The pandemic has amplified the need for behavioral health services and also made it more difficult for people at risk to access care, as noted by the Biden administration.
At the same time, the fallout of COVID-19 has accelerated people’s willingness to engage with telehealth and telemedicine. So how do hospitals and health systems deal with an influx of mental health patients seeking fast access to high-quality psychiatric care while improving patient throughput?
Between the nationwide shortage of psychiatrists, staff burnout, tight budgets and changing healthcare regulations, many hospitals and health systems don’t know where to start. Fortunately, telepsychiatry can help.
Andy Flanagan is CEO of Iris Telehealth, a telepsychiatry technology and services company. We interviewed him to get the lay of the land for virtual psychiatric care today and beyond the pandemic.
Q: How do healthcare provider organizations manage a surge of mental health patients looking for quick access to quality psychiatric care while improving patient throughput?
HAS: The growing demand for behavioral healthcare is difficult for everyone, including health systems. The truth is, these systems are overwhelmed and were never designed to handle the influx of behavioral health patients coming to them for help.
Currently, many hospitals are working to meet the needs of their behavioral health patients through innovation, leveraging telehealth and extended provider networks to create proactive behavioral health care models.
From what we’ve seen, the most successful strategy is an integrated model where the health system, psychiatrists, therapists, psychiatric mental health nurse practitioners (PMHNPs) and other key stakeholders surround the patient in a coordinated fashion to deliver individualized, value-based care.
Hospitals need to think of patients first and consider how value-based care will benefit them. While the behavioral health consult may not be profitable for the hospital, the patient could escalate to the emergency department without it.
When this escalation happens, both the health system and the patient feel the financial impact of the ED visit. A holistic approach that leverages telehealth for front-end encounters with behavioral health patients, on-premises visits for those who need it, and remote monitoring for home-based tracking and follow-up is a solid strategy for addressing volume and throughput issues, including referral backlogs.
Behavioral health conditions tend to require ongoing treatment, which means people will continue to need care at high volumes. With such a high need, there will never be enough hospital staff to handle the volume of behavioral health patients entering the health system, let alone their ongoing care.
Hospitals need help. Supplementing traditional care delivery methods with technology to support patient flow while ensuring coordinated care plans is essential to ensuring patients get the care they need when they need it.
Q: How can telepsychiatry help with the psychiatrist shortage crisis?
HAS: The numbers are clear – there simply are not enough clinicians to support the needs of behavioral health patients using traditional care delivery methods. Technology and innovation must play a key role in meeting the high demand for care. That’s where telepsychiatry comes in.
Telepsychiatry offers a practical solution for more efficient distribution of clinical psychiatric resources like LCSWs, psychiatric nurse practitioners and psychiatrists. Behavioral health can be treated effectively in a remote setting because it isn’t an illness where severity and treatment are based on lab tests, biomarkers or physical examinations.
Most patients can be effectively assessed and cared for remotely, allowing providers to make the most effective use of available resources, regardless of location.
Telepsychiatry allows providers to put the right patient in front of the right clinician at the right time. Virtual care allows for reactive, on-the-spot triaging to ensure proper patient and provider alignment mid-consult.
For example, suppose a patient is initially scheduled for a consult with a psychiatrist and, during the assessment, it becomes clear that a therapist can adequately treat the patient. In that case, a provider switch can be implemented almost immediately. This agile framework allows psychiatric resources like psychiatric nurse practitioners or LCSWs to perform at the top of their licenses with no time lost on the part of the provider or the patient.
The telepsychiatry model also enables patients in historically underserved communities to receive top-quality psychiatric care. An overwhelming percentage of patients with behavioral health conditions live in regions with insufficient access to psychiatric resources.
Telepsychiatry connects these patients with virtual access to top-tier psychiatric providers from all over the country, regardless of where they are located. This helps capability address the supply and demand imbalance that exists across various geographies.
Finally, these benefits can be achieved throughout the care continuum. Telepsychiatry can aid in providing quality, timely, sustainable care – whether to patients in the emergency department, patients who have been recently discharged, patients waiting in a referral queue or those trying to seek care in ambulatory clinics.
Q: In your experience, does telepsychiatry help with patient satisfaction? And what about provider organization costs?
HAS: A wealth of peer-reviewed evidence has emerged indicating many patients are more satisfied with telehealth visits under certain circumstances. Convenience is a top characteristic of the technology that contributes to this satisfaction.
Telepsychiatry also helps to address many social determinants of health that can often serve as barriers to care. Additionally, behavioral health patients frequently face economic and social challenges, including getting the necessary transportation, child care and time off from work to accommodate in-person visits.
Telepsychiatry makes it easier for these patients to receive care on their schedules and within the framework of their lifestyles, leading to improved satisfaction.
There is also an element of privacy that accompanies telepsychiatry. In a virtual visit, patients don’t have to sit in a waiting room with other people. They don’t face the anxiety associated with others potentially wondering why they are there.
Telepsychiatry facilitates a highly private setting where only the patient and provider are involved. This privacy helps to reduce the fear of being stigmatized, again leading to a more satisfying experience.
Finally, telepsychiatry improves patient satisfaction by enabling patients to receive timelier care. With traditional methods, patients may be forced to wait several months to get a consult. Virtual care provides more options and allows patients to be seen more efficiently.
From a cost perspective, telepsychiatry helps health systems optimize utilization by ensuring every service line practices at the top of its license. Furthermore, by enabling more streamlined behavioral health consults, providers can prevent patients from escalating to the ED – the costliest care setting for patients and providers.
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