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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Usual Source of Sick Care.

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Strategy. Expanded Telehealth Services

Approach. Expand telehealth services

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Overview. Expanded telehealth services allow for convenient access to healthcare professionals, particularly for CYSHCN, ultimately reducing challenges to timely care and unnecessary exposure to illness.[1] Telehealth services offer a unique solution to families seeking usable, but not overly costly, care.[2] Promoting access to primary care, sustaining payment for primary care telemedicine, addressing challenges in rural areas and designing care delivery systems for lower-health literacy populations will enhance healthcare systems' ability to provide telehealth services.[1] Evidence shows that telehealth services improve usability, communication and monitoring of chronic conditions in pediatric patients.[3]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Patient and family satisfaction surveys
  • Telehealth utilization and appointment data
  • Program quality assurance and improvement data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Direct Care (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of healthcare providers partnered with Title V offering telehealth services across various specialties. (Measures availability of telehealth options)
  • Number of patients supported by Title V engaging in telehealth visits and remote monitoring programs. (Assesses patient utilization of telehealth)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of telehealth encounters adhering to clinical guidelines and quality standards identified by Title V. (Measures fidelity to best practices)
  • Percent of healthcare providers partnered with Title V offering telehealth services across various specialties. (Measures availability of telehealth options)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Percent of providers demonstrating proficiency in delivering virtual care after comprehensive training.
  • Percent of patients reporting high satisfaction with provider interactions during telehealth visits. (Measures patient-reported experience)
  • Number of communities experiencing expanded access to care through widespread adoption of telehealth. (Measures population-level impact)
  • Number of healthcare delivery models redesigned to optimize integration of telehealth services. (Assesses health system transformation)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of providers demonstrating proficiency in delivering virtual care after comprehensive training.
  • Percent of patients reporting high satisfaction with provider interactions during telehealth visits. (Measures patient-reported experience)
  • Percent of communities experiencing expanded access to care through widespread adoption of telehealth. (Measures population-level impact)
  • Percent of healthcare delivery models redesigned to optimize integration of telehealth services. (Assesses health system transformation)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Ray KN, Wittman SR, Burns S, Doan TT, Schweiberger KA, Yabes JG, Hanmer J, Krishnamurti T. Parent-Reported Use of Pediatric Primary Care Telemedicine: Survey Study. J Med Internet Res. 2023 Feb 9;25:e42892. doi: 10.2196/42892. PMID: 36757763; PMCID: PMC9951070.

[2] Brophy PD. Overview on the Challenges and Benefits of Using Telehealth Tools in a Pediatric Population. Adv Chronic Kidney Dis. 2017 Jan;24(1):17-21. doi: 10.1053/j.ackd.2016.12.003. PMID: 28224938.

[3] Wang CJ, Ma J, Zuckerman B, Car J. The Opportunities for Telehealth in Pediatric Practice and Public Health. Pediatr Clin North Am. 2020 Aug;67(4):603-611. doi: 10.1016/j.pcl.2020.03.001. PMID: 32650856.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.