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Telemental Healthcare Soars to the Top of the To-Do List

Health systems are finding that quick, online access to a mental health professional can reduce costs and improve outcomes.

By Eric Wicklund

- Health systems seeking an entry point to telehealth are increasingly looking at telemental health services.

That’s what Houston’s Texas County Memorial Hospital is doing. Armed with a grant from the Ozarks Independent Hospital Alliance, the hospital is launching a service this month, giving local residents a chance to meet with their regular psychiatrist at the TCMH Outpatient Clinic inside the hospital, rather than travelling to his office at Ozarks Medical Center in West Plains.

“This is wonderful,” Omanez Fockler, a TCMH board member, told the Houston Herald. “Texas County residents will finally have access to a psychiatrist without having to travel far from home.”

Hospital officials see this as the first step in a more comprehensive telehealth platform, and said they could soon launch a telestroke program and one for pulmonology cases.

At Hawaii’s Kona Community Hospital, officials last month launched a bedside telemental health program with Dignity Health Telemedicine and In Touch Health. The platform enables acute care patients to connect via a HIPAA-compliant video feed on one of two InTouch Lite robots with a mainland-based, licensed, board-certified psychiatrist within 20 minutes.

Hospital officials say the psychiatrist can not only talk with a patient, but collaborate with the patient’s care management team for ongoing care. They hope to expand the program to the emergency department.

“This patient-centered service will greatly enhance mental health services at Kona Community Hospital,” Pat Kalua, the hospital’s chief nurse executive, told Big Island “This will improve patient care and improve the patient encounter.”

Whether it’s behavioral health or psychiatric services, the telemental health concept is gaining favor with health systems for two reasons. First, such services have often been separated from the healthcare delivery network, and are open to innovative ideas that might be otherwise bogged down in a health system struggling with federal mandates, EHR adoption and other issues. Second, the shortage of mental health professionals is more acute than in most other healthcare fields, while an estimated one in four adults suffers from some mental health issue in a given year.

Writing in a recent issue of Behavioral Healthcare, Rene Y. Quashie, senior counsel for the Washington D.C.-based Epstein Becker Green law firm’s healthcare and life sciences practice, said telemental health services are booming.

”Many reasons exist for the boom,” he said. “First, telehealth is a good fit for providing mental health services because providers rarely have to lay hands on the patient in conventional face-to-face encounters. Second, telemental health is accepted by a large number of payers as a legitimate use for telehealth - more so than other telehealth disciplines. Finally, patients surveyed have consistently stated that they believe telemental health to be a credible and effective practice of medicine, and studies have found little or no difference in patient satisfaction as compared with face-to-face mental health consultations.”

Health systems are also finding that they can bend the cost curve and improve outcomes by offering telemental health services at the point of care, where a quicker, more accurate diagnosis can make a difference down the road. According to a recent Washington Post story, health systems like Intermountain and Advocate Health Care are adding such services at the point of care. In four Advocate hospitals in Illinois, for example, a mental health team provides round-the-clock services via telehealth for any high-risk patients and each hospital’s emergency department.

The Carolinas Healthcare System launched its telemental health program in 2014, and now reaches roughly a quarter of its physician practices. With many counties in North Carolina having only one mental health professional on hand, the service is urgently needed.

“The very fact that we are identifying patients in primary care who are having suicidal (thoughts) is a victory,” Martha Whitecotton, the system’s senior vice president, told the Post. “These are the friends, neighbors, mothers, brothers, etc., that commit suicide, and people ask themselves why they did not see it coming.”


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