- A Texas-based psychiatry clinic is using telehealth to help patients manage their health outside the doctor’s office.
Carter Health Psychiatry & Wellness, located just south of Houston in Friendswood, has launched a remote patient monitoring program that enables clinic staff to keep in touch with patients when and wherever they need help. Through a text messaging platform that uses some video visits for those in remote locations, the clinic engages its patients almost every day to check on medication compliance, sleep, diet, activity and moods.
“These are people with chronic mental health conditions,” says the clinic’s founder, R. Dakota Carter, MD, EdD. “They don’t just take a pill and they’re not fixed overnight.”
Carter, who is using Medocity’s Virtual Care Platform, is part of a growing trend of mental health providers turning to telemedicine and telehealth to not only connect with patients outside the office, but to gather data from the patient’s home to augment and improve care management. That information helps providers go well beyond the time-honored tradition of meeting with patients once a week or month and having them try to recall what they’ve felt or experienced.
“Before this there was very little engagement with patients outside the office, and that’s not good for this” patient population, says Carter, an avid researcher and member of the American Psychiatric Association’s telehealth committee. “I wanted a platform that would be easy to use and that would collect data that I could use at any time. Research is important, and real-time data is critical.”
He’s proven that the platform – and the information it collects – is working.
In a case study undertaken with Medocity this past year that involved some 40 patients with either depressive or anxiety disorders, Carter saw 90 percent to 95 percent compliance with prescribed medications over a three-month span. In addition, 93 percent of those patients averaged at least one connection per week, 90 percent used the telehealth platform three times a week, and 91 percent reported that they felt more engaged with their care providers.
Beyond those numbers, Carter says the virtual care platform enables he and his staff to better identify and react to shifts in a patient’s mood or activities, or other warning signs that the patient might or might not be aware of. For example, those patients who are prescribed Clozapine need to be monitored carefully, as the drug has many side effects.
“We’re getting real-time results rather than waiting for phone calls,” he says. “And I feel like the patients are better able to manage their health because they are having that clinical engagement.”
Sometimes those connections can be life-saving. Carter says he’s initiated four or five video visits with patients immediately after getting information from the RPM platform that they were experiencing a mental health crisis.
“I like the fact that I can help you in real time,” he says. “That ability to engage and get it out and do it at home when people are (experiencing a crisis), that can really save lives.”
Like any telehealth or telemedicine technology, there are challenges. Both staff and patients had to get accustomed to the platform before they felt comfortable using it. And the data coming in from patients has to be relevant and actionable – too much data could overwhelm a provider, causing him or her to miss out on important clues mixed into a sea of information.
Carter sees that data as the key to future care management and coordination. It won’t replace the in-person visits, he says, but it will guide both provider and patient into making better decisions on health and wellness. And it’ll make those office visits more meaningful.
“We’ll already know what to ask the patient before they even come into the office,” he notes.
And he wants even more data. He envisions a day when he can use mHealth wearables like the Fitbit or Apple Watch to track more physiological information. With that, he might be able to get into “behavioral activation,” searching for the triggers that cause mood changes and instances of depressive behavior.
Above all else, Carter wants this telehealth platform to support the patient-provider relationship. His focus is on improving engagement, so that his patients are more equipped and comfortable to manage their health and wellness.
“I really like positive reinforcement,” he says. “Now I have the (technology) to offer that.”