Other Programs

Telehealth

Authorizing Legislation - Section 330I of the Public Health Service Act.

FY 2008 Authorization ..........................................................................................................Expired

Statement of the Budget Request - The FY 2008 Budget of $6,819,000 is equal to the FY 2007 Continuing Resolution (CR).

Program Description - Electronic information (computer) and telecommunications technologies are changing every aspect of life. Telehealth is the use of electronic information and telecommunications technologies to support clinical health care, patient and professional health-related education, public health, and health administration. This is in contrast to telemedicine, a subset of telehealth technologies, defined as the use of telecommunications and information technologies to provide or support long-distance clinical care. Telemedicine and telehealth technologies are not things or ends in themselves, but the means to provide services at a distance. Information may be in various forms -- audio, video, data, or text.

HRSA envisions these technologies as playing an integral role in facilitating linkages between health care institutions over distance to improve access to quality health care services in this nation and provide educational opportunities for those who would otherwise not have or would have difficulty accessing such opportunities. The Office for the Advancement of Telehealth (OAT) is the operational focal point within HRSA’s Office of Information Technology for advancing the cost-effective use of telehealth technologies throughout the agency.

As HRSA's programs have improved and expanded, new priorities have emerged. The rapid rise in health care and health insurance costs has created a greater emphasis on demonstrating the value-added of HRSA's telehealth programs, not only in improving access to care, but in improving the efficiency and quality of the services being offered. The growing elderly population continues to place a tremendous burden on the health care system, not only in terms of cost, but in terms of the shortage and mal-distribution of qualified health professionals to address the needs of this population. As the “baby boomers” age, they experience a myriad of chronic physical and psychological problems that threaten to overwhelm the capacity of the health care sector. Telehealth technologies have the potential to address some of the health care needs of this population by providing health care support, monitoring, and disease management in a manner that is effective, efficient, and convenient for patients, families, and providers, while allowing this population to maintain the maximum level of independence consistent with their health status. The tragic events of Hurricane Katrina and September 11, 2001 further highlight the need to make greater use of the federal and private investment in the nation's telehealth infrastructure to better address the nation’s challenges in providing health care services or respond to disasters, both natural and man-made. Despite the availability of first-rate resources and expertise in many parts of this nation, many rural and underserved urban communities continue to lack critical health care providers to meet the needs of their populations.

In FY 2006, Congress recognized some of the significant challenges to making the promise of telehealth programs a reality in this nation and expanded HRSA’s telehealth programs to include grants for: (a) pilot projects examining the cost impact and value added of tele-home care and tele-monitoring services (Telehealth Networks-Telehomecare); (b) telehealth resource centers to improve technical assistance to communities wishing to establish telehealth services; and (c) demonstrations to provide incentives for licensure coordination among states. These grants were to be in addition to the grants funded under the existing Telehealth Network Grant Program. At the end of that year, three-year grants were awarded as follows:16 grants for telehealth networks and telehealth homecare networks, 5 regional telehealth resource center grants, one national resource center grant, and two grants to improve licensure coordination among states. If the President’s budget is enacted, the funds will be used to support continuation of these grants, consistent with their 3-year cycle.

Rationale for the Budget Request - The FY 2008 Budget of $6,819,000 is equal to the FY 2007 CR. The funds requested will support the continuation of grants that will support a consortia of health providers that deploy telehealth technologies to: (a) provide access to, coordinate, and improve the quality of health care services; (b) improve the training of health care providers; (c) improve the quality of health information available to health care providers, patients, and their families; (d) evaluate the impact of tele-home care and tele-monitoring services; and (e) reduce the barriers to physicians and nurses electronically practicing across state lines.

Outputs -

Rationale for the Budget Request - The FY 2007 request of $6,819,000 is equal to the FY 2006 appropriation.   The funds requested will support the continuation of grants that will support a consortia of health providers that deploy telehealth technologies to:  (a) provide access to, coordinate, and improve the quality of health care services; (b) improve the training of health care providers; (c) improve the quality of health information available to health care providers, patients, and their families; (d) evaluate the impact of tele-home care and tele-monitoring services; and (e) reduce the barriers to physicians and nurses electronically practicing across state lines.

Performance Analysis - A Program Assessment Rating Tool (PART) review of the Telehealth Network Grant Program (TNGP) was conducted in 2006 for the FY 2008 budget cycle. The program received a rating of Moderately Effective. During this review the program established new performance measures that are indicators of the program’s reach and impact.

As a result of the TNGP many rural and other communities have gained access to services
(e.g., adult and pediatric mental health services) that otherwise would not have been available in the absence of the TNGP. The total number of telehealth sites/services has grown considerably as grantees increase both the types of services made available and the sites at which services are offered. (See “Details of Performance Analysis.”)