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There are two main telemedicine approaches, and most sites used a hybrid approach

• There are two telemedicine staffing models: the dedicated staffing model, in which health centers hire staff dedicated to telemedicine, typically including a coordinator; and the cross-trained model, in which staff who manage in-person encounters receive cross-training in telemedicine.
• Most programs in the initiative have a hybrid model — at least one full-time coordinator or similar position and other supplemental staff, either dedicated or cross-trained to facilitate telehealth implementation. Staffing models depend on the needs and resources of each health center.

Telemedicine coordinators' responsibilities are determined by the characteristics of the health centers at which they work

• Specific responsibilities of the coordinator are shaped by the size of the health center, number of clinics implementing telemedicine, number of additional staff members who are cross-trained and available to work on telemedicine, and needs of the health center. They often are hired from within the health center after gaining institutional knowledge.
• Coordinators spend time on a variety of activities, mostly making improvements to the telemedicine workflow and managing visit logistics, staff training, and provider engagement.

More than half of the health centers had adopted new and improved policies, procedures, or workflows that had been initiated by the coordinator

• Coordinators can help the clinic develop new policies and procedures to improve telemedicine workflow, engage with leadership and providers to promote the benefits and increase the use of telemedicine, improve no-show rates by engaging with patients, and facilitate relationships with vendors and health plans.

This brief report offers lessons learned about telemedicine staffing and the coordinator role from the experience of nine community health centers in California that participated in the Sustainable Models of Telehealth in the Safety Net (SMTSN) initiative, which was funded by the California Health Care Foundation. As part of the SMTSN initiative, which aimed to support community health centers in increasing telemedicine volume, most participating health centers hired telemedicine coordinators or maintained someone in a coordinator role. The health centers tailored the coordinator role to what was needed based on each center's unique staffing and telemedicine models. Experiences with the coordinator role might be informative for health care settings that are planning for or currently implementing clinic-based telemedicine programs.

• Chapter One

  Introduction

• Chapter Two

  The Many Faces of Telemedicine: Diverse Staffing Models in SMTSN Health Centers

• Chapter Three

  Defining the Telemedicine Coordinator Role

• Chapter Four

  How Coordinators Can Benefit Telemedicine: Anecdotal Evidence from the SMTSN Initiative

• Chapter Five

  Tips and Take-Aways from the Field

• Appendix A

  Sample Telemedicine Coordinator Job Descriptions

• Appendix B

  Resources