Launching a Telebehavioral Health Strategy: Addressing Gaps in Care and Increasing Access to Behavioral Health Services

Geoffrey Boyce, Chief Executive Officer of InSight Telepsychiatry, spoke at the 11th Annual mHealth and Telehealth World Summit put on by World Congress on Thursday, August 1. He co-presented alongside Lan Chi “Krysti” Vo, MD, the Medical Director of Telehealth, Psychiatry and Behavioral Health Services of the Children’s Hospital of Philadelphia. Attendees included c-suite, VPs and directors of telehealth/telemedicine, virtual care, digital health, innovation, medical informatics and connected health organizations.

Boyce and Vo spoke about building and maintaining a telebehavioral health program using two distinct models. Here are the key takeaways from this presentation.

Academic Medical Center Example: Children’s Hospital of Philadelphia

The Children’s Hospital of Philadelphia, founded in 1855, is the nation’s first hospital for children. When they realized they had an increasing need for mental health services, they decided to leverage internal resources to meet these needs.

They utilize telepsychiatry in collaborative care models with aims to increase behavioral health access, provide additional support to behavioral health clinicians and provide education and training to pediatricians to increase their comfortability with managing behavioral health needs. With the collaborative care approach, they are able to leverage their own resources, including pediatricians, clinical social workers and psychologists, to provide mental health treatment to consumers. In this model, an individual meets with the telepsychiatry provider and pediatrician or therapist.

In addition to providing services internally with telepsychiatry, the Children’s Hospital of Philadelphia’s Department of Child and Adolescent Psychiatry and Behavioral Sciences (DCAPBS) also plans to partner with various community entities to use telebehavioral health to meet the mental health needs of the community.

Outsourced Provider Example: InSight Telepsychiatry

InSight Telepsychiatry, a private telepsychiatry provider organization with 20 years of experience, partners with organizations such as hospitals, health systems, outpatient facilities, community mental health programs and more to provide access to psychiatrists and psychiatric mental health nurse practitioners.

While, implementing a telebehavioral health program with outside providers is often thought of as a “band-aid” for the immediate needs of an organization to backfill gaps and provide temporary coverage, InSight stresses that telepsychiatry needs to be seen as a long-term solution. With telepsychiatry, organizations can add more resources in the longer-term, use existing resources more effectively, improve efficacy of existing programs, develop new programs, facilitate behavioral health integration and build and enhance relationships.

Telepsychiatry enhances relationships with the in-house team, partners, fellow community agencies and consumers. Since telepsychiatry can be used across a wide variety of sites and settings, it also serves to connect communities. Connected community models create a comprehensive, sustainable and multi-faceted behavioral health strategy that improves treatment access at key entry points and across all levels of care.

Key Considerations for Implementing and Launching a Program

Before implementing and launching a program through either model, there are several key considerations. This includes, but is not limited to, reimbursement, licensure and credentialing, training and designing workflows. It is important to keep in mind that reimbursement varies by location and by state for Medicare, Medicaid and private payer coverage. When it comes to licensure, providers should be licensed in the state where the consumer is located and the licensure process also varies from state-to-state. There is often bureaucracy hindering the ability for providers to be credentialed at multiple sites in a timely manner so it is important for organizations to take into account how long the process takes.

Another consideration is how to train both onsite and remote team members. Onsite team members should know how to talk about telepsychiatry with consumers and how to communicate effectively with a remote provider. It is also important to consider who should be in the room with the individual and assist with the session, particularly with children. Organizations also need a telepsychiatry presenter to take vitals, set up rooms before sessions and connect to the telepsychiatry provider.

Remote providers need to know best practices at the organization where they are providing services such as where to make referrals, nuances of prescribing and how they are going to stay up to date with organizational changes and updates.

To stay up to date on telebehavioral health strategy, organizations such as the American Telemedicine Association, OPEN MINDS, Telehealth Resource Centers and the Center for Connected Health Policy are great resources.