Resources for Telehealth at Safety Net Settings

Delivering healthcare through telehealth within safety net settings may pose barriers not typical in other settings. To rapidly respond to the COVID pandemic where telehealth uptake is high, we have gathered resources here to help support patients who may have limited digital literacy or limited English proficiency in using video visits.  This includes examples of workflows and multi-lingual how-to videos.

CVP core faculty Courtney Lyles, PhD and Associate Professor of Obstetrics and Gynecology Malini Nijagal, MD, MPH developed and collated these resources with funding support from the Donaghue Foundation.

For Patients
For Clinicians
Considerations for using Remote Visits within Safety Net Healthcare Settings
Limited Digital Literacy
Limited English Proficiency
  • When working with a patient with limited English proficiency
    • Follow best practices, such as not taking shortcuts with interpreters
    • Tips Document - developed by clinician experts in language access
    • To facilitate this, work with interpreter services to determine a video (and phone) visit workflow that is inclusive of interpreters and protects patient from seeing direct interpreter contact information
  • Ensure digital literacy efforts (patient education, outreach, or instructions) are inclusive of language needs
    • Zoom download videos above may be helpful
    • Any standard patient instructions should be made into a system's threshold language
  • COVID-19 Fact Sheets in over 30 languages


Sample Clinic Workflows

The following is an example of a high-level, simple workflow and decision tool for clinics to use to convert remote telephone visits to video visits. 

  • Each health system and clinician is encouraged to adapt the example provided for their own needs. Alterations are often necessary for your clinic environment
  • Offering video visits and technology solutions more than once has been shown effective in other work, such as signing patients up for online portal access
  • Keep up best practices for privacy during the video or phone visit session
    • Confirming unique medical identifiers of the patient at the beginning of the visit
    • Ensuring a private space for the conversation, without others present if possible

Center for Care Innovations (CCI) Samples

Telehealth Policies in Response to COVID-19
  • Prior to the COVID-19 pandemic, each healthcare system had to have a Business Use Agreement with the video vendor like Zoom to cover medical liability, even if that vendor was HIPAA compliant.  However, the current loosening of regulations allows systems to proceed with HIPAA compliant video platforms without the insurance coverage.
  • Center for Connected Health Policy’s Summary of State Actions (updated frequently as policies evolve)
Reimbursement for Medicare & Medicaid

Telehealth Coverage Policies (updated frequently as policies evolve)

Additional Resources

Please let us know if these resources were helpful and if you have any suggestions at this survey:

Updated 2020-04-24 4:40pm PDT