Telehealth has become increasingly important for WIC State Agencies to modernize the way they provide services to WIC participants. However, telehealth vendors face obstacles with expanding services across WIC State Agencies. Here, we present some of the obstacles discussed in recent interviews with THIS-WIC telehealth vendors and highlight some of their suggested solutions.
Planning for required IT staffing and general staff capacity of State Agencies
Developing and implementing new telehealth solutions requires dedicated IT staff, which State Agencies should plan and budget for. State Agencies should also consider capacity within existing State Agency staff and what will be needed to develop, implement, and support rollout of the solution. One vendor noted that “if WIC implements this across all locations, there will be additional manpower needed…they need a team of people who are invested and dedicated to just this role. It’s not an added duty like you can integrate in some services. This is very specific.”
Keeping up with the speed of technology development given constraints of funding
Another obstacle is keeping up with the speed of technology development, such as operating system updates. These require ongoing vendor support to ensure functionality and investment in and planning for updates. A vendor stated, “I think it’s also something to there’s a little bit of a learning curve where it’s helping people understand that technology moves forward in ways that you don’t have control over… to be fully taking advantage of all that [different software] platforms empower you to do to reach people comes at the cost of having to have a certain amount of investment in that adaptability.” Another participant noted “you know, the solution we pick today has to last a certain amount of time. We can’t keep reinvesting commercial, even commercial companies…they have a threshold for how much they can reinvest in their technology to keep things going. And I think that is something the investment in not just updating technology, like getting patches and so forth, but really looking towards you know, what is the newest thing and can it be beneficial to us…” State Agencies should consider how best to balance the changing nature of technology and the need to “future proof” solutions with funding constraints.
Variability across WIC systems and policies
Another challenge vendors addressed is variability across States, including different WIC systems and policies. A participant noted that, “my feeling at first would be if they all had the same requirements it’d be nice. We’ve had very different experiences with different states.” Another participant noted “How does the telehealth solution need to change in order to meet requirements for each state? For us, that’s the biggest challenge, just understanding the workflows and the policies and procedures and regulations around each one of those state work departments.” While state-specific policies and systems in WIC are factors that are unlikely to change, at least in the near term, vendors that want to work with multiple states need to consider how best to work with these different parameters, requirements, and workflows.
Uncertainty about federal policies for future telehealth use in WIC
Telehealth has become a critical tool for many WIC programs in reaching participants and delivering services, especially during the COVID-19 pandemic. However, there is uncertainty about federal policies for supporting telehealth adoption in WIC in the future. Many telehealth vendors expressed the need for clear and concise guidance from WIC at the national level on what will be acceptable for telehealth and telemedicine going forward. One vendor suggested having a simple framework of approved telehealth methods. Vendors noted that the COVID-19 waivers have been helpful for WIC programs, but the uncertainty about their expiration has been challenging. One vendor stated they want, “…clear guidelines on what can and cannot be done, so WIC providers and programs can customize [telehealth solutions] according to their needs.”
