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Telemental Health in the Heartland

A Wisconsin-based healthcare provider is using a simple telehealth platform to extend its counseling program to consumers hundreds of miles from the nearest clinic.

By Eric Wicklund

- A Wisconsin-based provider of behavioral health services is expanding its reach in the Midwest with a very simple formula – “just a therapist and a camera.”

Wisconsin Lutheran Christian Family Solutions, based just outside of Milwaukee, has been dabbling in virtual visits since 2008, offering a variety of services through their 29 outpatient clinics in Wisconsin, Minnesota and Michigan. More recently, they’ve been building their telemental health platform, adding online counselors in Indiana, North Dakota, Idaho and Florida.

The key to the healthcare provider’s continued growth: Simplicity.

“We don’t use anything fancy in our offices,” says Dan Nommensen, LPC, NCC, DCC, coordinator of WLCFS’ member assistance program and a licensed professional counselor. “It has to be very easy and very simple for people to use. We don’t want to complicate the process for people who are already struggling with anxiety or depression.”

That, he says, includes forcing them to find a ride or drive to a counselor’s office – sometimes hundreds of miles away – when they can instead sit in a quiet, comfortable room in their own home and talk to their counselor via video.

Behavioral or telemental healthcare is one of the fastest growing segments of the virtual care market, and for good reason. It’s based on a face-to-face encounter between a patient and a doctor and focused on conversation, rather than a physical examination. It also places emphasis on putting the patient at ease, so that he or she might open up to a counselor. What better way to do that than to chat from one’s own home?

Nommensen says he has about 40 telehealth counselors now, working on the OmniJoin video visit platform powered by Brother. Patients are mailed instructions for connecting online, and must read and sign a digital informed consent form before connecting with a counselor.

While advances in broadband speed and connectability have help WLCFS improve its platform, the service isn’t without its challenges. Each state has different telehealth licensing rules and standards, thus restricting the network from branching out even farther. And insurance covers roughly 40 percent of the network’s sessions, leaving patients to foot the rest of the bill.

“Some payers are great, while others really haven’t thought about telehealth at all,” says Nommensen. “Then there are payers who will reimburse only when it’s on their own approved platforms. It’s hard when we use a HIPAA-compliant procedure and process but a payer says that’s not good enough.”

Still, Nommensen sees demand for the service growing – both from patients and providers. He’d like to see guidelines put in place that allow his counselors to treat patients in other states. And while the overhead for video counseling is minimal, he longs for the day when his EMR, registration, scheduling and patient portals are all on one easy-to-use platform, instead of cobbled together from best-of-breed solutions.

“We’re waiting for some of the costs to go down,” he says.

It’s a dream shared by many small and mid-sized providers who’ve pieced together a telehealth program from scratch, identifying needs and devising platforms to address them, like new rooms added on to a house.

For now, Nommenen is expanding the video counseling platform where he can. It opens up a broad swathe of the heartland to WLCFS, allowing them to reach consumers rather than waiting for those consumers to find their way to a clinic (or to someone else’s office).

“We have access to a huge market that we don’t have within driving distance of our little clinics,” he says. “Why wouldn’t we do this?”

Dig Deeper:

Analyzing Telemental Health: 50 States, 50 Policies

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