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Texas Deputies Turn to Telemedicine to Treat Mental Health Crises

The Harris County Sheriff's Department is using tablets and an mHealth app to give responding deputies an instant telemedicine link to a psychiatrist.

Source: ThinkStock

By Eric Wicklund

- Sheriff’s deputies in the nation’s third most-populated county are using mHealth to connect people experiencing a mental health crisis with psychiatrists.

The Harris County Sheriff’s Department in Texas began arming some of its deputies with tablets and a modified mHealth app this month in a pilot telemedicine program designed to improve emergency access to mental health resources and reduce traffic to local Emergency Departments and jails.

"It will help better assess things and find a better outcome," Sheriff Ed Gonzalez told MySanAntonio.com. "We can better pinpoint the best way to deal with each individual."

The tablets offer a 24/7 connection via virtual visit to psychiatrists employed by Houston-based JSA Health, which offers telemental health services to health systems across the country.  Cloud 9, an Austin-based startup, modified its clinician-to-patient mHealth app to enable remote consults launched by first responders in the field.

The tablets are part of an increasing trend of mHealth and telemedicine devices and platforms used in emergency services. mHealth apps on smartphones and tablets – even telehealth backpacks - help link police and EMS providers to local healthcare providers in real-time, improving emergency care, preparing hospitals for incoming patients and in some cases diverting patients from the ER to more appropriate care.

Among the front-runners is the Houston Fire Department, which has been using telemedicine over the past two years to screen 911 calls and better coordinate care.

Called Project Ethan (Emergency TeleHealth And Navigation), the platform links the city’s fire and rescue first-responders with a call center manned by physicians from 8 a.m.-10 p.m. weekdays and 10 a.m.-6 p.m. weekends. When dispatched on a 911 call, an EMT can use a Panasonic G1 tablet to open a video chat with an emergency physician, who can speak to the patient, access medical records and advise whether the patient needs to be transported.

“There’s really a lot of good that has come out of this,” Dr. Michael Gonzalez, the program’s director and a professor of emergency medicine at nearby Baylor University’s College of Medicine, told mHealthIntelligence.com in a 2016 interview. “The ideal outcome is that the patient avoids the ER transport and winds up with their primary care provider. That benefits everybody involved.”

The Harris County program is slated to run eight weeks or until 25 to 30 virtual visits are conducted.

The tablets are dispatched with a deputy or a member of the department’s Crisis Response Team to a reported mental health crisis. JSA is also alerted, so that a psychiatrist is online and ready when the deputy arrives on scene and opens the video link.

"The goals are to reduce the transportation of patients to the hospital, and see if we can resolve some of these situations in the field and utilize other resources," said Frank Webb, a project manager at the sheriff’s department.

Officials say the tablets will also help first responders make better decisions on who should be referred to psychiatric care.

"If we are called for someone being suicidal and then we get there and say they're not — that would be perfect for this program," Sheriff's Deputy Don Hess told MySanAntonio.com. "But a guy naked with underwear on his head in the middle of the roadway? Meh, we'll probably leave this in the car.”

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