Telehealth Optimization Assessment 2026

1. General Information

Welcome to the CTRC Telehealth Optimization Assessment! By completing this assessment, you’ll help us better understand your organization’s telehealth program maturity, enabling CTRC to provide meaningful support and recommendations.

- Please answer each question thoughtfully. Your responses will shape our analysis of your current setup and future goals.
- Unsure of an answer? No problem. Just note it in the answer field, and we can revisit any areas where additional information may be required.

You must complete and submit in one sitting as this platform does not allow you to save your entries and come back to submit

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1. Respondent Name (Required.)

Your Name

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2. Respondent Email (Required.)

Your Email

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3. Today's Date (Required.)

Date

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4. Organization Basics (Required.)

Provider/Health System Name

Website

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5. Organization Type (Required.)

Critical Access Hospital (CAH)

Rural PPS Hospital

Rural Health Clinic (RHC)

District / County Hospital

Federally Qualified Health Center (FQHC)

FQHC Look-Alike

Community Health Clinic

Tribal Clinic

Other (please specify)

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6. Primary Payment Structure

Medicare cost-based

Medicare PPS

Medi-Cal FFS

Medi-Cal Managed Care dominant

Commercial dominant

Mixed balanced

Other (please specify)

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7. Service Mix

Inpatient + Outpatient

Outpatient dominant

ED stabilization heavy

Specialty limited

Clinic network owned

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8. What demographics do you serve? (e.g., age groups, socioeconomic status, common health conditions)

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9. Annual Net Patient Revenue Range

< $25M

$25-75M

$75-150M

> $150M

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10. Geographic Broadband Reality

Strong fiber backbone

Mixed fiber + cellular

Primarily cellular dependent

Severe connectivity limitations

12% of survey complete.

Telehealth Optimization Assessment 2026

1. General Information

Question Title

* 1. Respondent Name (Required.)

Question Title

* 2. Respondent Email (Required.)

Question Title

* 3. Today's Date (Required.)

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* 4. Organization Basics (Required.)

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* 5. Organization Type (Required.)

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* 6. Primary Payment Structure

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* 7. Service Mix

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* 8. What demographics do you serve? (e.g., age groups, socioeconomic status, common health conditions)

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* 9. Annual Net Patient Revenue Range

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* 10. Geographic Broadband Reality

1. Respondent Name (Required.)

2. Respondent Email (Required.)

3. Today's Date (Required.)

4. Organization Basics (Required.)

5. Organization Type (Required.)

6. Primary Payment Structure

7. Service Mix

8. What demographics do you serve? (e.g., age groups, socioeconomic status, common health conditions)

9. Annual Net Patient Revenue Range

10. Geographic Broadband Reality