The recent fallout around telehealth startups and their prescribing practices has rocked the mental health industry. Unfortunately, the patients served by these companies are experiencing the most damaging effects from this fallout, including loss of access to treatment, lack of access to medications, negative impact on mental health and quality of life, and an overall weariness and confusion regarding what’s to come.
Investigations from the Department of Justice and the Drug Enforcement Administration caused many pharmacies to enact policies where they no longer fill certain prescriptions from telehealth companies, particularly stimulants used to treat ADHD, leaving patients without medications vital to their care. What practices and tools could have prevented this scenario from occurring?
Quantitative information is vital to better-aligning telehealth practices and patient care, especially for ADHD diagnoses and treatment. Telehealth visits do present their own unique challenges, especially for ADHD patients, but having a first-line objective test can save time and reduce concerns from both the patient and provider as they move forward with the diagnostic process.
With objective data, clinicians can supplement subjective measures and observation, which is extremely helpful for in-person and telehealth visits alike. Through a computer-based test, we can identify behavior patterns of individuals with ADHD and measure the core symptoms – inattention, hyperactivity, and impulsivity. This data provides evidence, offering deeper insight for clinicians as they consider treatment options. It also provides a visual representation of how severe the patient’s symptoms are, furthering affirmation for patients and families who may be struggling with the diagnosis.
If objective ADHD assessments were standardized or at least recommended as an integral part of the diagnostic process, these companies and their clients might not be in the unfortunate position they are in today.
Clinician Benefit: Quantitative Information for Quality Assurance
As a Psychiatric Nurse Practitioner who specializes in ADHD, I see several patients a day – predominantly via telehealth – who either need an initial assessment or are conducting their routine follow-up so we can gauge how their treatment is working. I, along with my fellow NPs and clinicians in our practice, use the standard DSM-5 criteria and thorough assessments to form our diagnoses. However, with a keen eye on the wave of scrutiny into telehealth prescribing practices, especially for stimulant medications used to treat ADHD, we want to have the most thorough diagnostic evidence for the condition.
Therefore, we implement quantitative information via FDA-cleared objective assessments to diagnose and monitor treatment for our ADHD patients. Through objective data, we can confidently rule in or rule out an ADHD diagnosis – meaning we have much greater insight into whether the patient does or does not need pharmaceutical ADHD treatment. This proven technology, used by thousands of other clinicians worldwide, offers an added safeguard for our clients, providers and practice.
Objective data is used alongside the standard subjective assessment, offering the most comprehensive evaluation to confirm our prescribed diagnosis and treatment. Our policy also requires patients to schedule regular visits to ensure the treatment program is effective and clients are compliant with treatment plans.
With quantitative data, we can better ensure that patients are not incorrectly diagnosed or receiving unnecessary treatment. While most clinicians are optimistic they would never find themselves in an investigation, quantitative data gives us the confidence to know we’re providing our patients with the best quality of care available with the data to back it up.
Cooper Johnson is a psychiatric nurse practitioner in Arizona.