Mission
The Missouri Telehealth Network increases access to patient-centered health care for rural and underserved Missourians via telehealth by providing technical assistance to health care organizations, partnering with key stakeholders, operating telehealth programs and supporting and developing telehealth policies.
The Missouri Telehealth Network exists to develop, study, and use telehealth solutions that improve access by providing high-value, patient-centered health care and medical education in Missouri and beyond.
Six Pillars of Our Culture
- Mission oriented
- Exceptional customer service
- Continuous improvement
- Excellent communication
- Collaboration
- Active listening
Message from Our Director
It is my pleasure to present the Missouri Telehealth Network’s 2025 Annual Report. As I reflect on this past year, I am deeply grateful to the many people and partners who make our work possible. To our stakeholders, Show-Me ECHO participants and hub team members, telehealth partners, and the dedicated MTN staff—thank you. Your commitment to improving access to high-quality care for Missourians continues to drive our mission forward. In 2025, MTN finalized an updated strategic plan that sharpens our focus on quality, engagement, service, stewardship, and growth. This plan guides our work as we strengthen our programming, deepen our partnerships, and expand opportunities for impact across the state. This year also marked an important milestone for telehealth research at MTN. Dr. Mirna Becevic was awarded HRSA’s Rural Telehealth Research Center and established the Center for Telehealth Research and Policy here at MTN—an exciting advancement that elevates both our statewide leadership and our national presence in telehealth innovation. Telemedicine remains an evolving landscape, and 2025 highlighted both challenges and opportunities. Nationally, reimbursement and regulatory policy continue to face uncertainty as the federal government relies on extensions to public health emergency-era rules. While we await long-term federal clarity, Missouri continues to shine as a state that champions telehealth. This year’s passage of audio-only telehealth regulations is a tremendous step forward and adds to the already strong telehealth regulatory environment in Missouri. We also look with anticipation toward how the Rural Health Transformation State Plan will unfold—particularly its provisions related to telehealth and workforce development. As we conclude 2025, we are energized for the year ahead. We are committed to ensuring our programming is impactful, accessible, and increasingly valuable to health care professionals across Missouri. We are pursuing new strategies to raise awareness, expand our reach, and meet providers where they are. Thank you again for your continued partnership and support. Together, we are building a stronger and more connected health care system for all Missourians.
With gratitude,
Increasing Access to Telehealth
In collaboration with other state leaders, MTN provided funding for critical telehealth services through the Rural Citizens Access to Telehealth (RCAT) program and expanded the availability of essential services through the Sexual Assault Forensic Examinations via Telehealth training (SAFEvT).
RCAT’s Impact on Care: Strengthening Telehealth in Rural Missouri
The Rural Citizens' Access to Telehealth (RCAT) program is a collaborative effort between the Missouri Telehealth Network (MTN) and the Missouri Department of Social Services, MO HealthNet Division. Designed to expand access to high‑quality care in rural communities, RCAT provides funding, education, and hands‑on support to help healthcare organizations introduce or enhance telemedicine services for patients—including those covered by Medicaid. Since the program launched in late 2023, 26 organizations have joined the initiative, supporting 35 projects across Missouri. These projects span six key areas of care: behavioral health, primary care, hospital services, chronic care, dental care and pharmacy. During the first three quarters of 2025, organizations reported 21,074 telehealth visits, with 36% of encounters serving Medicaid recipients. Programs also completed 1,683 asynchronous visits and expanded remote patient monitoring services to 1,234 patients by the end of September. 1498 prescribers and non‑prescribers participated in telehealth training, strengthening the statewide workforce and building the skills needed to deliver care in new and effective ways. While teams navigated challenges common to telehealth expansion—such as EMR integration, staffing, equipment procurement, and vendor coordination—they also celebrated significant achievements. Organizations enhanced their digital infrastructure, implemented new clinical technologies, and developed workflows that made it easier for patients to receive timely, convenient care closer to home. Many sites reported reduced travel burdens, improved care coordination, early identification of health concerns, and high patient satisfaction. Through continued collaboration and innovation, RCAT is helping ensure that rural Missourians have equitable access to the care they need—when and where they need it.
"Through RCAT funding, nurse navigators have been able to successfully link children to pediatric providers via telehealth. Parents have expressed gratitude for this program as it has mitigated the need for them to miss work in order for their child to have their care needs met." (Citizens Memorial Hospital)
Rural Citizens' Access to Telehealth Services (RCAT)
Missouri Expands Access to SANE Services Through Telehealth
Access to forensic sexual assault examinations has historically been limited in many parts of Missouri, especially in regions without trained Sexual Assault Nurse Examiners (SANEs). To address these gaps, Missouri passed The Justice for Survivors Act in 2020, requiring all hospitals to provide sexual assault exams upon request. This expanded mandate relies on the statewide teleSANE network, ensuring hospitals can deliver SANE services either in person or through telehealth so survivors receive timely, comprehensive care—regardless of where they live. To support this system, the Missouri Telehealth Network (MTN), in collaboration with SANE experts, developed asynchronous training programs for the three essential roles involved in telehealth‑assisted SANE exams: SANE Nurses, who guide and mentor remotely; Prescribers, who support examinations and prescribe needed medications; and Satellite Nurses, who may not be fully SANE‑trained but are prepared to provide hands-on support during the exam. In partnership with the Missouri Department of Health and Senior Services – Office on Women’s Health, MTN implemented the SAFEvT training program to strengthen the statewide response. Since 2024, more than 400 individuals completed SAFEvT training, expanding Missouri’s teleSANE‑ready workforce and ensuring survivors across the state have access to high‑quality, trauma‑informed forensic care close to home.
Providing Technical Support and Resources
As the Missouri partner for the Heartland Telehealth Resource Centers, we delivered technical support related to telehealth services. Additionally, we offered valuable resources, including a free, web-based telehealth billing resource and training through the Interprofessional Telehealth Training Program (ITTP).
Heartland Telehealth Resource Center
In 2025, MTN concluded its long-standing partnership with the Heartland Telehealth Resource Center (HTRC), which supported telehealth expansion in rural and underserved communities across Missouri, Kansas, and Oklahoma. Throughout this collaboration, MTN provided specialized expertise in technical support, clinical practices, operational strategies, legal and regulatory matters, and program evaluation. HTRC provided 35 outreach events (webinars and training sessions) and offered assistance close to 2700 recipients in 2025.
Telehealth Billing
Telehealth regulations and guidelines are continually changing, which can be confusing and overwhelming. To assist, we have developed a FREE, Missouri-specific billing guide to support Federally Qualified Health Centers, Community Mental Health Centers, Critical Access Hospitals, Rural Health Clinics, and more. This guide is easily accessible, frequently updated, and provides telehealth rules, general information, and useful resources tailored to organization type, services, and payers.
Interprofessional Telehealth Training Program
MTN’s online telehealth education program continues to grow and make an impact. Designed to close gaps in training for medical, nursing, and other health-related students and professionals, the program offers five interactive modules covering essential topics such as best practices, technology guidance, legal and regulatory updates, and patient safety considerations. In 2025, 240 individuals have enrolled, with 78% completing at least one module. Feedback remains overwhelmingly positive—97.5% of participants report they plan to make changes in their practice after completing the modules. Participants represent a wide range of professions, including physicians, nurses, physical therapists, social workers, and more, and come from communities across Missouri. This program continues to strengthen telehealth knowledge and confidence statewide, helping providers deliver safe, effective care in an evolving healthcare landscape.
Educating Healthcare and Other Professionals
Show-Me ECHO
Moving Knowledge, Not People
Show-Me ECHO is more than education—it’s a statewide network where every participant is both a teacher and a learner. This spirit of collaboration drives 35 dynamic programs that reach every corner of Missouri, creating opportunities for thousands of professionals to share expertise and solve real-world challenges together. Our success is built on strong partnerships and sustained funding, and we remain committed to expanding access to knowledge and improving care for all Missourians. Hear from participants in their own words in the video montage that follows—stories that show how shared learning transforms healthcare.
Testimonials
Each ECHO session is led by a multidisciplinary hub team—a group of specialists dedicated to supporting participants through collaborative learning. Hub teams include local and regional experts, individuals with lived experience, and subject matter specialists. Show-Me ECHO prioritizes recruiting members who reflect the communities served and represent diverse perspectives from across Missouri. Hub team members share expertise through brief educational presentations and by mentoring participants during case-based discussions using a guided practice model. This approach is grounded in the principle of “all teach, all learn,” ensuring that both hub members and participants benefit from shared knowledge and experience. Through these interactions, hub teams gain valuable insight into the challenges faced by clinicians and patients in underserved areas, strengthening their ability to support meaningful change.
Show-Me ECHO Makes a Difference
New in 2025
Responding to Missouri's Changing Needs
Healthcare challenges don’t stand still—and neither do we. This year, MTN introduced four new ECHO programs designed to address critical issues facing Missouri communities. The IBT for Healthy Weight ECHO helps clinicians and care teams apply intensive behavioral therapy strategies to support healthier lifestyles and long-term success. Our Cancer Survivorship ECHO focuses on life after treatment, equipping teams to manage late effects, monitor recurrence, and provide holistic support for survivors. The Pain Management ECHO tackles one of healthcare’s most persistent challenges, sharing evidence-based approaches for chronic pain that emphasize safety and effectiveness. Finally, the Child Trafficking Awareness ECHO delivers essential training to recognize warning signs, respond appropriately, and connect survivors with resources. Each program reflects MTN’s commitment to collaboration and knowledge-sharing. By connecting experts with those on the front lines of care, we’re building stronger systems and healthier futures for Missouri.
Connecting Providers to Help Missourians Quit: The Vaping, Tobacco, and Nicotine Treatment ECHO When it comes to helping Missourians quit tobacco, Jenna Wintemberg believes collaboration is key. As an Associate Teaching Professor and Director of Undergraduate Studies in the Department of Health Science at the University of Missouri, Dr. Wintemberg has dedicated her career to advancing tobacco treatment and prevention across the state. A nationally certified Tobacco Treatment Specialist, Dr. Wintemberg provides clinical support through MU Health Care and the Ellis Fischel Cancer Center, where she co-facilitates the Quit Tobacco Now program. The long-standing program, now celebrating its tenth year, offers patients practical tools and compassionate support to quit tobacco use for good. In January 2023, Dr. Wintemberg was part of the original hub team that helped develop and launch the Vaping, Tobacco, and Nicotine Treatment ECHO. In this role, she collaborates with experts from across disciplines to guide discussions, share best practices, and support healthcare providers statewide in delivering effective nicotine and tobacco cessation care. “The ECHO model allows us to reach providers in every corner of the state,” Wintemberg explains. “By sharing what works and learning from one another, we can expand access to effective treatment and help more Missourians quit.”
This ECHO was created in response to a growing public health concern: the rise in vaping and nicotine use, especially among youth and young adults. Missouri continues to experience high rates of tobacco use—particularly in rural areas—where access to evidence-based cessation programs is often limited. Many providers in these regions want to help their patients quit but may lack specialized training, up-to-date resources, or a network of experts to consult. The Vaping, Tobacco, and Nicotine Treatment ECHO helps close those gaps. Through virtual case discussions and expert-led learning sessions, participants gain the tools to recognize nicotine dependence, guide conversations about quitting, and offer effective treatment options tailored to each patient’s needs. This ECHO has also built strong partnerships with other ECHO topics including oral health, child psych, asthma, hypertension, cardiovascular disease, and certified peer specialists. These collaborations have allowed experts and participants to address the intersection between tobacco use and other healthcare concerns, helping participants see the full picture of tobacco’s impact on patient health. Beyond its clinical impact, the program fosters a statewide community of practice dedicated to reducing tobacco-related disease and death. By empowering healthcare providers in all settings, from large hospital systems to small rural clinics, the ECHO is expanding Missouri’s capacity to deliver consistent, evidence-based care for nicotine addiction. During Show-Me ECHO’s “Decade of Excellence” celebration in 2024, Dr. Wintemberg was awarded the ECHO Champion Award for special recognition and appreciation for her outstanding commitment and dedication to the program. Always speaking at conferences and presenting data on posters at professional events, Dr. Wintemberg continues to share the value of the ECHO model. She encourages other professionals to join by highlighting the resources offered, the expertise exchanged, and the welcoming learning community she helps foster in every session. An exceptional leader and facilitator, Dr. Wintemberg draws on each hub team member’s unique strengths to ensure participants receive the best possible experience and leave each session with a wealth of knowledge and practical tools they can use immediately. She is truly a champion for the Show-Me ECHO program and the cause of helping Missourians live healthier, happier, tobacco-free lives. Dr. Wintemberg explains, “Each conversation we have through ECHO helps someone, somewhere, receive better support to quit. That’s what makes this work so meaningful.” The Vaping, Tobacco, and Nicotine Treatment ECHO meets every 2nd and 4th Wednesday of the month from 12:00 – 1:00 PM CST
Cases: Positive Outcomes for Patients
Case presentations in Show‑Me ECHO provide meaningful, real‑world learning opportunities for clinicians across Missouri. Since 2014, over 4,000 cases have been presented, reflecting a broad range of clinical and practice‑based challenges. Participants bring de‑identified cases to the ECHO, creating space for collaborative discussion and shared problem‑solving. Through guidance from peers and expert mentors, clinicians gain practical insights they can apply immediately, strengthening both their confidence and their capacity to address similar situations in day‑to‑day practice. In 2025, 98% of cases were presented by professionals working in health‑professional shortage areas—a reflection of Show‑Me ECHO’s reach into communities with the greatest need. These discussions often represent situations in which patients may have otherwise forgone specialty care due to geographic or financial barriers. By equipping participants with specialty‑informed guidance, each case presentation effectively extends expert care to patients who might not otherwise receive it. This improves access for hundreds of Missourians and supports better health outcomes statewide.
Participant Perspective: Self-Efficacy & Satisfaction
Show-Me ECHO participants complete a satisfaction and self‑efficacy survey twice a year. The self‑efficacy questions measure how confident participants feel in their ability to apply new skills, address challenges, and achieve specific goals in their practice. Participants consistently report increased confidence after engaging in ECHO sessions. An analysis of the 2023 through 2025 survey responses shows statistically significant improvements in self‑efficacy before and after participation in Show‑Me ECHO programs. In addition, 95% of respondents rate their overall ECHO experience as “Good” to “Excellent” (4 or 5 on a 5‑point scale).
ECHO Participant Perspective: HIV ECHO Makes a Difference
HIV remains a significant public health concern in Missouri, with approximately 15,000 residents living with the virus and an estimated 480 new infections reported in 2022, representing an incidence rate of 9.1 per 100,000 people (Centers for Disease Control and Prevention [CDC], 2025; AHEAD, 2023). Rural Missourians face unique challenges in accessing HIV care, including limited healthcare infrastructure, transportation barriers, and heightened stigma, which can delay diagnosis and treatment (Missouri Department of Health and Senior Services [DHSS], 2021; MU Extension, 2021).
Programs like HIV ECHO help bridge these gaps by connecting rural clinicians to expert guidance and peer support, ensuring that patients—regardless of location—receive timely, high-quality care. Strengthening these connections is essential to reducing new infections and improving health outcomes statewide.
Watch Janet Miller discuss her experience participating in the HIV ECHO.
Additional Information
Expanding healthcare access for Missourians takes more than vision—it takes dedicated teams working together every day. MTN’s Business, Clinical Liaisons, Knowledge Management, Education, Operations, and Partner Management teams each play a vital role in making that vision real. This year, we’re shining a light on the Knowledge Management team, whose work connects people, data, and programs to keep everything moving forward. Future reports will spotlight other teams, because every success story begins with collaboration—and together, we’re building healthier communities across Missouri.
References
Centers for Disease Control and Prevention. (2025). HIV prevention in Missouri. Retrieved from https://www.cdc.gov/hivpartners/media/pdfs/2025/06/cdc_hiv_o3pc_factsheet_missouri_2025_508.pdf AHEAD. (2023). HIV data in Missouri. Retrieved from https://ahead.hiv.gov/missouri/ Missouri Department of Health and Senior Services. (2021). Epidemiologic profiles of HIV, STD, and hepatitis in Missouri. Retrieved from https://health.mo.gov/data/hivstdaids/pdf/mo-hiv-std-2021.pdf MU Extension. (2021). Missouri health care availability and outcomes differ regionally. Retrieved from https://extension.missouri.edu/publications/mx56 https://data.hrsa.gov/topics/health-workforce/shortage-areas/map-gallery-hpsa https://www.mapchart.net
Credits:
Created with images by Angkana - "Empty space studio dark room of Concrete floor with spot lighting and smoke in black background." • MQ-Illustrations - "Rural Health.,Doctor in smock holds stethoscope.,The word Rural Health is next to it.,Symbol of medicine, illness, health" • Syda Productions - "unhappy woman crying on floor" • gustavofrazao - "Good Health written on rural road" • Andrey Popov - "Telehealth Patient Making Hypertension Blood Test" • peopleimages.com - "Child, black man and laptop screen with doctor for telehealth service, communication and advice.,Home, boy and father with pediatrician on tech for medical support, discussion or virtual consultation" • InfiniteFlow - "Doctor telemedicine service online video with pregnant woman for prenatal care .,Remote doctor healthcare consultant from home using online mobile device connect to internet for live video call ." • JPC-PROD - "Doctor with a stethoscope on the computer laptop screen.,Telemedicine or telehealth concept, sore throat," • Vadim Pastuh - "View from back above male shoulder on the laptop with diverse employees, coworkers on the screen, video call, online meeting.,App for video conference with many people together" • vepar5 - "outline map of us state of missouri on blackboard" • Studio Romantic - "Doctor and patient during obesity consultation support.,The physician writes notes as the fat overweight man listens during medical exam in clinic.,Collaborative medical weight management" • nenetus - "Beautiful cheerful female doctor talking while explaining medical treatment to patient in the consultation." • Dzmitry - "Time to telehealth.,Male hand flips wooden cubes and changes the word 'health' to 'telehealth'.,Beautiful yellow table, white background, copy space.,Business and telehealth concept."