not move forward in providing technical expertise to rural providers and communities.

Finally, the NRHA calls for a study on the effect of telehealth on recruiting and training clinicians. Telehealth not only addresses the direct clinical application, but also can help address workforce challenges.

AMERICAN TELEMEDICINE ASSOCIATION

Stewart Ferguson, Ph.D.
Alaska Native Tribal Health Consortium;
American Telemedicine Association

Providers who use telehealth usually start locally and then build to regional, national, and international efforts. Telehealth has largely been successful in Alaska—it is depended upon to decrease costs (especially travel costs) in the delivery of health care services, and Alaskan leaders are looking for incentives to increase the use of telehealth. Alaskan hospitals embrace telehealth as part of their strategies and business plans. Tribal partners mandate the use of telehealth, and have demanded increased use for access to specialty care. Just like others, Alaska has a vision that telehealth will be fully integrated into the health care system to improve the quality, access, equity, and affordability of health care throughout the world. After this type of success, the challenge will be trying to scale the system to meet the demand.

The ATA provides resources to local telehealth providers such as its journal, webinars and webcasts, social media outlets, and opportunities for member participation. The annual meeting of the ATA is the largest of its kind anywhere in the world devoted specifically to telehealth. It convenes providers, device manufacturers, educators, and academics to discuss the best evidence and the best financial models. Aside from meetings, the influence of the ATA has a lot to do with the participation of its members. Within the ATA, there are several special interest groups that are made up of subject matter experts who hold their own webinars and meetings. There are also various chapters, discussion groups, an Industry Council, and an Institutional Council (representing those who provide health care). These member groups are important in the development of practice guidelines, advocacy, training, and peer review.

A major challenge in the adoption of new telehealth programs is not knowing the best practices for doing so; the ATA is a major resource for this information. With the involvement of academia, industry, providers, and clinicians, the ATA has developed several evidence-based practice guidelines, with many more in progress (see Box 12-1). Guidelines and standards are especially important because telehealth is a solution of scale.



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