ATTACH 1_Evidence Based Telehealth Network Program Report (2)

OMB # 0906-XXXX-NEW. Expiration Date: (XX/XX/20XX)
Federal Office of Rural Health Policy (FORHP)
Office for the Advancement of Telehealth (OAT)
Evidence Based Tele-behavioral Health Network Program (EB THNP)
Substance Abuse Treatment Telehealth Network Grant Program (SAT TNGP)
RTRC Recommended Measures

Measure 1 (Access)
Measure:
Number of behavioral health encounters per patient, by intervention group (Telehealth
vs Non-telehealth): total and by service type, provider type, and disposition
Description:
Indicates number of encounters patient received for behavioral health treatment
Measure 2 (Access)
Measure:
Percent of scheduled behavioral health encounters not completed, by intervention
group (Telehealth vs Non-telehealth): total, by service type, and specific reason
Description:
Indicates percent of encounters not completed, by reason, as an alert for low
completion rates
Measure 3 (Cost Savings/Cost Effectiveness)
Measure:
Percent of encounters where behavioral health services are billed to insurance, by
intervention group (Telehealth vs Non-telehealth): total and by service type
Description:
Indicates the extent to which behavioral health services are being billed to insurance as
an estimate of sustainability
Measure 4 (Cost Savings/Cost Effectiveness)
Measure:
Estimated reimbursement for behavioral health services, by intervention group
(Telehealth vs Non-telehealth): total and by service type
Description:
Used to describe type of behavioral health service delivered and used to calculate
national Medicare reimbursement rate for services delivered as a proxy for cost
Measure 5 (Cost Savings/Cost Effectiveness)
Measure:
Estimated travel costs for behavioral health services, by intervention group (Telehealth
vs Non-telehealth): total and by service type
Description:
Indicates travel cost and time for the patient
Measure 6 (Clinical Outcomes)
Measure:
Change in mental and physical health quality of life over time, by intervention group
(Telehealth vs Non-telehealth): total and by service type
Description:
Measure will use the Patient-Reported Outcomes Measurement Information System
(PROMIS) Global Health to assess patient functioning.
Measure 7 (Clinical Outcomes)
Measure:
Change in depression symptoms over time, by intervention group (Telehealth vs Nontelehealth): total and by service type

Rural Telehealth Research Center – Recommended Measures for EB THNP/SAT TNGP Grantees – 2019-5-16

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OMB # 0906-XXXX-NEW. Expiration Date: (XX/XX/20XX)
Description:

Measure will use the Patient Health Questionnnaire - 9 (PHQ-9) to assess depression
symptoms in patients whose primary complaint is depression or who have a primary or
secondary ICD-10 indicative of depression.

Measure 8 (Clinical Outcomes)
Measure:
Change in generalized anxiety symptoms over time, by intervention group (Telehealth vs
Non-telehealth): total and by service type
Description:
Measure will use the Generalized Anxiety Disorder Scale – 7 (GAD-7) to assess anxiety
symptoms in patients whose primary complaint is anxiety or who have a primary or
secondary ICD-10 indicative of anxiety.
Measure 9 (Clinical Outcomes)
Measure:
Change in substance use severity over time, by intervention group (Telehealth vs Nontelehealth): total and by service type
Description:
Measure will use the Drug Use Disorders Identification Tool - Consumption (DUDIT-C) to
assess substance use severity in patients whose primary complaint is substance use or
who have a primary or secondary ICD-10 indicative of substance use.

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently valid OMB control number. The
OMB control number for this project is 0906-XXXX-NEW. Public reporting burden for this collection of
information is estimated to average 14 hours per response, including the time for reviewing instructions,
searching existing data sources, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room
14N136B, Rockville, Maryland, 20857.

Rural Telehealth Research Center – Recommended Measures for EB THNP/SAT TNGP Grantees – 2019-5-16

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