Unanticipated Outcomes of a Telehealth Pilot Project in Skilled Nursing Facilities Care:
Don’t Put the Cart Before the Course
Preface from the Sponsor
The California Emerging Technology Fund (CETF) sponsored and funded the Skilled Nursing Facilities (SNF) Telehealth Pilot Project. The mission of CETF is to close the Digital Divide in California. CETF works at the intersection of digital access and quality healthcare through Telehealth. The COVID-19 pandemic made it abundantly clear that broadband access is essential for all Californians. (“Broadband” is a generic term in State law for high-speed Internet infrastructure, including both wireline and wireless networks). The public health emergency (PHE) lockdowns made it impossible to ignore digital access vulnerabilities and the impacts on California’s unserved and underserved communities. Thus, COVID-19 underscored that access to broadband Internet is a social determinant of health. Further, the Digital Divide is a manifestation of the Economic Divide rooted in systemic racism.
CETF is committed to being part of a strategy to fight the suffering and death of residents and staff in long-term care facilities due to the COVID-19 pandemic. Early media reports out of New York, which was the first state to be hard hit by COVID-19 – left viewers with haunting images of that state’s skilled nursing facilities. On March 24, 2020, the CETF Board of Directors called a Special Meeting to discuss the CETF response to the COVID-19 crisis. After a vigorous discussion, the Board decided unanimously that the imperative for adequate broadband infrastructure and provider capacity to deliver Telehealth services – coupled with the requirement for experienced leadership – warranted CETF action at this time. The initial emphasis would focus on skilled nursing facilities (SNFs) and senior congregate care residential complexes.
CETF, a non-profit directed by the California Public Utilities Commission to be established in 2005, provides leadership statewide to close the Digital Divide by accelerating deployment and adoption of broadband Internet for underserved and unserved communities across California. CETF success has been due to effective leadership with state and national advisors required to identify gaps and to propose solutions affecting California. CETF has been working to secure large-scale support and funding to design and deploy Telehealth services in long-term care facilities across California.
Telehealth Fact-Finding Listening Conferences
CETF conducted 2 Telehealth Fact-Finding Listening Conferences in late 2020 to understand the status of Telehealth in California, identify the gaps and barriers to optimizing Telehealth to improve the health status for Californians, and gather input to inform an Action Plan that will advance Telehealth policy and funding in California. The Fact-Finding Listening Conferences brought together thought leaders and experts from Community Clinics and Federally Qualified Health Centers (FQHC) Serving Medically- Underserved Populations, Senior Care Facilities (Skilled Nursing Facilities and Assisted Living Complexes), Managed Health Care Plans (Public and Private), Medical Centers, and Veterans Affairs Administration, as well as the Governor’s Office, State Agencies, Legislature, Regional Broadband Consortia, Community-Based Organizations, and Philanthropy.
The Final Report highlighted significant findings, including that Telehealth utilization rates increased exponentially during the pandemic letting the proverbial “genie out of the bottle.” This provides the opportunity to reimagine the way healthcare is delivered and make healthcare systems fairer for everyone while improving patient outcomes and increasing overall population health.