Addressing Family Planning Clients' Needs through Telehealth Services in Tennessee

For Tennessee Department of Health (TN DOH), a Title X grantee, starting a telehealth program was a goal even before the COVID-19 pandemic. Across Tennessee, while Title X family planning services are offered in every local health department, many clinics do not have advanced practice providers or physicians available onsite at all times. Instead, clinics are run by registered nurses adhering to protocols. To address clinician availability, TN DOH set up a telehealth program, helping clients avoid delays in care or longer travel time to another county for advanced care. Clients now have focused and consistent access to a practitioner who can provide complicated family planning counseling.

Yoshie Darnall, the Title X Program Grant Director, and Crissy Hartsfield, Interim Section Chief of the Reproductive & Women’s Health Division, designed their telehealth model to be centralized, serving Title X clients across the state. The program is operated by a nurse practitioner and licensed practical nurse, and clients are able to schedule appointments through a toll-free phone number or online. Additionally, when clients go to Title X sites in person where nurses cannot carry out family planning counseling services, they will be referred right then to telehealth on the same day or at another time that is convenient for the client.

While developing and improving this model, TN DOH encountered several challenges: working within the existing grantee scheduling system, advertising availability of services to clients, and getting buy-in from local health department staff. Yoshie advises other programs to “be persistent and patient. Our team thought that the telehealth program would take off like wildfire. It didn’t, which was very disappointing. We had to step back several times to think about our approach and messaging to make the program more successful.” 

Over time, Yoshie and her team have implemented processes and workflows to ensure clients are able to access additional services at their convenience to meet their health care needs. For example, when either a contraceptive and STI test are ordered for a client, clients can pick up their order from either  the local health department or a local pharmacy.

So far, the telehealth model has been well-received by clients. Results from TN DOH’s client satisfaction survey (offered in English and Spanish) show that clients have reported that scheduling telehealth appointments is easy (94%), that providers are meeting their family planning needs (96%), and that they would recommend the services to friends and family (95%). The RHNTC has a client satisfaction template that grantees can use to assess client satisfaction with telehealth services. TN DOH plans to expand its telehealth program to offer extended and weekend hours in the future.

Family planning agencies looking to offer telehealth services or improve the quality of services provided via telehealth can get started with these Telehealth Services Informed Consent Samples and the Telehealth Services: Taking an Inclusive, Equity-Driven, and Trauma-Informed Approach job aid from the RHNTC.