Telehealth Program Questionnaire
The following questions are designed to help IMST Telehealth Consulting's experts gain a better idea of your current experience, and the degree of clinical and administrative support for adopting telehalth services in your organization.

It gives us a better understanding about how we can best help you embrace telehealth with confidence and clarity.

For best results, each question should be answered using the following 6 point scale, 1= Don't Know/Not Applicable , 2= NO, Never Considered, 3= NO, But have considered, 4= YES, In Progress, 5= YES, Nearly Completed, 6= YES, In Place

Has a Strategic Planning process for telehealth services taken place in the past year?
Don't Know/Not Applicable
Yes, in place
Has a specific health service been identified to deliver via Telehealth?
Don't Know/Not Applicable
Yes, in place
Do key persons in the organization have knowledge of the types of Telehealth technologies that are available?
Don't Know/Not Applicable
Yes, in place
Has your organization identified examples and evidence of effective Telehealth technologies used in similar contexts?
Don't Know/Not Applicable
Yes, in place
Have staff & other stakeholders been involved in the Planning Process?
Don't Know/Not Applicable
Yes, in place
Does your organization use a process to engage the community stakeholders in providing feedback about the Telehealth initiative?
Don't Know/Not Applicable
Yes, in place
Has your organization has identified potential collaborators?
Don't Know/Not Applicable
Yes, in place
Does your organization's Board of Directors support the Telehealth initiative?
Don't Know/Not Applicable
Yes, in place
Do your Executive Leaders & Senior Administration fully support the Telehealth initiative?
Don't Know/Not Applicable
Yes, in place
Have internal & external champions been identified for the Telehealth initiative?
Don't Know/Not Applicable
Yes, in place
Have staff been involved in selecting the technology, setting policies & drafting evaluation measures?
Don't Know/Not Applicable
Yes, in place
Has your organization had past successes with instituting programs that have required complex change processes?
Don't Know/Not Applicable
Yes, in place
Have change leaders been selected to take responsibility in key areas?
Don't Know/Not Applicable
Yes, in place
Has an Implementation Plan been created that clearly identifies anticipated changes, along with budget considerations & needed resources to facilitate the change process?
Don't Know/Not Applicable
Yes, in place
Has a Feedback Mechanism been developed for both employees & clients/patients to comment on Telehealth technology service provision challenges, concerns, successes & setbacks?
Don't Know/Not Applicable
Yes, in place
Submit
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