Tag Archives: Jim Varrell

Using Telehealth to Better Balance Supply and Demand of Psychiatry – Infographic

Despite how common mental health concerns are, less than half of those with mental health concerns seek treatment, either because they choose not to or are unable to. Those who are not able often face barriers such as insurance, limited mental health providers and a disconnect between primary care and mental health services.

Telepsychiatry is a proven medium for increasing psychiatric capacity at single facilities and across entire systems. Through telepsychiatry, more people than ever can have access to mental health care. Investing in telehealth supports the goals and objectives of health plans, allows plans to meet regulatory demands and results in better overall health of members.

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Telepsychiatry 101 | What Healthcare Organizations Need to Know

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.

Download this white paper.

Telepsychiatry: Advancing Connected Community Models

By Dr. James Varrell

The concept of “connected community” holds great potential for elevating and improving behavioral health outcomes for all patients. Connected communities proactively address a patient’s whole health—both physical and mental—and benefit from a comprehensive, multi-faceted behavioral health strategy.

Health care leaders recognize the potential of these models to positively impact clinical outcomes and reduce the need for higher-cost interventions by improving access to care at various points along the continuum. Yet, today’s communities often struggle to achieve this framework amid a severe shortage of psychiatric providers.

The reality is 96 percent of U.S. counties have unmet needs for mental and behavioral health services at a time when demand is soaring.1 Current shortages leave those needing care with less-than-optimal choices. People often turn to primary care doctors, or alternatively, opt for no treatment at all—leading to further deterioration or crisis situations that result in costly interventions.

The good news is that direct-to-consumer (D2C) telepsychiatry can help fill these gaps and improve the outlook on connected community models. While D2C is a relatively new concept, other settings across the care continuum have leveraged telepsychiatry for the past two decades, including hospitals, inpatient units, community-based case centers and correctional facilities.

Leveraged through easy-to-use videoconferencing technology, D2C offerings are opening new doors to psychiatric providers for evaluation, consultation and treatment.

D2C Telepsychiatry: Expanding Access And Referral Options

Growth of D2C telepsychiatry in recent years has expanded as patients become more empowered and seek out convenient ways of managing their care. Patients increasingly prefer “anywhere, anytime” options like the D2C model because it enables access to care from the comfort of home—or other private locations—on their own schedule.

This type of care allows providers to be more proactive and address issues before conditions reach what Mental Health America (MHA) refers to as a “stage four” level of severity. In effect, better patient engagement can trigger greater follow-through with care plans and minimize the potential for symptoms and issues to escalate.

Telepsychiatry often gives providers greater insights into their patients’ environments. For instance, a colleague of mine is a therapist in New Jersey, and she’s been treating one of her patients for years in person. When my colleague started using D2C Telepsychiatry, she was able to see her patient online through real-time video calls rather than in person, and noticed right away that her patient was hoarding her belongings. My colleague was able to learn about her patient’s living condition and other factors that influenced her treatment plans. Further, her patient reported feeling more comfortable and at-ease during their appointments.

D2C telepsychiatry also provides more referral options, enabling earlier interventions and greater access to services. While frequently sought out as a mental health alternative, many primary care providers are uncomfortable prescribing psychotropic medications or lack psychiatry expertise.

By providing a reliable behavioral health referral option, D2C telepsychiatry takes the pressure off of primary care providers. Moreover, collaboration and information exchange between the referring physician and D2C provider can allow for more comprehensive care.

Outside of primary care, D2C expands referral options for discharge planning from acute and inpatient settings. The current mental health provider shortage can slow down referral processes, leading to disjointed transitions where patients must “settle” on whatever is available in the nearby area instead of what is best.

Closing The Loop To A Connected Community

Even as health care leaders increasingly embrace telepsychiatry models, most are currently used in siloes across community settings. However, there’s opportunity to leverage existing resources and establish community-wide telepsychiatry networks to connect all appropriate care settings.

This connected community model improves both information sharing between providers and continuity of care for patients. Patients can use telepsychiatry to see the same provider or same network of providers across different care settings or from home with D2C care. In tandem, primary care doctors, community organizations and telepsychiatry providers can better collaborate on patient care.

Telepsychiatry networks not only improve care outcomes, but also create economies of scale. For instance, health care settings can benefit from sharing a telepsychiatry provider network. This option places less pressure on community resources to recruit and retain local behavioral health providers.

Communities can take steps to utilize a telepsychiatry network across care continuums by:

  • Bringing together payers, primary care, hospital systems, outpatient behavioral health, corrections, schools, skilled nursing and other community organizations
  • Assessing their current behavioral health resources to identify gaps and opportunities
  • Setting multiple locations up with technology to access telepsychiatry
  • Establishing a telebehavioral health network of licensed providers who are aware of community services and resources
  • Utilizing shared scheduling tools for booking psychiatric resources and appointments

Telepsychiatry helps address the gaps in behavioral health care across the continuum by proactively treating patients’ whole health through the concept of the connected community. By increasing patient access to care and referral options, this evolving model supports timely, proactive intervention, minimizing the potential need for more costly care and enabling better outcomes.

About The Author

James R. Varrell, M.D. is a child and adolescent psychiatrist who has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry. InSight’s direct-to-consumer division that accepts patient referrals for psychiatry and therapy is called Inpathy.

Original article published on Health IT Outcomes

How Telepsychiatry is Carving Out its Healthcare Niche

With a dwindling supply of psychiatrists nationwide, telepsychiatry services are starting to become more mainstream

It was nearly 20 years ago when a clinician (non-james-varrell-225x225psychiatrist) brought up the notion of telepsychiatry to James Varrell, M.D., a licensed psychiatrist himself who at the time didn’t know much about the telemedicine subsector. “This was 1999 and it was like voodoo to me,” Varrell says, adding that after that conversation he needed to do his due diligence and research.

What came from that conversation, and ensuing exploration into telepsychiatry, was a realization that there was more support for it than Varrell initially assumed. In fact, the American Psychiatric Association (APA) put out a significant paper in 1995 in support of telepsychiatry, and it was around that time when research began on its ability to facilitate access to care, overcome geographical obstacles and how it compared to in-person care. “All of the go-to organizations in the [industry] have always been supportive of it. Clinicians individually have been skeptical since they’ve never done it. But now, many [places] are incorporating into their residency programs,” Varrell says.

Indeed, folks might not be as familiar with telepsychiatry as they are with other forms of telemedicine, since behavioral health often flies under the radar compared to its physical health brethren. But according to the APA, by the 2000s, the field began to see it as effective, but slightly different, than in-person care, and research in outcome studies provided a platform for practice guidelines, via the American Telemedicine Association.

Varrell says that today’s mental health landscape is characterized by an increased need for services coupled with a dwindling supply of psychiatrists. Indeed, more than 55 percent of U.S. counties are currently without any psychiatrists, and the mental health landscape is facing shortages in more than 4,600 areas, according to Kaiser. Varrell, who has been practicing telepsychiatry for 18 years ever since it was brought up to him back in 1999, now works at telepsychiatry service provider organization InSight, a Marlton, N.J.-based company that he founded in 2008 and where he currently oversees a team of more than 200 psychiatrists and psychiatric nurse practitioners—many of whom work full-time doing telepsychiatry.

Speaking to the growth in the sector, Varrell says that his company began with telepsychiatry mostly in ERs where patients in crisis environments were prioritized. But, he notes, “The place more than anywhere where it started to develop was in rural environments, where access to basic psychiatry care would be otherwise inaccessible. That’s still growing,” he says. “Now, the new wave is that we are starting to do integrated care in medical offices, and that was a big push with Obamacare. We think the next trend is in-home services for consumers, which is telepsychiatry direct-to-patients in their homes or wherever they are [in a private space].”

The reason InSight started to provide telepsychiatry services was because it was located in a rural environment, but Varrell says beyond that, there have been valuable lessons learned since the organization’s inception: primarily that telepsychiatry works well for most people in most areas. “For people in crises, you don’t want to do an in-home visitation if they are psychotic or suicidal. You want them in more supported environments like outpatient mental centers or ERs if it’s very acute,” explains Varrell. “Over the years, we have learned that we can accommodate all types of people.”

Among these are: translations [for people who speak] different languages; the geriatric population, for which a great sound system is needed for older folks who have hearing issues; and also for those with cognitive and intellectual disabilities in which the patients’ families are present to make it easier and provide the psychiatrists with the necessary information, says Varrell.

Over the years, telepsychiatry has continued to grow both in volume and acceptance. Varrell notes how educating organizations such as the University of Virginia and Johns Hopkins University have big electives for all of their psychiatry residents who are mandated to learn telepsychiatry. And, InSight as a sole organization performed more than 100,000 encounters via telepsych in all settings last year (hospitals, clinics, treatment centers, universities), while its in-home platform, Inpathy, is still growing but has around 100 direct-to-consumer sessions in a week, according to officials.

“This is an area that used to be weird and hard, but now people are jumping into it,” says Varrell. “Doctors are calling us all of the time saying they want to work with us. That’s good since there’s a national shortage and we’re often begging doctors to work with us in person, but this is the opposite of that,” he says, noting how on one recent day alone, eight psychiatrists called looking for work.

Original article posted on Healthcare Informatics 

Expanding Access to Mental Health Care

Expanding Access to Mental Health Care - NAMI

By James Varrell, M.D. | Jul. 07, 2017 – Original article on NAMI.org/Blog

Anna struggled to leave her home because of her severe anxiety and depression. Because her psychiatrist’s office was more than an hour away, the stress of commuting often made Anna’s symptoms worse. Anna needed a more practical treatment option and believed there had to be one out there. In her search, she discovered telepsychiatry.

Telepsychiatry is a growing and clinically effective way to provide mental health care via online video calls. One of telepsychiatry’s newest applications called direct-to-consumer (D2C) telepsychiatry is quickly becoming a popular solution for many struggling to find convenient and effective care. D2C telepsychiatry allows providers to deliver mental health care to individuals in their homes (or any other private space) using computers, tablets or phones.

For Anna, and the millions of people living with mental health conditions, this innovative option takes away the stress of commuting to and from an in-person office setting. Telepsychiatry sessions are also far easier to fit into busy schedules. With telepsychiatry, Anna could have her sessions at home after her children had gone to bed. Most importantly, Anna could now receive consistent treatment, empowering her to better cope with her conditions.

The Benefits of Telepsychiatry

Unfortunately, Anna is not alone. More than 55 percent of U.S. counties are currently without any psychiatrists at all. Even in areas that do have mental health professionals, there are simply not enough providers to go around. And because most psychiatrists are concentrated in cities, many people outside these areas, like Anna, endure long commutes to reach the nearest psychiatrist with available appointment times.

For those who share Anna’s experience, D2C telepsychiatry offers an alternative. Here are some of the many ways a person can benefit from telepsychiatry:

  • Convenience. Anyone can schedule appointments—even outside of traditional workweek hours—and can easily attend sessions using any computer, tablet or smartphone with a webcam in any private space with a reliable internet connection.
  • Increased access to care. Telepsychiatry expands choices for providers beyond those who are within driving distance. Any licensed provider in the individual’s state can offer services to them, allowing individuals to connect with the provider most appropriate for him/her.
  • High-quality care. With more providers to pick from, a person can choose someone who best fits their personality, needs and schedule. Reputable D2C telepsychiatry programs train their licensed providers in best practices of delivering care appropriately and effectively through telehealth. Technical support is also available for pre-session test calls.
  • Privacy. Telepsychiatry removes the fear of running into someone you know in the waiting room, while also protecting your information and following state and federal regulations. Many D2C telepsychiatry providers have annual audits to ensure their encryption systems meet HIPPA standards—this is how telepsychiatry providers differ from Skype or FaceTime.

Telepsychiatry makes it possible for people like Anna to receive care in a comfortable, familiar environment. This new form of treatment has the capacity to improve the lives of millions by increasing access to mental health care across the country.

 

James R. Varrell, M.D. is a child and adolescent psychiatrist who has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry. InSight’s direct-to-consumer division that accepts patient referrals for psychiatry and therapy is called Inpathy.

InSight Telepsychiatry Expert Presents Grand Rounds at Deborah Heart and Lung Center

BROWNS MILLS, NJ – Dr. Jim Varrell, InSight’s Medical Director spoke at the Deborah Heart and Lung Center in Brown Mills, NJ during grand rounds. Dr. Varrell gave a presentation on applications of telepsychiatry in hospital settings to an audience of doctors, residents and other behavioral health professionals.

Deborah Heart and Lung Center is a specialty hospital that sees heart and lung patients and has no emergency department. Deborah Heart and Lung Center is also a partner of InSight, where they utilize telepsychiatry on their medical floors.

Dr. Varrell’s presentation gave an in-depth outline of telepsychiatry, which included topics such as:

  • Overview of telepsychiatry
  • Telepsychiatry use in hospitals
  • How to set up a telepsychiatry program
  • Technological setup
  • Clinical workflow
  • Telepsychiatry regulations
  • Clinical best practices and case studies

“Our work at InSight has given us access to all the ins and outs of delivering behavioral healthcare via telemedicine,” said Dr. Varrell. “It is an honor to impart the knowledge we’ve gained from years of experience in the field, to a new generation of healthcare professionals.”

Dr. Varrell and other InSight leadership often present during grand rounds to educate medical professionals on the importance and best practices of telemedicine and its ability to increase access to quality care.

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. Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists. More information can be found at www.InSightTelepsychiatry.com.

About Deborah Heart and Lung Center

The Deborah Vision means continuing to be the premier provider of cardiovascular and pulmonary services in the region. We will be known for excellent clinical outcomes and for supreme customer-driven service, and as the ultimate leader in patient safety and privacy. We will continue to partner with other quality providers and payers to ensure a seamless continuum of care to the patients we serve. We will continue to improve both service and quality in the most cost effective manners. This is our uncompromising standard of care.

The Psychiatrist Shortage in Virginia

By James Varrell, MD

HOW TELEPSYCHIATRY CAN HELP

Due to trends in mental health advocacy and growing clinical evidence, people are increasingly recognizing the benefits of psychiatry and behavioral health care. For example, a 2012 study published in Contingencies measured the cost of a single employee’s depression over a two-year period prior to that employee receiving depression treatment and found the cost to the business to be as high as $3,386 per affected employee.

Unfortunately, even with a cultural shift towards addressing mental illness in Lynchburg, employers and families are struggling to get convenient and timely access to care due to a significant shortage of psychiatrists. According to the National Alliance on Mental Illness, there are over a million Virginians who experience mental illness and about 300,000 of those illnesses are classified as serious. Even with 930 psychiatrists licensed in Virginia, there simply aren’t enough providers to go around. As a psychiatrist, the demands for services can be overwhelming.

Moreover, because most psychiatrists are concentrated in Virginia’s urban pockets (Northern Virginia, the Richmond metropolitan area and Hampton Roads) many individuals outside of these areas endure long commutes to reach the nearest psychiatrist who has available appointment times. Oftentimes, getting care for oneself or a family member can be off-putting and stressful.

How Telepsychiatry Can Help
Telepsychiatry is a growing and clinically effective way to provide psychiatry, mental and behavioral health care to individuals through online video calls. Telepsychiatry can be used to provide psychiatric evaluations, consultations and treatment to individuals in various settings including outpatient offices, correctional facilities, hospitals, emergency departments, crisis centers or even in homes.

Facility-based telepsychiatry has a decent foothold in the healthcare industry. Today one of telepsychiatry’s newer applications, direct-to-consumer (D2C) telepsychiatry, is quickly becoming popular. D2C telepsychiatry allows providers to give psychiatry, mental and behavioral health care to people directly in their homes or any other private space. This takes away the stress of commuting to and from in-person offices. It also means that the time individuals and their families spend getting care is shortened to only the duration of the session, making it easier to fit into a busy schedule.

An Individual’s Experience with D2C Telepsychiatry
For example, one of my patients, whom I will call Anna, suffers from severe anxiety and depression. As a result of her disorder, Anna struggled to leave her home, and her husband, Rick, often had to take time off of work to accompany her to appointments with her psychiatrist whose office was 50 minutes away.

The stress of her appointments made Anna’s symptoms worse, negatively impacted Rick’s work and put additional strain on their family life.

It was in their search for a better care solution that Anna started to receive psychiatric medication management from me and therapy from one of my colleagues all through telepsychiatry. Anna started to access her sessions from home in the evenings after her children had gone to bed. Using telepsychiatry allowed her to receive treatment independently and the reduced stress of receiving care has empowered her and helped her to better cope with her disorder.

The Benefits of D2C Telepsychiatry

Anna’s experience is one that is shared by many Virginians who struggle to find a convenient psychiatry or behavioral health solution for themselves or their loved ones. Here are some of the many ways people can benefit from D2C telepsychiatry:
• Convenience. People can schedule appointments outside of traditional weekday hours and can easily attend sessions using any computer, tablet or smartphone in any private space with a reliable internet connection.

• Increased access to care. Telepsychiatry expands choices for providers and specialists beyond those who are within driving distance. Any provider nationwide who is licensed in the individual’s state can offer services to them. Practicing online means providers can spend more time treating people instead of traveling between offices.

• High-quality care. With more providers to pick from, people can choose the one who best fits their personality, needs and schedule. Reputable D2C telepsychiatry programs will have their providers trained to deliver telehealth appropriately and effectively.

• Privacy. Telepsychiatry is safe and secure. Some individuals prefer seeking care from the privacy of home without the fear of running into a nosy neighbor in the waiting room.

Not only does this type of treatment make it possible for people like Anna to receive care in a comfortable environment, but it also removes stress from their work and personal relationships. Telepsychiatry improves lives and is an excellent tool for increasing access to psychiatry and behavioral health care in Virginia communities.

Original story posted in Lynchburg Business Magazine.

Telepsychiatry: Raising the Bar on Access to Mental Health Care

By Dr. James Varrell, Telepsychiatrist and Medical Director of InSight

As May—Mental Health Awareness Month—rolls around each year, health care stakeholders are reminded to reflect on the notable achievements and strides made in mental health treatment. The industry continues to forge new paths in terms of technological advancement, research, discovery and awareness, leading to a more holistic approach to care delivery and improved health outcomes across U.S. communities.

In terms of improving access to care, one advancement in particular carries significant weight for expanding care options and lowering costs for patients, providers and communities: telepsychiatry. Telepsychiatry is a form of telemedicine that uses videoconferencing to provide psychiatric evaluation, consultation and treatment. A growing segment of telepsychiatry is direct-to-consumer care, which is working to tear down stigma-related barriers to treatment and open doors to expanded referral options and more timely care. In fact, industry stakeholders increasingly recognize direct-to-consumer telepsychiatry as a primary solution for filling mental health care gaps at a time when the need is soaring.

In tandem with the goals of value-based care, today’s patients and providers are no longer willing to settle for limited mental health treatment choices within their community. Similarly, communities should no longer view the long waits traditionally associated with accessing psychiatric care as acceptable, especially when telepsychiatry lays the foundation for more optimal, timely care delivery.

Recognizing the Need for Greater Access

Today’s mental health landscape is characterized by an increased need for services coupled with a dwindling supply of psychiatrists. The reality is that 42.5 million Americans struggle with mental health conditions including stress, depression, anxiety, relationship problems, grief, mood disorders and other psychological concerns. Unfortunately, accessing effective treatment is not easily attainable given the following statistics:

  • More than 55 percent of U.S. counties are currently without any psychiatrists.
  • The mental health landscape is facing shortages in more than 4,600 areas.

In addition, referrals to community-based psychiatrists often have an average 3-6 month wait time—a fact that is especially true for specialty psychiatrists, such as those who have expertise in complex child conditions. To put this need into perspective, the number of child and adolescent psychiatrists in New Jersey would need to triple to adequately support the need in that state alone.

Primary care doctors are often sought out as a resource for filling these service gaps created by growing demand. Yet, many may be uncomfortable prescribing medication for mental health disorders or lack specific expertise on psychotropic medications.

Consider the following scenario:

A 53-year-old female has a history of refractory depression and has tried numerous antidepressant options through her primary care doctor, who is at a loss as to the correct formula for the patient’s needs. The patient’s history reveals that she has had discrete hypomanic episodes, characterized by sudden displays of energy, productivity and noticeably more creativity. These 1-2 week episodes were followed by a decline back to her usual depression. Looking for a second opinion regarding her care, her primary care doctor referred the patient to a telepsychiatrist.

When the telepsychiatrist reviewed her symptoms he made the conclusion that the patient has type two bipolar disorder and needed an appropriate medication regiment.

Fortunately, in this example, the patient suffering from type two bipolar disorder accessed the needed psychiatry expertise in a timely manner by using direct-to-consumer telepsychiatry. After an accurate diagnosis and subsequent follow-up visits with the telepsychiatrist, the patient’s medications were further adjusted, resulting in effective management of the disorder and a satisfied patient.

The Telepsychiatry Advantage

Direct-to-consumer telepsychiatry introduces notable opportunities to improve access to care. Through live, interactive communication with a licensed psychiatrist in a private setting of the patient’s choice, this treatment model diminishes many of the existing challenges to reaching patients in need.

For instance, patients who live in remote areas where mental health services are lacking have access to psychiatry expertise within a few days rather than several weeks or months. Also, stigma becomes less of an issue as patients are able to experience more privacy, and care is more conveniently accessed in the home or a private location.

Appointment scheduling options outside of traditional office hours address the roadblocks of busy lifestyles that are often a deterrent to consistent follow-up and treatment. In tandem, mental health providers can see more patients with this increased flexibility. Direct-to-consumer telepsychiatry can also support greater continuity of care. For instance, some patient populations, like teens and college students, are more willing to continue treatment if a relationship is maintained with the same psychiatric provider during life transitions like moving to a new city for college.

Telepsychiatry is clinically proven to deliver high-quality care that meets the standard of traditional in-person care for diagnostic accuracy, treatment, effectiveness, quality of care and patient satisfaction. Along with the majority of medical associations, the American Psychiatric Association supports the use of telepsychiatry as long as it is used in the best interest of the patient and complies with medical ethics and federal privacy and security regulations. For these reasons, telepsychiatry is increasingly becoming reimbursable by a number of insurance plans.

Forward Looking

Going forward, the industry must embrace the promise of direct-to-consumer telepsychiatry as a critical strategic component to improving access to care. Telepsychiatry is a viable option and an alternative to traditional in-person care for mental health issues that has the potential to better serve communities and improve population health.

Original story published in HIT Leaders & News.

Live & Practice: Small Towns and Cities

(Original story published in PracticeLink Magazine—Spring 2017)

Marlton, New Jersey

Just 30 minutes from Philidelphia, 90 minutes from New York City and 2 hours from Baltimore, Marlton is popular among people who want to be near family in one of these major geographic areas while enjoying a small-town lifestyle. Marlton has strong community spirit, with several annual festivals sponsored by local government and scores of free exercise facilities, family activities and classes such as yoga and karate for residents.

Small towns and rural areas sometimes present a challenge for health care providers. That was the case when a rural southern New Jersey community first contracted with CFG Health Network, which is based in Marlton.

The community asked CFG to cover its psychiatry needs. But a week before the contract was to begin, there was a new requirement: all physicians had to be able to get to the facility within an hour of getting a call.

To continue reading, click here.

PracticeLink article

 

 

Telepsychiatry: Reaching More Patients For Better Outcomes

By Dr. Jim Varrell, Medical Director, InSight Telepsychiatry

(Originally Published 3/17/17 on Health IT Outcomes)

A 42-year-old woman with chronic anxiety and agoraphobia found herself unable to leave her apartment. She reached out to her primary care doctor who prescribed Xanax, but the medication was only making her feel worse. Unable to go out in public, she found a telepsychiatry provider who adjusted her medication and dosage, connected her with cognitive behavioral therapy, and helped her reclaim her life.

Health IT Outcomes Every year, about 42.5 million Americans struggle with mental illness — enduring stress, depression, anxiety, relationship problems, grief, mood disorders or other psychological concerns. Despite the availability of treatment most people don’t get the help they need, not necessarily due to stigma or denial, but because they can’t: it’s inconvenient or mental healthcare providers aren’t available in their area or within the time frame they need an appointment. To increase access to behavioral healthcare, people need an alternative to traditional doctor referrals, and telepsychiatry can help. Telepsychiatry is a type of telemedicine that uses videoconferencing to provide psychiatric evaluation, consultation, and treatment.

A Growing Market
A key driver of telepsychiatry is the serious shortage of psychiatry providers and other mental health professionals in the U.S. Today there are more than 4,600 mental health professional shortage areas making it difficult, if not impossible, for patients to access services. People referred to psychiatry providers by their primary care doctors face long and potentially dangerous wait times — often three to seven months or longer.

The situation is even worse for those in need of specialty providers, such as child and adolescent psychiatry providers. Currently, there are only about 8,200 practicing child and adolescent psychiatry providers nationally. To put this in perspective, New Jersey alone would need three times as many practitioners as it now has to adequately support the number of children in the state.

Telepsychiatry also offers the promise of delivering more effective mental healthcare in primary care practices. The burden of mental healthcare often falls on primary care doctors, yet many are unable to provide the most appropriate behavioral health resources. Adequately assessing and treating behavioral health issues requires more time with the patient than many doctors or nurse practitioners are able to spend. Moreover, while it is perfectly acceptable for primary care doctors to not know the ins and outs of mental healthcare, many don’t feel equipped to treat behavioral health conditions themselves because they lack specialized training. But without referral options, primary care doctors are often forced to do so. Many practices are overwhelmed with changes in how care is delivered and reimbursed, and under pressure to maximize time with patients, making it difficult for doctors to do it all.

Meeting Behavioral Healthcare Needs

Quality: Telepsychiatry is leading the way in telemedicine for delivering high quality care that meets the standard of traditional in-person care. The American Psychiatric Association supports the use of telepsychiatry as long as it is used in the best interest of the patient and complies with medical ethics and federal privacy and security regulations. It supports the patient-doctor relationship required by law to prescribe medications with documentation — a process identical to the traditional outpatient setting. For these reasons as well, it is increasingly reimbursable by insurance plans.

Continuity of care: In addition to meeting care standards, telepsychiatry positively impacts continuity of care by providing greater accessibility to psychiatry providers. It meets patients where they are. Many patient populations including children, college students, and veterans respond well to this form of treatment, especially since they can maintain the relationship with their same psychiatric provider regardless of location. Other studies have found telepsychiatry can positively impact care for seniors and nursing home residents, reducing costs for the facility as well as improving access to needed care. Age has not been found to be a barrier to acceptance and most seniors readily accept the format.

Access to care: Telepsychiatry is one of the most effective ways to increase access to care for individuals who might otherwise go without. Providing access to specialists for people in rural and remote areas is a challenge. Telepsychiatry offers a practical and cost-efficient way for psychiatry providers to reach these patients. The logistical benefits extend to those in urban centers as well. In light of the dramatic provider shortage, resources are scarce in all settings driving up wait times and commutes to be seen in-person. Telepsychiatry allows existing behavioral health providers to see more people at more flexible times. Many providers who offer telepsychiatry services do so during off-hours to meet the needs of consumers who have trouble finding time for commutes and waiting rooms, or who have trouble leaving their homes.

Cost-effective: Behavioral health issues cost $135 billion every year — almost as much as heart disease and cancer treatment combined. Telepsychiatry can help lower costs for both psychiatry providers and their patients. Studies have found telepsychiatry incurs fewer direct and indirect costs than in-person services saving on provider time, medical supplies, technology, and reimbursement, as well as costs associated with the clinical space, administrative support, travel, and time off work. Nowhere is this savings more pronounced than in the rural setting where telepsychiatry has been found to reduce costs by as much as 40 percent. For hospitals and inpatient residential programs required to provide patients with follow-up care options, telepsychiatry can help ensure a seamless care transition with proactive post-discharge outreach, reducing potential penalties for providers under value-based care.

A Solution For Better Outcomes
Telepsychiatry meets patients’ needs for convenient, flexible, and accessible mental health services, helping improve patient outcomes. The convenience of online appointments makes patients more likely to attend their behavioral health sessions than if they were seeing a provider in person — and when people are consistent in managing their behavioral health, their physical health also improves. It also gives patients more options to find the right provider for them and the care that meets their specific needs, and allows typically underserved groups to access care. This combined with less travel time, less time off work and shorter wait times for services means people get the care they need sooner, are more engaged in their health and happier with their experience of care.

About The Author
James R. Varrell, M.D. has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry.

Inpathy Gets a Makeover – New Website Makes it Easier to Get Online Psychiatry and Therapy Anytime, Anywhere

Online Therapy and Psychiatry

WASHINGTON, DC (PRWEB) FEBRUARY 20, 2017 – Inpathy has launched a new look for its website, http://www.Inpathy.com. Inpathy is dedicated to making it easy for people to get access to psychiatric, behavioral and mental health care through convenient, online video calls. Inpathy is the newest division of InSight Telepsychiatry, the leading national telepsychiatry service provider organization with nearly two decades of experience delivering online behavioral health care safely and securely.

While InSight’s other divisions bring psychiatrists and mental health providers to community-based facilities and organizations through telehealth, Inpathy uniquely brings life-changing behavioral care directly into people’s home or any other private place. While the website makes it easy for people to self-direct themselves, Inpathy also has a team of care navigators for users to call or email if they would like the extra assistance finding and connecting with a provider.

Online Sessions Make Care Convenient

“Inpathy allows me to help people who have mobility issues, anxiety around commuting or those who just don’t have the time to get to their in-person appointments,” says Jeanine Miles, a New Jersey licensed professional counselor.

There are many reasons people prefer online therapy and psychiatry services.

  • It’s convenient: Be seen when and where it works for you without the hassle of taking time off work or sitting in waiting rooms. Inpathy providers often have next-day appointments and are available evenings and weekends.
  • It provides options: Find the right provider who fits your needs and preferences — whether or not they live in your community. Access licensed counselors, therapists and psychiatry providers who are licensed in your state.
  • It’s safe and secure: Unlike Skype or FaceTime, our technology is HIPAA-compliant and protects your personal information.
  • It’s completely private: Your session on Inpathy is strictly confidential. Inpathy sessions are never recorded and you have control over whether you invite family or friends to join your online video call.
  • It’s easy to use: Inpathy works on any computer, tablet or smartphone with internet and a webcam. Plus, we offer 24/7 support for tech issues, test calls and troubleshooting.
  • It’s flexible to schedule: Weekdays a no-go? Need to do a session after the kids go to bed? No problem. Appointments are available 7 days a week from 7 a.m. to 11 p.m. — and it often only takes a few days from your request before you can meet with a provider.
  • It’s effective: Numerous studies have also shown that it is highly effective as a form of treatment and sometimes more effective than traditional in-person care.

According to Dr. Varrell, Medical Director of Inpathy and a child and adolescent psychiatrist who has been doing video sessions with people for the past 18 years, “Many people, especially children, are able to talk to me more easily through televideo than in person. Online care is more comfortable, less intimidating and it removes some of the power dynamics so people are more likely to open up more quickly than in-person care.”
Insurance companies and employers are also recognizing the advantages of online care and are starting to include services like Inpathy as a benefit.

Referring to Online Psychiatry and Therapy Saves Time and Money

In addition to convenience for individuals seeking care, Inpathy also acts as a non-traditional resource for health care providers or organizations that would like to use it as a referral option.

In a recent webinar on expanding referral options through online psychiatry, Inpathy’s Practice Liaison, Anne Marie Jones, explains its benefits: “With a network of over 300 behavioral health care providers, Inpathy can help reduce opportunity costs in terms of time, transportation and absenteeism.”

The New Inpathy Website

The Inpathy new website is a resource for people who want to connect with licensed professional therapists, counselors and psychiatry providers. It offers:

  • Online assessments
  • Information on the types of behavioral health care providers and the services they offer
  • Explanations on how to sign up, find a provider and book a session
  • A searchable directory of providers who offer online sessions
  • Access to care navigators who can answer questions and help you sign up
  • 24/7 technical support

“We wanted this new website to be helpful for people seeking care and give them hope that receiving behavioral health care doesn’t have to be a stressful ordeal every time they meet with their provider. It can be as easy as a Skype call and as private as online banking,” says Olivia Boyce, InSight’s Marketing and Communications Manager.

Inpathy services are available is most states. Inpathy has its largest provider and insurance networks in California, New York, New Jersey, Delaware, Virginia, and Missouri.

Read the original press release here.

 

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[1]. Additionally, over 75% of Montana’s population has inadequate access to psychiatry[2]. 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.

 


[1] 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

[2] 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

MHA Ventures Partners with InSight Telepsychiatry

Dec. 19, 2016 | MHA Ventures and InSight Telepsychiatry are partnering to help bring on-demand, scheduled and direct to consumer care to hospitals in the state of Montana. These efforts will improve access to mental health care and providers.

Helena, MT — A new partnership between MHA Ventures and InSight Telepsychiatry will improve care options throughout communities in Montana. MHA Ventures (MHAV), the for-profit subsidiary of the Montana Hospital Association, works with successful healthcare organizations to help Montana become a “Top 10 Healthy State.”  InSight has been endorsed by MHAV to help members of the association improve mental health in the communities they serve through telepsychiatry.

Telepsychiatry is psychiatric care delivered through secure videoconferencing.

Members of the Montana Hospital Association provide the full spectrum of health care services, including hospital inpatient and outpatient, skilled nursing facility, home health, hospice, physician, assisted living, senior housing and insurance services.

Mental health is an important topic to address across the state as Montana has the highest suicide rate among any state in the United States at nearly twice the national average. Approximately 54 of 56 counties in Montana are designated as mental health professional shortage areas meaning those counties do not meet the criteria of having at least one mental health professional per 10,000 people. Psychiatric providers are particularly hard to come by in Montana outside of a few cities.

“We are excited by this partnership’s ability to help bring care to Montana communities that have been struggling with acute needs for psychiatric care,” says Dr. Jim Varrell, Medical Director of InSight. “With on-demand telepsychiatry, hospitals can have access to psychiatrists who can make admission or treatment decisions within an hour on average. Other locations like clinics, primary care offices or correctional facilities can also benefit from our scheduled telepsychiatry services. With telepsychiatry, psychiatry providers can offer care to anyone, anywhere as long as there is adequate internet connectivity.”

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.

InSight is already working with the Billings Clinic in Montana to provide on-demand, after-hours telepsychiatry services in the emergency department.

Telepsychiatry is an effective, cost-conscious and proven way to bring psychiatry providers, especially those with hard-to-find specialties, into areas where there may be a shortage like Montana rural and frontier land.

For nearly 30 years, MHAV has improved consumer care and reduce operating costs by tailoring flexible programs to fit the needs of each individual hospital.

InSight, the leading national telepsychiatry service provider organization, has over 17 years of industry experience, serves over 225 organizations across 26 states and has implemented telepsychiatry programs across the spectrum of care. Together, MHAV and InSight will work to improve the mental health of communities throughout Montana.

 

Telepsychiatry Leader Predicts Major Industry Changes

Telepsychiatry, or psychiatric care provided through real-time videoconferencing, is a widely used medium for bringing psychiatric care into locations with limited access to mental health professionals. Telepsychiatry is allowing individuals to access behavioral health services like never before.

In this white paper, telebehavioral health leader James R. Varrell, M.D. details exciting developments he foresees for the telepsychiatry industry.

Download this white paper.

Telepsychiatry Can Help Increase Access to Psychiatric Care in Rural Illinois

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February 11, 2015 | Jim Varrell, MD 

See this article on The InSight Bulletin.

Illinois, like many other states across the country, struggles to serve the psychiatric needs of its citizens because of a huge shortage of psychiatric prescribers, particularly in rural and underserved areas.

In addressing this issue, I challenge Illinois to consider innovative solutions like telemedicine to alleviate some of the problems associated low psychiatric capacity in rural area.

Telepsychiatry, or psychiatric care provided through real-time videoconferencing, is a widely used medium for bringing psychiatric care into locations with limited access to mental health professionals. It allows for a psychiatrist or other mental health professional to see, evaluate, diagnose and treat patients without having to be in the same physical space.

Telepsychiatry is an application of telemedicine, a rapidly growing industry that incorporates technology into healthcare delivery to enable remote assessment and treatment. Scores of clinical research have shown the effectiveness of telepsychiatry in nearly all settings and populations.

Telepsychiatry is a way to increase access to Illinois-licensed providers who may live across the country. It is also a way to better leverage the time of existing Illinois-based psychiatric prescribers who could seamlessly transition between appointments at different facilities without having to physically travel, as many of them now do.

Telepsychiatry providers could be used in several ways in Illinois:

  • In hospital emergency departments: By incorporating 24-hour on-demand telepsychiatry programs, hospitals could have timely access to psychiatric providers for commitment and treatment decisions. Experienced psychiatric nurse practitioners and psychiatrists consistently assess risk with a high degree of certainty and therefore can significantly reduce unnecessary admissions, which frees up beds for those who need them and sends home those who don’t. While telepsychiatry is not able to create hospital beds, it is an advantageous way to bring psychiatric care where it is not readily available.
  • In inpatient units or psychiatric hospitals: Illinois could use telepsychiatry within inpatient units or the two state psychiatric hospitals to increase their psychiatric capacity and more quickly and appropriately treat mentally ill patients.
  • In community-based facilities: Other settings can benefit from improved access to psychiatric providers including correctional facilities, outpatient facilities, schools, primary care offices, urgent care centers and FQHCs. By increasing the psychiatric capacity of community-based programs it is less likely for a person to reach psychiatric crisis that requires hospitalization.

I urge Illinois to consider this medium of care as they work to improve their psychiatric services in rural areas.

See this article on The InSight Bulletin.

Telepsychiatry: The New Frontier in Mental Health

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January 15, 2015 | By Kristen Crane
View this story on U.S. News and World Report.
How technology is helping ‘bring’ psychiatrists to people in underserved areas.

When Hind Benjelloun, a District of Columbia–based crisis psychiatrist with InSight Telepsychiatry, works an overnight shift, there’s never a dull moment. Even when the emergency room empties out, Benjelloun still has patients waiting for her on her computer screen. Whether they’re from the inner city or rural Virginia, they have to be seen remotely, and advances in technology have made it possible for them to get the help they need at all hours of the day.Picture4

Like telemedicine, telepsychiatry relies on technology to bring clinical medicine to patients, rather than the other way around. Patients typically videoconference with doctors using computers or videoconferencing equipment. Telepsychiatric services are growing, and the advantage is that such technology opens access to care, particularly for those in remote areas where there are fewer psychiatrists.

The disadvantage, Benjelloun says, is that the human touch is missing. “A caring touch or handing a patient a tissue can never be possible,” she says, adding that this can also lead to missed cues on her part. “I am unable to clearly see self-inflicted wounds or tears.”

But many experts agree that despite the challenges of delivering care remotely, the advantages of telepsychiatry far outweigh the disadvantages.

South Carolina Transforms Psychiatric Care

In South Carolina, a steady decline of hospital beds for psychiatric patients in the 1980s and ‘90s due to downsizing at hospitals led to waiting lists in the early 2000s, says Mark Binkley, general counsel at the South Carolina Department of Mental Health.

This hit the community hospitals particularly hard. “When somebody needs a hospital bed, they usually wind up in a hospital emergency room,” Binkley says. And if you don’t have a psychiatrist on staff, he adds, “the tendency for the small ER was to hold onto the patient.” This led to prolonged hospital stays, which became a drain on already strapped hospital budgets.

In 2006, the state’s new health director, John McGill, proposed a solution: technology. With funding from The Duke Endowment, one of the nation’s largest private foundations, he was able to “deploy” psychiatrists to people living in underserved, rural areas via the Internet. This enabled psychiatrists, many of whom were (and still are) clustered in the state’s capital, Charleston, to consult with patients in real-time, irrespective of location, Binkley adds.

The results of this pilot study have been promising. Since the program started in March of 2009, there have been 21,900 total consultations, an average of about 400 per month. While only available to those admitted to emergency departments, patients at participating hospitals have experienced shorter stays, yielding $1,400 in savings per episode of care, Binkley says. Furthermore, patients who came through the program are 200 percent more likely to show up for aftercare, he adds.

Telemedicine vs. Telepsychiatry

Although telepsychiatry has developed on the heels of telemedicine, which uses technology to do things such as take patients’ vital signs and send the results remotely, studies have shown that telepsychiatry might actually benefit psychiatric patients more. That’s because their propensity to use the ER may be greater, Binkley says, so helping them avoid that visit through remote care is particularly advantageous.

Also, psychiatric patients may be more willing to open up from the comfort of their home. “Very rarely do patients have a problem talking to a psychiatrist on a big video screen,” Binkley says.

Jim Varrell, a New Jersey–based psychiatrist and medical director of Insight Telepsychiatry, which provides telepsychiatry services to clinics and private users of telepsychiatry services, adds that patients with behavioral problems are more often compliant with remote consultations. “They do better in response to this service, as opposed to being in a room with one to two adults who are pointing out what’s wrong with them,” Varrell says. “They open up more through this medium.”

The profile of patients using telepsychiatry is wide-ranging and includes everyone from children to geriatric patients; English to foreign-language speakers; and people experiencing mild depression to those in the midst of a psychotic episode. “Ultimately people are absolutely able to do it,” Varrell says. “We haven’t had any group unable to do it.”

Sound quality can be more important than picture quality, he adds, especially in older patients with hearing problems. And while the major disadvantage of remote services is the absence of personal contact, which limits a psychiatrist’s ability to use all senses when evaluating the patient, the equipment (a computer and video camera) has a number of features that can help offset that limitation. For example, it can allow the camera to zoom in on the face to visualize the dilation of eyeballs and any tics, Binkley says. There are extensive security protocols for protecting patient privacy as well, Varrell adds.

Expanding Across the Country

While South Carolina is a leader in the nation’s adoption of telepsychiatry, thousands of programs have been launched in all 50 states, says Geoffrey Boyce, executive director of InSight Telepsychiatry. More than 1 million consultations are estimated to occur in the United States this year, he adds – many of which will be in underserved populations that extend beyond just rural pockets. “When you’re talking about the weekends and after hours, that’s where it can make a lot of sense in the urban areas,” he says.

“In a more rural area, nobody has access [to psychiatric care],” he says. Telepsychiatry is “enormously more affordable at that point,” Boyce says, since people who otherwise might have had to take a whole day off work to travel to see a doctor can now be seen in the comfort of their community hospital or home.

So far, California, Texas and Colorado have been the biggest adopters of telepsychiatry, apart from South Carolina. Regulatory and insurance reimbursement issues have held other states back from wide adoption of these services, Boyce says.

Many psychiatrists have begun to embrace the concept of serving patients remotely, Varrell says.

Several, like Benjelloun, find it gratifying to reach patients who were once out of reach. “[Telepsychiatry] allows for patients to be examined by a psychiatrist within an hour, as opposed to waiting for days in an emergency room,” she says.

View this story on U.S. News and World Report.