Residents of more than half of the counties in the U.S. have no access to mental health professionals, making telepsychiatry an absolute game changer for improving access and closing disparity gaps.
It’s no surprise, then, that a growing number of healthcare organizations are using telehealth to provide access to high-quality psychiatric care.
Westchester Medical Center Health Network is a recent example. It became the first private health system in New York last year to launch a telepsychiatry platform after the state authorized telepsychiatry between healthcare settings. Previously, New York had allowed the use of telepsychiatry only for assessment and treatment services provided between two state-licensed clinic sites.
The state’s new regulations enable Westchester’s 10-hospital network, known as WMCHealth, to provide inpatient and outpatient psychiatric consultations across a 6,200 square-mile region that includes many rural areas with little or no access to psychiatric care.
While some health systems outsource their telehealth specialty services, WMCHealth decided to build the program from scratch, investing $7 million to create a 5,000-square-foot operations center on its Valhalla campus. The center features 20 workstations where psychiatrists, emergency physicians, intensive care physicians and other specialists work side-by-side to provide 24/7 consultations to patients and colleagues throughout the system. Psychiatric patients access the service directly from the office of their behavioral healthcare provider or from the ED of one of network’s campuses.
A patient seeing a psychotherapist or social worker for an office visit, for example, can also have a face-to-face consult with a psychiatrist for medication management on the very same day, giving the term “patient screening” a whole new meaning. Although the physician may be an hour or two away, the consultation still has the feeling of intimacy, “like we’re in the same room,” says Stephen Ferrando, MD, director of psychiatry at WMCHealth’s Maria Fareri Children’s Hospital and Behavioral Health Center.
Patients seem to agree. Ferrando cites preliminary data showing that WMCHealth’s 2,500 outpatient telepsychiatry visits to date have had lower no-show rates compared with in-person behavioral health visits. He attributes this to the technology’s ease of use. A formal data analysis is underway.
“Patients are really happy they now have the service and are more inclined to come,” Ferrando says.
Ferrando also cites a cultural shift in the age of Skype and Facetime that has made patients more comfortable using video technology to speak with physicians. True, some patients refuse to use telepsychiatry, but they’re few and far between. “I’ve seen more than 500 patients through this technology and I’ve had maybe five refusals,” he says.
For their part, providers like the efficiency. “It cuts down on travel,” Ferrando says. Previously, he and other psychiatric specialists often drove an hour or longer to provide emergency consultations to patients at other hospitals within the network.
Besides expanding psychiatry services to underserved patients across the state, WMCHealth’s program is also aimed at reducing unnecessary ED visits and hospital readmissions—and saving money.
“Behavioral health is a big driver of excess utilization,” Ferrando says. “People with medical, psychiatric and substance abuse comorbidities tend to drive the psychiatric admissions and high utilization of emergency services. We’re expanding behavioral health services to outpatient arenas so that we can integrate behavioral health services into primary care...and less in the emergency room and through inpatient admissions.”
Ferrando will present at the Telemed Leadershp Forum 2018 on how Westchester Medical Health Center’s 10-hospital network leverages telehealth to reduce high ER utilization and avoidable inpatient admissions among psychiatric patients, particularly those in rural areas that have traditionally lacked access psychiatric care.