Connection Through Care: Telehealth’s Expanding Role in Tennessee’s Community Health Centers

In a state where the northern mockingbird, Tennessee’s official state bird, fills the air with borrowed melodies, its many songs serve as a powerful form of communication. That same spirit lives in Tennessee’s community health centers, which continue to adapt and respond to the changing needs of their communities. Like the mockingbird, these centers listen closely, adjust their approach, and find new ways to connect. With telehealth transforming how and where care is delivered, they are extending their reach, strengthening patient trust, and creating new pathways to health across the state.  

Becky Grando, Senior Director of the Center for Quality in Community Health (CQCH) at the Tennessee Primary Care Association (TPCA), has witnessed this transformation firsthand. TPCA is a nonprofit membership association that supports Tennessee’s community health centers (CHCs) through education, customized support, and advocacy to help them deliver high-quality, accessible healthcare. One of TPCA’s key programs is the CQCH, which advances clinical, operational, and financial quality across the state through health information technology, data strategies, and collaborative learning. Backed by a federal Health Center Controlled Network grant, the CQCH has helped providers use telehealth to remove barriers and reimagine how care can be delivered. 

Before the pandemic, telehealth followed a rigid structure. CHCs were required to use specific technology within their walls, and patients often had to come into the clinic to connect with a remote provider. Through grant funding, TPCA equipped health centers with mobile carts, privacy screens, and secure platforms. This model helped connect rural communities with hard-to-reach specialists.  

As the pandemic unfolded, emergency waivers allowed providers to use familiar tools like Zoom and FaceTime to continue care. HIPAA-compliant versions of these platforms quickly became available. Ms. Grando shared the story of a nurse who was diagnosed with high blood pressure at the start of the pandemic. With a home monitoring device already on hand, she was able to check her readings and review them with her provider over Zoom. The experience was simple, accessible, and offered much-needed reassurance during a time of widespread uncertainty. As a healthcare professional herself, she understood the strain on the system and the importance of keeping patients and providers safe. Telehealth allowed her to stay connected to her care team while also helping reduce the burden on in-person clinics. Her story reflects how telehealth supported not only patients, but also the providers and professionals working tirelessly to keep care moving forward.

By 2023, Ms. Grando began to see a clear shift. Although the carts and health center-based systems were still available, most patients and providers now relied on personal devices. Appointments could be conducted over smartphones and laptops, often through a secure link sent by email. This made healthcare more convenient and helped reduce no-show rates. For many CHCs, telehealth was no longer an emergency solution. It had become a natural extension of care. 

The network of 30 community health centers across Tennessee now serves 71 counties through more than 200 sites, including school campuses, remote locations, and satellite offices. Telehealth is widely used to support behavioral health services, especially in rural areas where providers are scarce. If a patient visits their primary care provider and a mental health need is identified, a video or phone consultation can be arranged. This model improves access and speeds up referrals, creating a more responsive and connected care system.

Telehealth has become a powerful solution to long-standing barriers in access to care, especially for rural and medically underserved communities. In places where specialty care is limited or transportation is a challenge, virtual visits have made it possible for patients to connect with providers they would not otherwise be able to reach. From behavioral health support in remote counties to follow-up appointments with specialists, telehealth has opened doors that once seemed closed. What once required traveling long distances or navigating waitlists can now happen with the click of a link. Providers have gained the flexibility to reach more patients in less time, and patients have gained the ability to receive care from the comfort and safety of home. The shift from in-clinic telehealth carts to secure, user-friendly platforms has removed both technical and physical barriers, making care more immediate, more personal, and more equitable for patients. 

SCTRC, which supports providers in Arkansas, Tennessee, and Mississippi, has worked alongside TPCA throughout this journey. In 2020, SCTRC helped plan a statewide telehealth webinar with TPCA that offered urgent guidance when providers were adapting to new care models. That partnership continues today as the two organizations prepare a new education session to reflect the latest updates and best practices.  

SCTRC has also exhibited at TPCA’s annual conferences, sharing resources and practical tools with clinical staff and leadership. Ms. Grando pointed to the value of their support during rapidly changing times. SCTRC’s website, she said, became a trusted source for timely answers when policies and procedures were in flux. It helped clinics across the state move forward with clarity and confidence. 

Ms. Grando shared a vision for focusing telehealth on areas such as cardiology and endocrinology, where specialty access remains limited. Some clinics use these services regularly, while others rely on them only when needed. She looks forward to a future where every patient has the same opportunity to connect with specialized care through more consistent use of telehealth across the state. She also noted the importance of planning ahead. When winter weather or other disruptions close clinic doors, providers need a clear process for shifting appointments to virtual care. These procedures can make a lasting difference in how centers respond during future events.  

Ms. Grando also noted that nutrition services could become a growing area of focus in telehealth. Whether addressing obesity, diabetes, or high blood pressure, nutritional counseling plays an important role in prevention and chronic disease management. For patients who cannot access a registered dietitian locally, virtual visits may offer a critical option. As health centers remain focused on whole-person care, telehealth will continue to be a vital tool.

TPCA continues to offer customized support across areas like billing, coding, and digital workflows. Some providers embrace telehealth easily, while others take more time to adjust. Ms. Grando emphasized the importance of collaboration and knowledge sharing, especially for providers who are less familiar with new technology. Over time, she has seen even the most hesitant adopters grow confident in their use of virtual care. 

Special thanks to contributor Amy Moses, MEd, Senior Program Manager, South Central Telehealth Resource Center.