the inclusion of telehealth training in proposals. He added that exposure to telehealth is key to provider acceptance. Antoniotti stated that several educational models are already using distance education to a large degree, which could be used to train many professionals in telehealth technologies. Rheuban commented that HHS funded the Virginia Health Workforce Development Authority, and one of the grant projects they will support is the development of a certified telehealth technician program. She stated that health care providers need to understand what the technology can do, but do not need to operate the technologies, so a trained workforce can be developed to do this. Antoniotti disagreed, stating that in their model, providers were trained in how to use, fix, and maintain their own equipment, as this was much more efficient than calling in others to do it, and prevented abandonment of the technology. Rheuban responded that because most clinic providers are already overwhelmingly busy (and likely to be even busier after full implementation of the ACA), their vision is to train an on-site licensed practical nurse or certified nursing assistant to support the telehealth technologies, thereby maximizing the efficiency of the primary care or specialty care providers.

Medicaid

One participant noted that Medicaid is a key player in telehealth because of the numbers of individuals they cover, because of the high amount of expenditures, and because success with these populations will be the most difficult challenge. Nesbitt agreed that with Medicaid expansion, there will be tremendous pressure on the Medicaid managed care program. He noted that telehealth might be seen as a solution in states that are required to show the ability to provide timely access to services for newly added populations. Telehealth might also help solve problems with lack of local providers, particularly specialty providers, who are willing to serve Medicaid populations, and provide more choice to patients.



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