Value-based care and the concept of connected health care communities go hand-in-hand. It is simply not possible to extract the full “value” of forward-looking care delivery models without a strategy that addresses patients’ whole health—both physical and behavioral—across the entire continuum. Connected community models achieve this objective through a comprehensive, sustainable and multi-faceted behavioral health strategy that improves treatment access at key entry points and across all levels of care.
Health care stakeholders increasingly recognize the power of connected community models, yet behavioral health remains significantly fragmented due to supply and demand challenges. While rapid evolution of integrated delivery networks is increasing scale and synergies on the medical side of the house, behavioral health lags behind partially due to professional shortages that exist in all U.S. states. These shortages are felt across the continuum, beginning in the most acute settings and flowing into outpatient care and referral networks.
Telepsychiatry models have emerged as one solution that holds great promise for changing this dynamic. Through video conferencing sessions that enable anytime, anywhere access, this model is opening new gateways to care and disrupting traditional approaches to behavioral health.
The Telepsychiatry Advantage
Providers and patients are embracing telepsychiatry as a viable treatment alternative for good reason: it meets the standard of traditional in-office care for diagnostic accuracy and quality, while also improving care continuity, outcomes and patient satisfaction.
Patients appreciate the convenience and privacy afforded by direct-to-consumer (D2C) telepsychiatry sessions that can be accessed at home or other comfortable locations that are private. By empowering patients with greater choice in location and time, telepsychiatry models help tear down communication barriers and reduce stigma—a key factor that keeps many from seeking treatment. Appointments are easily scheduled outside of traditional office hours where a reliable Internet connection exists. Additionally, patients can look outside of local areas to access services, expanding provider options.
In tandem with patient benefits, behavioral health providers often find telepsychiatry a good fit for work-life balance. Today’s health care communities rely heavily on existing behavioral health professionals to fill care gaps. As such, it’s not uncommon for those in the field to have upwards of three to four different jobs. Telepsychiatry relieves some of the pressure by allowing existing providers to schedule sessions in more convenient, creative ways.
In addition, many providers want to address the urgent need for services in rural communities and desire to fill care gaps. Yet, they often prefer to live in urban areas or are unable to relocate. Telepsychiatry allows them an outlet to reach those locations where the greatest need exists without moving their practice or making long commutes.
Leveraging Telepsychiatry Across the Continuum
Communities are realizing notable gains by integrating telepsychiatry across the continuum in various ways including:
Emergency departments (EDs)
Busy ED physicians often lack the psychiatric resources needed for timely evaluations of critical-need patients. As a result, patients are stuck waiting in the ED or transferred to a med/surg unit until a qualified provider is available. This scenario leads to higher costs associated with longer wait times and inappropriate admissions. Telepsychiatry relieves this pressure by ensuring timely evaluation and quick triage to the most appropriate level of care.
Other hospital-based applications
Telepsychiatry can also be used on medical floors of the hospital for psychiatric assessments of medical patients. Some hospital inpatient units utilize telepsychiatry providers to augment their in-person staff and ensure units have 24/7 psychiatric coverage.
Telepsychiatry is increasingly an important resource for discharge planners, who are tasked with helping patients access post-discharge services in a timely manner. Consider, for example, that patients are often discharged from hospitals, correctional facilities or other residential programs with a 10-day “bridge” prescription and are required to continue treatment with a community-based psychiatrist. In these instances, discharge planners can face notable challenges to securing a timely follow-up appointment as waiting lists for psychiatrists at some community clinics can reach upwards of several months.
Medication lapses are common, and if the patient misses a follow-up appointment, the situation is exacerbated, opening the door for conditions to deteriorate. Ultimately, this scenario results in a vicious cycle of patient readmissions.
Community based referrals
For under-resourced clinics, telepsychiatry provides a lifeline of support through remote providers who serve a regular caseload of new and existing patients just like an in-person psychiatrist. This enhanced provider pool increases a clinic’s psychiatric capacity and potentially shortens the long wait periods for psychiatric appointments that exist in many communities.
More than half of all psychiatric drugs today are actually prescribed by non-psychiatrists due to provider shortages. Primary care doctors are increasingly sought for psychiatric care, although many are uncomfortable with or lack expertise with psychotropic drugs. Telepsychiatrists provide both an attractive referral option and consultative partnership, where knowledge and expertise can be shared.
While telepsychiatry is not a “magic wand,” it does provide an effective option for improving the fragmented behavioral health continuum. Communities are wise to consider effective telepsychiatry partnerships that can bolster behavioral health service lines. When these services are effectively integrated, communities achieve a more connected health care continuum that drives better outcomes and lower costs.
Geoffrey Boyce is Executive Director of InSight Telepsychiatry.