Telepsychiatry is a proven medium for increasing psychiatric capacity at single facilities and across entire systems. Through telemedicine, your organization can access psychiatric coverage without the recruiting, logistical and financial burdens that the onsite provision of those services would require. This white paper covers everything organizations implementing telebehavioral health need to know to make the most of this exciting development in health care service delivery.
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By: Geoffrey Boyce
Value-based care and the concept of connected health care communities go hand-in-hand. It is simply not possible to extract the full “value” of forward-looking care delivery models without a strategy that addresses patients’ whole health—both physical and behavioral—across the entire continuum. Connected community models achieve this objective through a comprehensive, sustainable and multi-faceted behavioral health strategy that improves treatment access at key entry points and across all levels of care.
Health care stakeholders increasingly recognize the power of connected community models, yet behavioral health remains significantly fragmented due to supply and demand challenges. While rapid evolution of integrated delivery networks is increasing scale and synergies on the medical side of the house, behavioral health lags behind partially due to professional shortages that exist in all U.S. states. These shortages are felt across the continuum, beginning in the most acute settings and flowing into outpatient care and referral networks.
Telepsychiatry models have emerged as one solution that holds great promise for changing this dynamic. Through video conferencing sessions that enable anytime, anywhere access, this model is opening new gateways to care and disrupting traditional approaches to behavioral health.
The Telepsychiatry Advantage
Providers and patients are embracing telepsychiatry as a viable treatment alternative for good reason: it meets the standard of traditional in-office care for diagnostic accuracy and quality, while also improving care continuity, outcomes and patient satisfaction.
Patients appreciate the convenience and privacy afforded by direct-to-consumer (D2C) telepsychiatry sessions that can be accessed at home or other comfortable locations that are private. By empowering patients with greater choice in location and time, telepsychiatry models help tear down communication barriers and reduce stigma—a key factor that keeps many from seeking treatment. Appointments are easily scheduled outside of traditional office hours where a reliable Internet connection exists. Additionally, patients can look outside of local areas to access services, expanding provider options.
In tandem with patient benefits, behavioral health providers often find telepsychiatry a good fit for work-life balance. Today’s health care communities rely heavily on existing behavioral health professionals to fill care gaps. As such, it’s not uncommon for those in the field to have upwards of three to four different jobs. Telepsychiatry relieves some of the pressure by allowing existing providers to schedule sessions in more convenient, creative ways.
In addition, many providers want to address the urgent need for services in rural communities and desire to fill care gaps. Yet, they often prefer to live in urban areas or are unable to relocate. Telepsychiatry allows them an outlet to reach those locations where the greatest need exists without moving their practice or making long commutes.
Leveraging Telepsychiatry Across the Continuum
Communities are realizing notable gains by integrating telepsychiatry across the continuum in various ways including:
Emergency departments (EDs)
Busy ED physicians often lack the psychiatric resources needed for timely evaluations of critical-need patients. As a result, patients are stuck waiting in the ED or transferred to a med/surg unit until a qualified provider is available. This scenario leads to higher costs associated with longer wait times and inappropriate admissions. Telepsychiatry relieves this pressure by ensuring timely evaluation and quick triage to the most appropriate level of care.
Other hospital-based applications
Telepsychiatry can also be used on medical floors of the hospital for psychiatric assessments of medical patients. Some hospital inpatient units utilize telepsychiatry providers to augment their in-person staff and ensure units have 24/7 psychiatric coverage.
Telepsychiatry is increasingly an important resource for discharge planners, who are tasked with helping patients access post-discharge services in a timely manner. Consider, for example, that patients are often discharged from hospitals, correctional facilities or other residential programs with a 10-day “bridge” prescription and are required to continue treatment with a community-based psychiatrist. In these instances, discharge planners can face notable challenges to securing a timely follow-up appointment as waiting lists for psychiatrists at some community clinics can reach upwards of several months.
Medication lapses are common, and if the patient misses a follow-up appointment, the situation is exacerbated, opening the door for conditions to deteriorate. Ultimately, this scenario results in a vicious cycle of patient readmissions.
Community based referrals
For under-resourced clinics, telepsychiatry provides a lifeline of support through remote providers who serve a regular caseload of new and existing patients just like an in-person psychiatrist. This enhanced provider pool increases a clinic’s psychiatric capacity and potentially shortens the long wait periods for psychiatric appointments that exist in many communities.
More than half of all psychiatric drugs today are actually prescribed by non-psychiatrists due to provider shortages. Primary care doctors are increasingly sought for psychiatric care, although many are uncomfortable with or lack expertise with psychotropic drugs. Telepsychiatrists provide both an attractive referral option and consultative partnership, where knowledge and expertise can be shared.
While telepsychiatry is not a “magic wand,” it does provide an effective option for improving the fragmented behavioral health continuum. Communities are wise to consider effective telepsychiatry partnerships that can bolster behavioral health service lines. When these services are effectively integrated, communities achieve a more connected health care continuum that drives better outcomes and lower costs.
Geoffrey Boyce is Executive Director of InSight Telepsychiatry.
Original article from Healthcare Business Today
TRENTON, NJ – New Jersey Governor Chris Christie signed Bill No. A1464 and S291/652/1954 on July 21st which allows for the practice and reimbursement of telemedicine and telehealth across the state. Before being signed by the governor, the telemedicine bill had bipartisan support and was passed unanimously through the New Jersey General Assembly and the Senate.
“Telehealth” as defined by the bill is the use of information and communications technologies to support clinical healthcare, and “telemedicine” is defined as the delivery of a health care service using electronic communications to bridge the gap between a health care provider and a patient. Telemedicine and telehealth are rapidly growing across the U.S. The American Telemedicine Association estimates that over half of U.S. hospitals use some form of telemedicine. Telemedicine has proven to be particularly effective for increasing access to care from specialty providers who no longer have to be physically present to deliver care.
One example of specialty care that this telemedicine law will help bring to New Jersey is access to child and adolescent psychiatry. New Jersey is estimated to need at least 3 times more child and adolescent psychiatrists in order to qualify as having a “sufficient supply” by the American Academy of Child and Adolescent Psychiatry.
While telemedicine policies vary in each state, the signing of this bill will make New Jersey one of the most innovative and patient-centered telemedicine states in the country. The state is already home to a handful of telemedicine programs, and the new law will provide the opportunity for the continued expansion of telemedicine.
“We’re enthused by the opportunities for improved access to care that this new law brings to the telemedicine industry and to New Jersey,” says Geoffrey Boyce, Executive Director of InSight Telepsychiatry, a national telepsychiatry service provider headquartered in New Jersey who helped to draft and advocate the bill. “We are thankful for the years of hard work the legislators and other advocates have put into making this come to life.”
Some of the highlights of the new legislation include:
- They allow New Jersey to join only a handful of states that require reimbursement for telemedicine services to the same extent as for in-person treatments and consultations.
- They take New Jersey from being only one of two states that lack an official definition of telemedicine to a state that defines how telemedicine can and should be safely and appropriately practiced.
- They allow greater access to care for patients who were previously not covered for telemedicine services. Greater access to care is expected to result in better outcomes for patients with chronic diseases and decreased expenditures over time.
- They allow patients to receive care from the comfort of their own homes when appropriate.
- They remove the requirement for mental health screeners to obtain an unnecessary, special waiver for services provided through telemedicine.
- They allow a large range of providers to practice telemedicine including: licensed physicians, nurses, nurse practitioners, psychologists, psychiatrists, psychoanalysts, clinical social workers, physician assistants, professional counselors, respiratory therapists, speech pathologists, audiologists and optometrists. This wide range of providers will increase the number of services that New Jersey residents can access.
- They involve minimal cost to the state while providing greater access to care and better outcomes for patients.
The legislators who helped champion this bill and ensure that New Jersey residents have better access to care include: Pam Lampitt (D), Joseph Vitale (D), Herb Conaway Jr. (D), Craig Coughlin (D), Valerie Vainieri Huttle (D), Joe Lagana (D), Raj Mukherji (D), Jim Whelan (D), Diane Allen (R) and Shirley Turner (D).
The enactment of this bill is a significant step for the telehealth industry and increased access to care in the state of New Jersey.
Billings Clinic is now Bringing After-hours Psychiatric Care to its Emergency Department and Inpatient Unit Through Partnership with InSight Telepsychiatry
Jan. 17, 2017 | Billings Clinic of Billings, Montana, has partnered with InSight Telepsychiatry to bring after-hours telepsychiatry services to their emergency department and inpatient unit, an innovative program which will ensure individuals in need of psychiatric treatment at Billings Clinic will have access to timely, quality care.
BILLINGS, MT — Billings Clinic, Montana’s largest healthcare organization, and InSight Telepsychiatry are pleased to announce a new partnership to increase inpatient and emergency psychiatric coverage.
The program is designed to lessen wait times for psychiatric evaluations, admission, and treatment decisions. The partnership gives Billings Clinic staff access to a team of remote psychiatrists who can do psychiatric evaluations, follow-up consultations and medical consultations through telehealth using video calls. Nurses and emergency department physicians can now connect patients with a remote telepsychiatry provider in as little as an hour.
The telepsychiatry program runs from 10 p.m. to 8 a.m., 7 days per week. Since, psychiatric emergencies often happen at night or on weekends, this schedule means that individuals in crisis are able to get the care they need more quickly.
The program is a result of a partnership between Billings Clinic and InSight Telepsychiatry, the leading national telepsychiatry organization and partner of MHA Ventures, a subsidiary of the Montana Hospital Association. Montana, like many other states across the country, struggles to have sufficient psychiatric coverage in its hospitals and clinics due to a national shortage of psychiatrists.
At nearly double the national average, Montana has the highest suicide rate in the United States with more than 23 suicides per 100,000 people. Additionally, over 75% of Montana’s population has inadequate access to psychiatry. So with the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to recruit in rural and underserved areas.
“Really, the best thing about a program like this one,” says InSight’s Medical Director Jim Varrell, MD, “is that Montanans now have access to psychiatric services where they may not have had previously.”
”This partnership is another step for Billings Clinic toward improving mental health care for people in crisis,” said Lyle Seavy, Billings Clinic Director of Psychiatry, “We are addressing those peak times when staffing is a challenge to help meet the needs of our patients, help reduce strain on our staff and help improve the experience for people in a mental health crisis.”
As a result of the partnership, the telepsychiatry program is expected to expand into additional Billings Clinic facilities.
In addition to facility-based models of telepsychiatry, InSight is also working with the Montana chapter of Mental Health America to offer telemental health care to individuals in their home or other private spaces online.
About Billings Clinic
Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, Billings Clinic is governed by a board of community members, nurses and physicians. At its core, Billings Clinic is a physician-led, integrated multispecialty group practice with a 285-bed hospital and Level II trauma center. Billings Clinic has more than 4,000 employees, including more than 400 physicians and advanced practitioners offering more than 50 specialties. More information can be found at www.billingsclinic.com.
About InSight Telepsychiatry
InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through telehealth. InSight’s behavioral health providers bring care into any setting on an on-demand or scheduled basis. InSight has 18+ years of telepsychiatry experience and is an industry thought-leader. More information can be found at www.InSightTelepsychiatry.com.
 Suicide: Montana 2016 Facts and Figures. (2016). In American Foundation for Suicide Prevention. Retrieved January 12, 2017, from https://afsp.org/about-suicide/state-fact-sheets/#Montana
 Mental Health Care Health Professional Shortage Areas (HPSAs). (2016, September 8). In Kaiser Family Foundation. Retrieved January 12, 2017, from http://kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0
Oct. 19, 2016 | InSight Telepsychiatry was proud to support three awards during the Psychiatry Innovation Lab at IPS: The Mental Health Services Conference organized by the American Psychiatric Association.
Washington, D.C. — InSight Telepsychiatry awarded three finalists for innovative ideas in the advancement of behavioral health care during the Psychiatry Innovation Lab at IPS: The Mental Health Services Conference organized by the American Psychiatric Association.
Chaired by psychiatrist and author Dr. Nina Vasan, the Psychiatry Innovation Lab is an educational workshop that fosters the advancement of health care delivery. The lab offers the opportunity for professionals in technology, business, medicine, government and nonprofits to connect and collaborate with psychiatrists and mental health professionals.
On Oct. 8, participants pitched ideas for the advancement of behavioral health care delivery by way of entrepreneurship, policy, systems redesign, education, collaboration, technology and more. InSight awarded a total of three of the six awards presented at the event.
A team of neuropsychiatry-minded high school students was awarded Outstanding Progress for their work on AlzHelp, an augmented-reality and intelligent personal assistant app that keeps individuals living with Alzheimer’s disease safe. The app was designed by Akanksha Jain, Michelle Koh and Priscilla Siow.
Presented by mental health care entrepreneur April Koh, Spring.com was awarded the Most Promising Innovation for enabling the prediction of treatment outcomes for depression by way of machine-learning and big data.
The last award supported by InSight went to a group called Beacon led by Shrenik Jain for the Most Disruptive Innovation. Beacon is a mobile application for chat-based group therapy that has participated in a diverse selection of health care technology initiatives. A consistent group of anonymous users come together in judgement-free communities with this group therapy app.
Other winners included: The grand prize winner Joseph Insler for his “overdose recovery bracelet” and the audience choice Swathi Krishna for SPECTRUM, an app for children with autism spectrum disorder.
As the leading national telepsychiatry organization, InSight is proud to support a workshop that cultivates the advancement of behavioral health care through innovative applications of technology. InSight provides psychiatric care through innovative applications of technology by providing telepsychiatry services to hospitals, outpatient clinics and other health care organizations nationwide.
September 16, 2016 – Mental health providers, including psychiatrists and therapists, are now available to offer psychiatric assessments, talk therapy and medication management through a newly launched behavioral health practice in New York called Inpathy. Inpathy is unique in that it operates entirely through telebehavioral health – a convenient, private and effective medium of care that is rapidly growing in popularity.
ROCHESTER, NY | Psychiatry appointments from the comfort and convenience of home are now available to New York residents through the launch of a new telebehavioral health practice – Inpathy.
Telebehavioral health allows individuals to attend sessions with behavioral and mental health providers online through secure videoconferencing. Inpathy is a division of InSight Telepsychiatry, the largest telebehavioral health organization in the nation.
Inpathy providers include adult and child and adolescent psychiatrists and psychiatric nurse practitioners that are available for psychiatric assessments, medication management and prescriptions when appropriate. Therapists and counselors are also available for talk therapy sessions through telehealth.
Many of the Inpathy telebehavioral health providers offer night and weekend appointments, which can be accessed through the internet from home using a smartphone, tablet or a computer with a webcamera. This makes managing behavioral health care more convenient by eliminating the need to travel to in-person appointments and sit in waiting rooms. Another benefit of telebehavioral health is that it is a more private way to access behavioral health services, which makes it a good option for individuals who are worried about a stigma on behavioral or mental health care.
Just like in an in-person office, the telebehavioral health providers who deliver services through Inpathy are fully supported by a clinical and administrative staff that handles their scheduling, billing, intake, general operations and clinical oversight.
Inpathy accepts insurance from several major insurance companies, including Aetna. For in-network telebehavioral health sessions, individuals are only charged their co-pay just like they would be for an in-person session. Inpathy providers are also available for out-of-network and cash-pay appointments.
“There is a huge shortage of psychiatrists across the nation,” says Geoffrey Boyce, executive director at InSight. “Telepsychiatry and telebehavioral health offer a unique solution for making psychiatry appointments easier to book and attend.”
Inpathy has telebehavioral health appointments available with many New York-licensed providers, including the following:
- Doug Ikelheimer, MD- an extremely experienced telepsychiatrist with expertise in the psychopharmacologic management of mood disorders, anxiety disorders, chronic mental illness and addictions
- Catherine Newton, LCSW – a licesnsed clinical social worker who specializes in working with individuals who have experienced trauma and is trained in Eye Movement Desensitiazation and Reprocessing (EMDR)
- Ragy Girgis, MD – a board certified psychiatrist with an interest in the psychopharmalcologic management of schizophrenia, mood disorders, anxiety disorders and eating disorders in adults
- Hinna Shah, MD – a board certified adult and child and adolescent psychiatrist with experience working with individuals who have depression, bipolar disorder, anxiety disorders, autism spectrum disorder and ADHD
- Liz Espinoza, LCSW – a Spanish-speaking licensed clinical social worker who is interested in helping individuals achieve life goals and specializes in anger management, relationship, communication and life transition issues
Telehealth is a rapidly growing industry and more and more insurance companies and providers are offering this form of care. Numerous studies have shown telebehavioral health to be as effective as in-person behavioral health services in most situations.
To get started as an individual using telebehavioral health care, individuals can visit http://www.inpathy.com to search the Inpathy provider directory, sign up, select an appropriate provider and schedule a session. Inpathy has a 24-hour technical support line and care navigation team that can be reached at 1.800.442.8938.
InSight is also in the process of developing referral relationships with a number of New York organizations that could benefit from additional behavioral health services for their clients. To learn more about this or connect individuals you know to care, visit http://www.inpathy.com.