By David Cohn, Founder & CEO, Regroup and Hossam Mahmoud, MD, MPH
For many hospitals and health systems, the emergency room is the front line for care for patients who need psychiatric help. According to the National Council for Behavioral Health, the number of patients going to emergency departments for psychiatric services increased 42% over a recent three-year period. The problem is particularly serious in rural and remote areas where clinicians are scarce.
As health systems work to provide high-quality care while containing costs, more of them are looking beyond traditional in-person care delivery to innovative new models. While telepsychiatry has been proven to resolve geographic constraints and the physical distances between clinicians and patients, healthcare facilities of all types recognize the clinical, operational and business benefits of its implementation into their care delivery processes.
By connecting patients and behavioral health clinicians virtually from anywhere, health systems can:
Improve access to care
Uneven distribution of mental health providers across the U.S. leaves many patients waiting weeks or even months for in-person care at hospital outpatient departments. As a result, many of them wind up in hospital emergency rooms. In 2016, nearly 10 million inpatient stays had a principal or secondary diagnosis of mental health or substance abuse disorders. The urgent need to address this situation has prompted many health systems to embrace telepsychiatry as a way to give patients more immediate access to care when and where they need it.
Encourage patients to seek care through primary care providers
Many patients who would never go to a counselor or a psychiatrist are willing to trust their primary care physician with their mental health concerns. In addition to direct patient consultation, telepsychiatry can also empower primary care providers to treat behavioral health issues themselves through an eConsult model. This can be used to create an innovative two-pronged approach to meet patient needs. Before referring a patient for direct psychiatric care, primary care providers use eConsult to contact a teleclinician and determine if a referral is clinically appropriate. Based on the telepsychiatrist’s response, a primary care provider may prescribe medications directly to the patient or refer them for additional services as needed. This “doc-to-doc” system allows primary care providers to treat many issues on their own in outpatient clinics while slashing wait times for psychiatric consultations from six months to six weeks.
Reduce avoidable hospital admissions
Over 12 million emergency department visits each year are made by people with mental health and substance abuse issues, often because they are unable to make an appointment to see a PCP. These stays can get expensive fast: A Wake Forest University study estimated that boarding psychiatric patients as they await inpatient care costs an average of $2,264 per patient, in part because they prevent the turnover of beds during their stays, impeding access to care and reducing potential revenues. Identifying and treating these issues earlier through telepsychiatry can improve patient outcomes and reduce ED visits, lowering overall costs for the healthcare system. For example, a Veterans Affairs study found that when treatment incorporated telemental health, psychiatric hospitalization went down by an average of nearly 25%.
Find new cost efficiencies
Beyond reducing avoidable admissions, health systems can leverage telepsychiatry to uncover ROI in other ways, too. These include dramatically reducing recruitment costs by accessing a turnkey network of qualified clinicians, as well as improving clinician productivity by right-sizing services and allowing in-house staff to focus on their core strengths. In addition, telepsychiatry can help health systems tap into new sources of revenue, including new patient enrollments, reducing cancellation rates and maximizing reimbursements for patient visits.
Steps for Success
While an external telepsychiatry partner can provide valuable support, not all partners are created equal. By working with a partner that combines a diverse clinician network and hands-on, ongoing support, organizations can launch successful programs that deliver care where and when it’s needed most.
Find the right approach
Telepsychiatry offers health systems enormous flexibility in patient care. To find the right fit, start by considering whether direct patient consultation, clinician-to-clinician consults or a combination of the two make the most sense for your organization. Leveraging both care methods can help health systems treat patients more quickly and effectively. In addition, consider whether your organization would benefit from an integrated approach to behavioral health. By coordinating efforts between virtual and on-site clinicians, facilities can identify patient issues earlier, reduce avoidable acute care episodes, and realize significant operational and financial benefits. In fact, a recent study found that telepsychiatry can help trim costs anywhere from 40% to 70%, depending on the size and nature of the facilities.
Find the right clinicians
Many organizations find they need clinicians with highly specialized skills to treat specific patients or conditions, making it especially difficult to find the right hire. Meanwhile, in-house staff can become overwhelmed with needs they may not be well-equipped to handle. An experienced telepsychiatry partner can provide access to a large and diverse pool of clinicians so organizations can find the right fit for their specific patient demographics and needs. The right telepsychiatry partner can help integrate teleclinicians into the on-site care team, enabling in-house providers to play to their strengths. They focus on long-term placements so that patients see the same clinician week in and week out, providing continuity that leads to more personalized, effective care.
Find the right partner
Choosing the right partner is key for long-term program success. Look for a company that can provide you with a robust technology and information system, the ability to help maintain the relationship between clinician and clinic, and the expertise to integrate a responsive support system that provides solutions for every aspect of the program.
David Cohn is Founder & CEO of Regroup and Hossam Mahmoud, MD, MPH, is Medical Director & SVP of Behavioral Health, Regroup.
In partnership with providers at more than 175 care locations across America, Regroup brings individualized mental health services to deliver hundreds of thousands of patient sessions per year. Regroup’s clinician-focused culture attracts highly qualified clinicians that are supported by a dedicated team of recruiting, licensing and credentialing, account management, clinician relations and technical implementation teams. For more information, visit www.regrouptelehealth.com.