Telehealth system usage increased during the pandemic. Telemedicine provides a cost-effective option for healthcare versus in-person office visits. Centers for Medicare and Medicaid Services (CMS) allows states to determine if telemedicine is included in services provided. (Medicaid, nd). Implementing a telemedicine program would start with an assessment of the needs for the organization. Knowledge of how state and federal guidelines for CMS. The four domains of applications for telehealth consist of remote monitoring, mobile health, store, and forward applications, and real-time applications. (Alexander, et al. 2019) Use of telemedicine in a clinical setting for patients with congested heart failure (CHF). My experience is that those participating in telemedicine post-hospitalization have decreased readmissions. CHF patients post discharged would be followed by a CHF Case Manager (CM). Through telemedicine (real-time), the case manager and the patient would go over vital signs, and weight, it provides a nurse to have eyes on the patient. Of course, there would have to be established protocols, education for patients, etc. CHF CM would not replace a doctor’s visit but as a 3-5 day follow-up post-discharge. Centers for Medicare and Medicaid Services provides a toolkit to guide in implementing a telehealth program. Prior to implementing a program, healthcare professionals must review state and federal rules and regulations, insurance company reimbursement, the ability of the organization to provide technical assistance, and organizational policy regarding obtaining vendors. An important thing to remember is to have stakeholder support and appropriate training for those involved. Alexander, S., Frith, K. H., & Hoy, H. (Eds.). (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning. ISBN-13: 9781284129175 Medicaid. Telemedicine. (nd). https://www.medicaid.gov/medicaid/benefits/telemedicine/index.htm