Telemedicine is Here to Stay

Mitchell Fong is the Director of Telehealth at Renown Health, a multi-hospital system that is locally governed and locally owned. Renown is a not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California and was an early adopter of telehealth in 2012.

Mitchell Fong and Ray Barrett of Telehealth Certification Institute discuss what goes into a telehealth program, the impact COVID-19 has had on the necessity and delivery of remote services, the increase in utilization of telemedicine for both provider and patient, the challenges of pushing through change to improve access to healthcare for all, and the fact that telemedicine is here to stay.

Fong has been in the field of healthcare for over a decade. He holds a degree in molecular biology, a masters of Public Health with a focus in epidemiology, and an MBA. He helps create the strategic plans for population health vision and is dedicated to improving healthcare in a community and getting services to those who really need it. Fong says that telehealth is essentially a startup of healthcare, looking to validate what you can do and how you can drive change. Being persistent is a key element for those innovators and ultimately for those in the industry. 

Nevada is the 7th largest state, yet is ranked 47th with regard to access to care. This is primarily due to Nevada having counties designated as frontier, which is more remote than rural and they have no access to specialists. Fong knows of patients who have driven over 2 hours during a snowstorm to attend a 20 minute follow up cardiac consult. There is a broad area in need in healthcare where telemedicine could be impactful and prove to be more efficient, easier and safer for the patient.

With COVID-19, we are facing a move to value and drive preventive medicine visits. For example even in urban settings, parents can’t take their kids as easily to the doctors office. The challenges we face when increasing the perceived value and the utilization of telemedicine include:

  • stigma
  • adoption
  • access to technology
  • learning curves
  • reimbursement and licensure parity
  • short-term solutions converting to long-term goals
  • modelling use of technology

The greatest challenge to overcome is the stigma that healthcare through a camera won’t provide the same quality of care as an in-person visit. We have to address this stigma from both aspects: the clinicians’ end and the patients’ end. More often than not, the care needed can be addressed through a virtual visit, and the necessity of this modality due to COVID-19 has proven to be quite successful.

Having the peripheral tools on the patients’ end (such as bluetooth stethoscopes, otoscopes, etc) makes a virtual visit just as impactful and as comparable as an in-person visit. We can also enhance the ability for asynchronous telemedicine. For example, patients can send pictures to a dermatologist, who can then use their “down time” (perhaps from no-shows or cancellations) to review the material and provide asynchronous care.

Barriers include reimbursement, state licensure and all of the policies that are restrictive of telemedicine and prevent parity. There are a lot of positive moves to address these as a result of COVID-19. Ultimately what we need to have is parity between telemedicine and in-office visits from both the service coverage and reimbursement standpoint. Once that is established, the access to care will be a challenge for health care providers, but it can be worked out if reimbursement is in place.

COVID-19 necessitated a lot of quick program launches for many organizations. You need to reevaluate what was done for the short term to make sure it meets your program’s long term sustainability goals. Making sure you have the right quality, the right vision and the right backbone to set yourself up for sustainability and expansion.


The process of being a telehealth coordinator requires persistence, transparency, to be a good collaborator, and a good model for what you want your product to be. If that means meeting via video, then encourage everybody to jump on video meetings. This has been new and a challenge for some, but we need to start encouraging the fact that video is now a part of healthcare - it’s no different than face-to-face.

A telehealth program requires teamwork and collaboration. Ask yourselves, “What is the value you want to deliver to the patient?” Change is not easy, so the program has to push through and make these changes and deliver value to the patient.  Be responsive and adaptive when tracking metrics - start with a clear baseline and make sure what you are doing impacts the key metrics. There will be a learning curve but the provider “buy-in” is extremely important. A program needs physician champions – this is ultimately what is going to be the drive to success.

Renown Health is currently working on “webside manner”: providers become more comfortable if they get the right training and understand why telehealth is so impactful on the other end. Delivering that training, making your care team feel supported to use technology while making sure you all have shared goals and vision, that’s the key to delivering the outcome you want.

The conversion rate of in-office visits to telehealth visits is a metric being followed closely. Defining the percentage of success for providers who are willing to see new patients via telehealth and then refining the algorithm to improve efficiency (improving no-shows and cancellation rates) and for identifying patients who are appropriate for telemedicine, and those who are not a good fit for remote services.


Adoption, access, parity, screening for fit, and modelling technology - all prove to be both the challenges and the key to drive successful telehealth care programs.

Mitchell Fong advises us all to keep pushing forward: Telemedicine is here to stay.

You can find more information about the Virtual Visits program at Renown Health here and detail on a telehealth grant they recently received.


  • Comment Link Beth Vanbeek Thursday, 27 August 2020 08:04 posted by Beth Vanbeek

    Burton T,
    Thank you for your comment! We are very happy to hear that you enjoyed the presentation and found it to be informative!

  • Comment Link Burton T Wednesday, 26 August 2020 17:50 posted by Burton T

    Fantastic presentation! Well spoken, and highly informative. Thank you for providing this content.

Leave a comment

Make sure you enter all the required information, indicated by an asterisk (*). HTML code is not allowed.

Course was very informative!
David Hopkins
MS, LPC / Thriveworks Woodstock
Informative and brief
Tracy Gilbert
Well designed. informative, comprehensive program broken down into manageable segments.
Dawn M. Miskus
Licensed Clinical Professional Counselor (LCPC) / Conscious Counseling & Coaching, Ltd.
This course offered a great overview of TeleMental Health and the important considerations that should be addressed when establishing an online practice.
Helen Geris
Registered Psychotherapist
Wonderful and approachable presenter, great information!
Sabrina Eads
I have completed the course requirements. Thank you a great program of videos and information.
Linda Lovisi-Dwyer
LCSW-R / Linda Lovisi-Dwyer, LCSW-R
Good introduction
Sylvia D. Jessup, MBA, MA
Owner / Sylvia Jessup Counseling Services PLLC
Very clear emergency planning laid out in this course, Helpful for many situation and settings.
Jane Schindler
The course was detailed.
Kelly Villarreal
MFT / Alan Behrman & Associates
Really chuck full of information and very helpful
Carolyn Spencer
social work
Great course!
Lashonda Jones
Ray's program is engaging and informative. I'm excited to extend my professional reach online.
Pamela Madsen
LAPC / Empower Counseling Center, LLC

Very informative session.

Valrey Richards-Lucas

Video was good, a little slow

Jessica Walraven

This is great material!

Erika T Johnson

Very Informative!!!!


Really good training so far!

Erika T Johnson

Excellent information, extremely generous resources and so well paced. I am really grateful.

Carolyn Spencer
LCSW / Carolyn Spencer

Very thorough and informative


This program is very informative and easy to use.

Gania Bruno Harrold

Love the convenience and easy-to-understand information in this course.

Natalia Gourlay-Fernandez
LAMFT / Rock Springs Positive Coaching, Caring, and Counseling

Very informative. Help give an overview of tele therapy and starting an online practice.

Meg Maginn
L.C.S.W Private Practice / Eating Disorder Associates

The course was easy to follow and provided a lot of valuable insight into the benefits and limitations to teletherapy.

Katie-Ann Magnuson
Mental Heath Therapist / Kwenyan Professional Health Services

Wonderfully compact and rich in information, many areas i had not even considered!

therapist / private practice
Very informative and guiding in educating all that you need to grasp to be properly compliant and aware.
Dena Damaskinos
A great overview for telehealth, including state to state
Susan Cortilet Jones
Integrative Lifeskills Coach

Great presentation!

Cristina Lazaro-Garcia
Mental Health Clinician, APC / CETPA, View Point Health
Oustanding presentation!!!
Michelle Collins

Helpful and inviting information to get started. Feel empowered to get this going and eager to start!

Dena Damaskinos

Well presented, easy to access and understand.

Sedonia Perrier
CEO / Steelhead LLC

This was very informative.

Wendy Pazdur
Substance Abuse Counselor / Transformation therapy
This course was full of detailed information, that I will utilize in my practice. I highly recommend this training to all interested in adding to their existing practice or transitioning to Telehealth Services.
Utopia Session
Class was informative.
Kimberly Horrell
This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist


Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy