually (e.g., lack of access to devices, connectivity, digital literacy).

In August 2020, 23 safety net organizations across California participated in the Connected Care Accelerator Innovation Learning Collaborative (ILC), a 12-month learning collaborative dedicated to supporting safety net health centers in California with the adoption and implementation of telehealth during the COVID-19 pandemic. The ILC was led by the Center for Care Innovations (CCI) and funded primarily by the California Health Care Foundation (CHCF), with some support from the Blue Shield of California Foundation and LA Care.

1. CHCF funded the learning collaborative’s evaluation, led by the Center of Community Health and Evaluation (CCHE). CCHE identified six key findings on telehealth implementation in the California safety net during the first 18 months of the pandemic:
2. Telehealth replaced a large volume of in-person care in the safety net during the COVID-19 pandemic, with audio-only (telephone) visits playing an instrumental role to support widespread access to care.
3. A few health centers provided greater access to video visits by using several key implementation practices, while most health centers experienced only modest gains in video visit utilization.
4. Health centers established the necessary infrastructure—staffing models, technology, operational changes—to facilitate the transition to virtual care.
5. Health centers made progress in meeting a variety of patient needs via telehealth and continue to seek solutions to address digital barriers.
6. Providers and care teams had generally positive experiences providing care through telehealth. 
7. The learning collaborative provided health centers with needed support to advance telehealth efforts, address challenges, and plan for the future of telehealth.

Read the report here.

To learn more, also read CHCF's blog: New Technology Is Transforming Care in California’s Safety Net