Tag Archives: telepsychiatry

Increasing Access to Mental Care with Telepsychiatry

Primary Care Doctor Referring to Telepsychiatry

By James Varrell, M.D.

The United States is facing a severe shortage of psychiatrists, in which 55 percent of counties nationwide currently have no psychiatrists available, according to a new report. This shortage is impacting the country’s health care system, particularly for primary-care doctors, who increasingly have to assume these roles to treat mental or behavioral health conditions.

Taking on mental health care often requires more time and resources to adequately assess and treat such conditions, which can further limit the valuable time doctors have with other patients at the point of care.

Moreover, the delivery of specialized mental healthcare can be out of the realm of expertise or comfort for many primary-care doctors. When it is, it makes sense to refer care to psychiatry providers. Yet, due to the current shortage of psychiatrists, patients may need to wait weeks—sometimes even months—to be seen by a local psychiatry provider in their community.

This is where direct-to-consumer telepsychiatry, also known as in-home telepsychiatry, can help fill the gap for primary-care doctors. Telepsychiatry is a type of telemedicine that uses videoconferencing to provide psychiatric evaluation, consultation and treatment.

Why direct-to-consumer telepsychiatry?

Telepsychiatry offers several benefits, and meets the standard of traditional in-person care. Telepsychiatry can meet patients where they are, whether at home or in a private office, eliminating time spent traveling to appointments or in waiting rooms. It also allows more flexibility with scheduling, as direct-to-consumer telepsychiatry providers usually work from home themselves and can offer appointments during non-traditional hours, including evenings and weekends.

By eliminating long wait times associated with community-based psychiatry options, direct-to-consumer telepsychiatry enables greater accessibility to psychiatry providers and supports continuity of care. It expands the reach outside the local community, so patients have access to high quality care and a variety of specialized providers. As long as a telepsychiatry provider is licensed in the state where a patient is physically located, they can deliver care. This also opens the door for patients to continue seeing their same psychiatry provider throughout many life transitions; including job changes, college, and vacations.

Just like with in-person treatment, patients meet with the same telepsychiatry provider over time, allowing the patient and his or her consented primary-care doctor to develop a rapport with the remote psychiatrist. By ensuring the mental health of a patient is appropriately addressed, primary-care doctors can better attend to the patient’s physical health.

Key considerations when referring patients

Referring patients to direct-to-consumer telepsychiatry is similar to referring to any outpatient setting. Like other referrals, the process begins with an intake of patient’s medical history and applicable screenings to determine if the patient requires specialty care.

Telepsychiatry is versatile and has been proven effective with all age groups. For patients who worry about mental or behavioral health stigmas, telepsychiatry may help them follow-up with referrals to psychiatry providers who they can see through telehealth as opposed to those they would have to see in-person.

Referral coordinators can help determine if a patient is appropriate for in-home, direct-to-consumer treatment by asking a few simple questions and considering the following:

  1. Can this condition be treated through direct-to-consumer telepsychiatry?
    Anxiety, depression, stress, life transitions, childhood mood disorders, and ADHD are all conditions that can be successfully treated using telepsychiatry. Much like outpatient care, direct-to-consumer telepsychiatry is not appropriate for patients who currently may be suicidal, homicidal, delusional or paranoid.
  2. Does the patient have the technology needed to access telepsychiatry?
    When considering patients for telepsychiatry, referral coordinators should make sure the patient has access to a computer, tablet or smartphone with video calling abilities. Most people already have one or more of these devices and can access telepsychiatry sessions from home. As long as the patient has an email address and is moderately comfortable using technology—telepsychiatry can be an option.
  3. Does the patient have a safe space for accessing direct-to-consumer appointments?
    The patient should have consistent access to a safe and private space in their home, office or another location, such as a community center to have their telehealth sessions.

For many remote referral groups, patients have the option to choose from a list of applicable psychiatry providers based on specialty and area of expertise, and schedule an online appointment at their convenience.

Expanding your referral community

Because telepsychiatry is a newer type of referral option, a practice may want to test direct-to-consumer care on a small group of early adopters to create an easy system for referring before offering this option practice-wide. When evaluating remote referral group options, primary-care doctors should consider:

  • Whether the group is a technology company or if real people are behind the service and involved in supporting the process.
  • If there are opportunities to meet the potential providers referred beforehand, either in person or via video.
  • Whether the group accepts only certain insurance or if all patients are eligible.
  • If the telepsychiatry provider will share information periodically with the primary-care doctor, so all parts of the care team can stay involved and informed (with the patient’s consent).

After a few early adopters, a practice can gauge their comfort level with this type of referral option, generate buy-in from staff and patients and roll out the direct-to-consumer referral option practice-wide.

The impact of telepsychiatry

With direct-to-consumer telepsychiatry as a referral option, primary-care doctors don’t have to settle for the limited choices within their community or provide mental or behavioral health services themselves. Using telepsychiatry, doctors can ensure the mental health of their patients is addressed in an effective and timely fashion, which can ultimately have a direct impact on their health, wellbeing and overall quality of life.

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 currently accepts patient referrals for psychiatry and therapy is called Inpathy.

Read the full article on Physician’s Practice here.

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 Experts Present Psychiatry Grand Rounds at Western Michigan University Homer Stryker, M.D. School of Medicine

WMU and InSight

KALAMAZOO, MI – Representatives from InSight Telepsychiatry participated in a grand rounds presentation for the Department of Psychiatry at Western Michigan University Homer Stryker, M.D. School of Medicine. This was the first time the School of Medicine held a presentation on the topic of telepsychiatry.

The presenters were Randy McCloud and Dillon Euler, M.D. McCloud has a decade of diverse healthcare experiences and extensive clinical knowledge of behavioral health, in addition to experience designing and implementing successful telepsychiatry programs. Dr. Euler has focused his career on public and community psychiatry, forensic psychiatry and administrative consulting. For the past two years, Dr. Euler has worked in emergency telepsychiatry and is very interested in improving access to and quality of psychiatric care in various communities.

In their presentation entitled, How to Make Telepsychiatry Work, McCloud and Dr. Euler discussed

  • How telepsychiatry is used
  • The benefits of utilizing these kinds of services
  • Different models of telepsychiatry
  • The best practices for organizations and providers when using telepsychiatry.

As an appropriate demonstration of telemedicine’s technological capabilities, Dr. Euler joined via videoconference and shared a clinical case study demonstrating the strengths of telepsychiatry care in practice.  Those in attendance were left with a few “Telepsychiatry Takeaways” to remember as they continue their work in the behavioral health field.

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.

InSight Brings Telepsychiatry Services to the Yellowstone County Detention Facility

insight-logo-square

BILLINGS, MT – Located in south central Montana, Yellowstone County is Montana’s most populous with an estimated 144,797 residents in 2009, according to the Montana Department of Commerce. The Yellowstone County Detention Facility brings six hours a week of InSight telepsychiatry services to their inmates from Psychiatric Nurse Practitioner, Renée Brunner Houser.

Renée Brunner Houser, PMHNP, MSN is a Montana licensed psychiatric nurse practitioner who has worked as a psychiatric nurse practitioner and registered nurse in a variety of settings such as psychiatric hospitals, inpatient/outpatient health centers, hospice facilities and public schools. InSight will provide first time evaluations, follow up care, medication management and more.

According the National Alliance on Mental Illness, at least 83% of jail inmates with a mental illness did not have access to needed treatment. In addition, telepsychiatry is found to improve access to mental health services for inmates and save correctional facilities from $12,000 to more than $1 million [1]. InSight brings years of experience in correctional facility psychiatric care to serve Yellowstone’s inmates and increase access to care when they need it the most.


[1] Deslich, S. (2013). Telepsychiatry in Correctional Facilities: Using Technology to Improve Access and Decrease Costs of Mental Health Care in Underserved Populations. The Permanente Journal,17(3), 80-86. doi:10.7812/tpp/12-123

The Psychiatrist Shortage in Virginia

the psychiatrist shortage in virginia

By James Varrell, M.D. (Original story posted on Lynchburg Business Magazine)

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.

Telepsychiatry Long-Term Partnership a Continued Success

Newpoint Cobrand

InSight Telepsychiaty and NewPoint Behavioral Healthcare Continue to Reduce Emergency Department Wait Times with Telepsychiatry for 15 Years

MARLTON, NJ — After 15 years of service, InSight Telepsychiatry and NewPoint Behavioral Healthcare continue to provide successful telepsychiatry services to individuals requiring emergency behavioral healthcare.

Winona InSight

As a New Jersey designated screening center, NewPoint Behavioral Healthcare provides behavioral health services such as emergency assessments, crisis intervention and referrals to inpatient psychiatric organizations.

The services offered by NewPoint Behavioral Healthcare combine traditional treatment options with telepsychiatry. When an individual enters a screening center during a psychiatric crisis, an on-site behavioral health screener conducts an initial assessment. The screener then meets with an InSight provider through phone or videoconference to determine diagnosis and treatment options. This could include admission, prescribing of medication or referral to follow-up care.

“NewPoint Behavioral Healthcare screeners truly develop a strong rapport with InSight’s providers,” says InSight’s Director of Operations Dena Ferrell, who worked as a behavioral health screener for the organization prior to joining InSight in 2007. “InSight providers really enjoy a friendly and productive working relationship that adds value to this partnership,” she added.

The partnerships success is exemplified through conducting over 200 telepsychiatry sessions in 2015 alone. “We use telepsychiatry 24/7 and most feel just as satisfied as they are with face-to-face psychiatrist sessions,” said Vikki McFadden, NewPoint Behavioral Healthcare’s Clinical Coordinator of Psychiatric Emergency Screening. “Before we were able to utilize telepsychiatry clients in other emergency room settings would sometimes wait days to be sent to the screening host,” McFadden added.

“The technology has gotten better,” says Jennifer Plews, NewPoint Behavioral Healthcare’s Director of Psychiatric Emergency, describing how telepsychiatry used to be delivered on a heavy cart with a monitor versus a cart that can now be easily pushed with one hand.

As one of InSight’s longest partnerships, NewPoint Behavioral Healthcare has seen firsthand how telepsychiatry has evolved. With a mission to provide a spectrum of quality services to maximize individual potential through education and empowerment, NewPoint Behavioral Healthcare has served communities in New Jersey for nearly 60 years through more than 16 outpatient behavioral health programs offering effective, affordable psychiatric screenings.

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 NewPoint Behavioral Healthcare

The mission of NewPoint Behavioral Healthcare is to provide a spectrum of quality services to maximize individual potential through education and empowerment. NewPoint Behavioral Healthcare is committed to be the leader of quality mental health services in the region.

InSight Telepsychiatry to Present at the American Telemedicine Association Annual Conference

InSight ATA

InSight Telepsychiatry representatives are presenting at the American Telemedicine Association’s Annual Conference and Trade Show in Orlando. Their presentations, will address innovative telebehavioral health programs in a variety of settings, drawing on InSight’s experience as the leading national telepsychiatry provider organization.

ORLANDO, FL – InSight Telepsychiatry, the leading national telepsychiatry provider organization with a mission to increase access to behavioral health care, today announced thought leaders from the company, along with CFG Health Network and InSight partner, Access Services, will give presentations on a variety of telepsychiatry topics during the American Telemedicine Association’s (ATA) Annual Conference and Trade Show, taking place in Orlando, FL from April 23 to 25. ATA is the industry’s leading event for insights into the latest telemedicine and mobile health trends.

On Monday, April 24, representatives from InSight, CFG and Access Services will present during the session called The Use of Consumer-Based Telemental Health for Acute and Long-Term Needs. This session will feature “Bringing Help Home: The Use of Telepsychiatry in a Mobile Crisis Program” presented by Dan Khebzou and Jessica Fenchel, and “Getting Ahead of the Curve: Layering Home-Based Telehealth into an Existing Outpatient Mental Health Clinic” presented by Joel Freidman, PhD, that discusses the use of Inpathy, InSight’s direct-to-consumer division.

Dan Khebzou, a regional account executive for InSight, and Jess Fenchel, the senior director for adult behavioral health and crisis at Access Services, will give details on the partnership that facilitated the nation’s first mobile crisis program to utilize telepsychiatry.

Access Services and InSight work together to connect individuals in crisis and crisis team members with a remote telepsychiatry provider who is able to rapidly meet the person where they are – all through telehealth. This case study will review the implementation steps the partners went through to develop and roll out a successful program including designing workflows, selecting providers, overcoming hurdles, informing payers, choosing their technology and educating their teams. In addition, they will discuss lessons learned.
In the second presentation, Joel Friedman, PhD., the clinical director of CFG Health Network, will give details on how Center for Family Guidance, an outpatient mental health organization with three offices, is utilizing Inpathy, in order to meet the increasing needs of consumers.

Additionally, InSight Executive Director Geoffrey Boyce will present the e-poster, “Do You Know Ryan Haight?” on April 23. This poster will break down the confusing elements of the Ryan Haight Act into digestible and applicable pieces.

Visit booth 1506 for more information and to connect with InSight. To schedule a time for a meeting, contact Olivia Boyce at oboyce@in-sight.net or 770.713.4161.

InSight Telepsychiatry is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through innovative applications of technology.

St. Joseph’s Villa Receives Telehealth Innovation Award

st. johns

Telehealth Innovation Award from the Mid-Atlantic Telehealth Resource Center recognizes effective use of telepyschiatry in the Villa’s Crisis Stabilization Unit.

RICHMOND, VA — St. Joseph’s Villa (SJV) of Richmond, VA received the prestigious Telehealth Innovation Award from the Mid-Atlantic Telehealth Resource Center (MATRC). The award recipients were announced on April 3, 2017 during the 2017 MATRC Telehealth Summit. The award is given to organizations that demonstrate an innovative application of telehealth and contribute to improved health outcomes and/or quality of life in the Mid-Atlantic region.

SJV partners with InSight to bring telepsychiatry to children receiving mental health services at their facility. One of SJV’s many innovative and effective programs is their Crisis Stabilization Unit (CSU), where children experiencing mental health crises can receive treatment in an environment that feels like home — all with the goal of preventing costly, unnecessary hospitalization. Since opening in 2012, the CSU has served nearly 500 children and has successfully diverted nearly 90 percent of them from hospitalization. InSight has helped the CSU work toward this goal for nearly two years with the help of telepsychiatrist Dr. Ashika Kapoor.

As one of the first crisis stabilization units for children and adolescents in Virginia, and one of the first crisis stabilization units in the country to use telepsychiatry, St. Joseph’s Villa exemplifies how combining modern technology and a personal touch can offer a meaningful and potentially life-changing service to patients and families in their time of need. The Villa is able to help children and families through a difficult time in their lives and provide them with opportunities to succeed because they have a telepsychiatry provider.

“St. Joseph’s Villa is committed to providing high quality behavioral health services to children and their families in innovative new settings. Our partnership with InSight has allowed us to expand our provider capacity,” said Kathleen Burke Barrett, CEO of St. Joseph’s Villa.  “We’re delighted that our efforts to provide care beyond the confines of an office were recognized by MATRC.”

Telepsychiatry allows children in the CSU to see psychiatry providers through videoconferencing. It has been proven an effective and cost-conscious way to bring psychiatric care to children and many other populations.[1]  With the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to staff in rural and underserved areas. When the CSU opened in partnership with the Richmond Behavioral Health Authority (RBHA) Region IV, SJV found that it was challenging to locate a qualified local child psychiatrist. In terms of mental health providers, several of the counties SJV’s CSU serves are Designated Health Professional Shortage Areas, according to the U.S. Health Resources and Services Administration.  Ultimately, SJV turned to telepsychiatry as the solution for bringing psychiatric care to their facility.

“InSight prides itself on developing partnerships with innovative, like-minded organizations and works hard to find the right fit between our telepsychiatry providers and our partners,” says Geoffrey Boyce, Executive Director of InSight. “Congratulations to St. Joseph’s Villa on this accomplishment and we look forward to sustaining a productive partnership.”

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 St. Joseph’s Villa

Established in 1834, St. Joseph’s Villa is the longest serving nonprofit for children in the country.  The Villa impacts 3,000 children and families each year facing homelessness, autism and developmental disabilities, mental illness, and other challenges.  Villa programs help them believe in themselves while providing them with the tools they need for long-term independence, stability, and success. For more information, visit www.NeverStopBelieving.org.

[1] Myers, K. M., Valentine, J. M., & Melzer, S. M. (2008). Child and Adolescent Telepsychiatry: Utilization and Satisfaction. Telemedicine and EHealth, 14(2), 131-137. doi: 10.1089/tmj.2007.0035

News on Telemental Health Services

ATATCC

(Original story published in Federal Telemedicine News — April 2, 2017)

Advancing critical telemental health services to help individuals with behavioral health issues was discussed at ATA’s Telehealth Capitol Connection (TCC) www.americantelemed.org briefing held on March 28, 2017. The use of technology enables mental healthcare to be delivered to major sectors of the population especially in rural areas in spite of the shortage of professionals.

Neal Neuberger as Senior Policy Consultant to ATA and moderator, opened the event by saying the use of technology in medicine has exploded since providers, patients, and employers see the advantages. However, as he pointed out, there are still policy matters that have to be addressed such privacy, finding eligible providers to deliver mental health care, and reimbursement issues.

Representative Tim Murphy (R-PA) https://murphy.house.gov Practicing Psychologist and Commander in the Naval Reserve reports, “Substance abuse and drug addiction is a major problem in this country, but the fact is that many people aren’t able to get adequate treatment fast enough because there are not enough professionals or facilities available to treat the affected population.

As reported, Congressman Murphy was able to secure an additional $15 billion in AHCA with a requirement that states must use the additional resources for mental health and addiction treatment. “We are continuing to build on our successful record to help families in the current mental health and addiction crisis. This additional $15 billion investment represents the largest surge in behavioral health funding in recent history.”

According to “Twelve percent of the 702,000 veterans have successfully received care using telehealth through the VA program”, according to John Peters, Deputy Director, Office of Connected Care, at the Department of Veteran’s Affairs, https://connectedcare.va.gov,

He reports, “Patient satisfaction for 304,000 veterans using store and forward telehealth is 94 percent, satisfaction for 307,000 veterans using video telehealth is 92 percent, and for 156,000 veterans using home telehealth, the patient satisfaction is 83 percent.”

He mentioned the bill “The Care Veterans Deserve Act of 2017” (H.R 1152) that was introduced on February 16, 2017. The bill amends the “Veterans Access Choice and Accountability Act” to make the VA’s Choice Program permanent and includes veterans with a 50 percent service connected disability.

Currently, a number of vital remote psychiatry services are available to community-based organizations, according to Geoffrey Boyce Executive Director, for InSight Telepsychiatry http://insighttelepsychiatry.com “Facing budget constraints, many community-based organizations are choosing to supplement their onsite psychiatric services with remote psychiatric prescriber teams.”

InSight is able to provide correctional facilities 24/7 access to psychiatric treatment within one hour after the request is submitted. InSight is able to respond to on-demand telepsychiatry services quickly to support an inpatient or a home setting crisis situation.

Deborah C. Baker, J.D., Director of Legal & Regulatory Policy in the Office of Legal and Regulatory Affairs, representing the American Psychological Association’s www.apa.org Practice Directorate, wants to see changes in licensing occur that would be specific to psychology.

As Baker explained, “The laws are confusing and a number of questions need to be clarified. To deal with jurisdiction issues, a few years ago, the “Psychology Interjurisdictional Compact” (PSYPACT) was introduced by the Association of State and Provincial Psychology Boards.

PSYPACT uses model language to discuss where a psychologist is physically related, where the psychologist is licensed to practice psychology, and where the client patient is physically located. Since PSYPACT is only model language, it would need to be passed in at least seven states to come into existence.

Lauren McGrath Vice President Public Policy for Centerstone, https://centerstone.org, a healthcare organization operating for 60 plus years, offers services for health homes, emergency follow-up services, integrated primary care, help for addiction, hospital and crisis services, intellectual and developmental disabilities services,  and also actively helps veterans suffering from PTSD and combat stress.

Today, Centerstone provides mobile and remote assessments in order to facilitate a quick referral for the coordination of care and appropriate treatments. The team is able to see how each person is doing by using a dashboard and if there is a problem, connections can be made by using a bidirectional app or be connected via telehealth.

— Carolyn Bloch of Bloch Consulting Group

Bloch has researched and reported on Federal government and legislative activities in the areas of science, R&D, defense, telemedicine, and health technology — and has worked with many scientific and technical newsletters, publishing firms, and other companies.

The author of 5 books and many articles based on Federal government activities, Federal funding programs, and university research grant opportunities. Carolyn Bloch has also taught courses in proposal writing for government contracts at a number of colleges and universities.

She is a member of the National Press Club, American Telemedicine Association, and the Healthcare Information and Management Systems Society (HIMSS) Maryland Chapter.

Live & Practice: Small Towns and Cities

PracticeLink article

(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

Health IT 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.

 

InSight’s Dr. Mark Alter Airs on Wharton Business Radio as Guest Speaker

Mark Alter

Mark AlterPhilidelphia, PA— Mark Alter, Associate Medical Director of On-Demand Services at InSight Telepsychiatry, recently appeared as a guest speaker on “The Business of Health Care” to talk about telemedicine on Business Radio Powered by The Wharton School.

The show, which originally aired on Sirius XM Channel 111, featured Dr. Alter along with fellow guests Jules Lipoff, Assistant Professor of Dermatology at the University of Pennsylvania, and George Bodenger, Health Care Law Attorney at George W. Bodenger, LLC. The show covered the rapidly growing size and potential of the telemedicine market and also explained how the various models of telemedicine work across specialties. Dr. Alter talked about the importance and opportunities of providing telemedicine and telepsychiatry, including increased access to care under current and new health care policies.

Listen to the show here.

New Jersey Awards Virtua $290,000 to Serve Veterans Via Telehealth

NJDOH and Virtua
Trenton, NJ – The New Jersey Department of Health announced a $290,000 telehealth grant to Virtua Health on January 27 that will assist veterans who need access to primary and behavioral healthcare services but may face mobility or transportation challenges.

By coordinating care with Oaks Integrated Care, Legacy Treatment Services and InSight Telepsychiatry, Virtua will offer primary and behavioral health visits conducted via online technology starting February 1.

Stigma, negative ideas about seeking help, perceptions of the Veterans Administration (VA) and a lack of access due to geography and transportation issues make it difficult for veterans to visit a doctor in person. Some medical conditions such as depression, anxiety, post-traumatic stress disorder (PTSD), brain injury, spinal cord injury and other psychiatric disorders further complicate the ability for travel. 

“For many veterans, travel to see a healthcare provider can be complicated and overwhelming, particularly in areas where transportation options might be limited,” Health Commissioner Cathleen Bennett said. “Telehealth can ease the burden by offering long-distance virtual care to veterans while they remain in a comfortable environment.”

Telehealth includes telepsychology, telepsychiatry, telebehavioral health, e-counseling, e-therapy, online therapy and cybercounseling. If veterans have other needs such as housing, employment or transportation, Virtua will seek to connect them to appropriate services.

One in five homeless Americans are veterans. One in three homeless men are veterans, and about 60 percent of homeless veterans are minorities. Veterans of Iraq and Afghanistan have an unemployment rate approximately 40 percent greater than the general population.

Veterans have disproportionate rates of mental illness, particularly PTSD, substance abuse disorders, depression and anxiety. Nearly half of combat veterans from Iraq report that they have suffered from PTSD, and about 40 percent of these veterans report problems with alcohol use.

Follow the New Jersey Department of Health on Twitter at twitter.com/NJDeptofHealth and on Facebook at facebook.com/NJDeptofHealth.

Billings Clinic is now Bringing After-hours Psychiatric Care to its Emergency Department and Inpatient Unit Through Partnership with InSight Telepsychiatry

InSight and Billings

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

MHAV and InSight

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.

 

InSight Telepsychiatry Presents at American Academy of Child and Adolescent Psychiatry Annual Meeting

Untitled design

October 28, 2016 │ InSight Telepsychiatry was proud to present on the legal, regulatory and financial realities of telepsychiatry at the American Academy of Child and Adolescent Psychiatry’s 63rd Annual Meeting.

New York, NY – InSight Telepsychiatry’s Executive Director, Geoffrey Boyce, and Medical Director, Dr. Jim Varrell, presented at the American Academy of Child and Adolescent Psychiatry’s (AACAP) 63rd Annual Meeting held in New York City. The AACAP annual meetings are a gathering place for leaders in the field of child and adolescent psychiatry, children’s mental health and other allied disciplines.

Boyce and Dr. Varrell’s presentation, entitled Legal, Regulatory and Financial Realities of Telepsychiatry, was delivered during the “Road Map to Establish and Sustain a Telepsychiatry Practice” clinical breakout session organized by Dr. Kathleen Myers and attended by over 100 child and adolescent psychiatrists. Their presentation covered topics including models of telepsychiatry, reimbursement, licensure, the provider-patient relationship and emergency protocol. Other presentations during this breakout session included Media Training to Develop and Authentic Patient-Doctor Relationship presented by Dr. David E. Roth and Competencies in Telepsychiatry: Residency Training and Maintenance of Skills presented by Dr. Daniel A. Alicata.

Additionally, Dr. Varrell presented on the entrepreneurial side of telepsychiatry during the breakout’s TED-talk style session. He discussed being a thought leader in telepsychiatry and telepsychiatry best practices. Dr. Varrell has been providing telepsychiatry services since 1999 and is one of the founding members of InSight Telepsychiatry, the national leading telepsychiatry service provider.

Boyce and Dr. Varrell also took part in the breakout session’s ‘Genius Bar.’ They hosted a “Careers in Telepsychiatry: Choose Your Own Adventure” station where attendees were encouraged to ask them questions about what a career in telepsychiatry looks like. Telepsychiatry provides a unique opportunity for psychiatric providers because it allows them to work from home, extending their hours to nights and weekends.

Geoffrey Boyce is the Executive Director of InSight Telepsychiatry and an active participant in telemedicine advocacy, education and reform initiatives.

Jim Varrell, MD is the President and Medical Director of the CFG Health Network and InSight Telepsychiatry who has been at the forefront of telepsychiatry across the nation and continues to educate the medical community regarding the benefits of telepsychiatry.

InSight Telepsychiatry is the national leading telepsychiatry provider organization with a mission to increase access to behavioral health care.

InSight Telepsychiatry Supports Creativity and Innovation During Psychiatry Innovation Lab Event

InSight -Psychiatry Innovation

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.

Online Behavioral Health for Mental Wellness

Scott Baker WVIB Interview

October 5, 2016 | Business Innovations Manager of InSight Telepsychiatry Scott Baker discusses how telebehavioral health services like Inpathy can increase access to mental and behavioral health care.

Buffalo, N.Y. – As part of Mental Health Awareness Week, InSight Telepsychiatry’s own Scott Baker was interviewed by WIVB-TV News 4 in Buffalo, NY and asked to discuss how telebehavioral health services like Inpathy can increase access to mental and behavioral health care.

Baker spoke about the convenience of online behavioral health care through Inpathy, the virtual office to over 300 behavioral health providers. Another InSight team member, Melissa Harward, provided a demonstration of the Inpathy videoconferencing platform.

WIVB-TV News 4 reporter, Angela Christoforos highlighted how being able to access care online offers many benefits to individuals and families seeking behavioral health care, including appointment availability at night or on weekends, clinical effectiveness and the convenience of using everyday technology for secure sessions with providers. This is especially helpful for individuals who have issues with scheduling, mobility, transportation and/or  local provider availability.

Inpathy providers are licensed psychiatrists, psychiatric nurse practitioners, psychologists and therapists who offer a wide variety of behavioral health services like medication management and therapy. View Inpathy providers by searching the directory here: https://portal.inpathy.com/directory-search/start

Watch and read about the interview here.

New Psychiatric Practice in New York Allows Individuals to Get Their Mental Wellness On(line)

PR NY - featured media

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.

Cathy Newton

Telebehavioral Health Practice Launches in Delaware and New York

Capture

AUGUST 21, 2016 | Mental health providers, including psychiatrists are now available for assessment, therapy and medication management through a newly launched behavioral health practice in Delaware and 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.

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 camera. 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 Delaware and 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
  • Lamont Josey, LCSW- a clinical social worker who offers therapy to individuals 8 years old and up and has a specialty in trauma-focused Cognitive Behavioral Therapy (CBT)
  • Humberto Quinanata, MD- a Spanish-speaking child and adolescent psychiatrist with an interest in psychopharmacology
  • Patti Rodgers, PMHNP- a board certified psychiatric nurse practitioner who serves adults and aims to educate and empower the people with whom she works
  • 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 disrders 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 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 Delaware and 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 www.Inpathy.com

Hawaii Teens Go Off-Island for Counseling: Any Other Options?

Scott Shimabukuro, a clinical psychologist in the Hawaii Department of Health's Child and Adolescent Mental Health Division, and Lynn Fallin, deputy director of behavioral health, pose at the Hawaii Department of Health offices in Honolulu on May 24. Dozens of mentally ill teens are sent to the mainland for treatment each year because they can’t find the proper services in the islands. (Marina Rikder/AP)

christian-science-monitor-logo

June 2, 2016 | A report shows Hawaii teens seeking mental health treatment often have to leave the island to find it. What are patients in other remote areas trying?

By Lucy Schouten

Scott Shimabukuro, a clinical psychologist in the Hawaii Department of Health's Child and Adolescent Mental Health Division, and Lynn Fallin, deputy director of behavioral health, pose at the Hawaii Department of Health offices in Honolulu on May 24. Dozens of mentally ill teens are sent to the mainland for treatment each year because they can’t find the proper services in the islands. (Marina Rikder/AP)

Scott Shimabukuro, a clinical psychologist in the Hawaii Department of Health’s Child and Adolescent Mental Health Division, and Lynn Fallin, deputy director of behavioral health, pose at the Hawaii Department of Health offices in Honolulu on May 24. Dozens of mentally ill teens are sent to the mainland for treatment each year because they can’t find the proper services in the islands. (Marina Rikder/AP)

Many patients in rural or remote areas of the country must travel long distances to meet with a counselor or receive mental health treatment, but some young patients face a much more burdensome trip by plane or boat.

Some Hawaii teenagers have faced such long waits for treatment that healthcare providers send them to the mainland, reports the Associated Press. This takes them away from the support of friends and family, leaving authorities looking for strategies employed by other communities.

An ongoing shortage of mental health providers, especially for those trained to work with specific populations such as adolescents or veterans, has strained public health resources in many communities throughout the United States – especially in rural areas.

Noting the lack of mental healthcare options in many remote areas, the US Department of Agriculture has invested $50 million in rural mental health access, especially for veterans, part of an overall strategy to integrate more mental health services into primary care, to which rural patients have better access.

In some communities, local leaders are being trained to recognize when someone may be in need of immediate mental health services. The Mental Health First Aid course, originally developed in Australia but adapted by the health departments of Maryland and Missouri, trains rural community and faith leaders to recognize signs that a patient is suicidal or in need of other help and to identify counseling resources.

“The course helps participants to not only gain confidence in their capacity to approach and offer assistance to others, but also to improve their personal mental health,” reported the US Department of Health and Human Services after investigating the program.

A 21st-century solution, the growing practice of telepsychiatry, enables patients in remote or underserved areas to meet with counselors over live video stream. The new practice followed telemedicine – where doctors might remotely check a patient’s heart rate – but telepsychiatry shows more promise, Kristine Crane reported for US News and World Report.

Designed for patients whose remote residency limits their access to counselors, telepsychiatry can give patients at busy community hospitals the help they need without adding to patient rolls in already overburdened emergency rooms. In South Carolina, where most therapists live in or near the capital, a 2009 pilot study turned into an ongoing practice. Psychiatrists now have about 400 remote consultations per month, saving $1,400 per episode.

Such remote counseling does have disadvantages, as counseling sessions require a secure connection because of privacy laws, and it makes a “human touch” impossible.

“A caring touch or handing a patient a tissue can never be possible,” noted Hind Benjelloun, a crisis psychiatrist based in Washington, D.C., who meets with some patients via computer, in an interview with US News and World Report. “I am unable to clearly see self-inflicted wounds or tears.”

But where face-to-face counseling isn’t possible, virtual therapy can help fill a much needed void, proponents say.

“In a more rural area, nobody has access [to psychiatric care],” Geoffrey Boyce, executive director of InSight Telepsychiatry, told US News and World Report. “[Telepsychiatry is] enormously more affordable at that point.”

 

View this story on The Christian Science Monitor.

Innovative ACT Program Utilizing Telepsychiatry to Be Highlighted at American Telemedicine Association Annual Conference

InSight RHD

May 17, 2016 | Representatives from Resources for Human Development and InSight Telepsychiatry will discuss a first-of-its-kind program that brings telepsychiatry to individuals with severe mental illness receiving care through assertive community treatment programs in Delaware.

InSight RHD

Speakers representing Resources for Human Development (RHD) and InSight Telepsychiatry will highlight their unique use of telepsychiatry in two Delaware assertive community treatment (ACT) programs at the American Telemedicine Association Annual Conference on May 17.

InSight telepsychiatrist Shelley Sellinger, MD, and RHD’s Unit Director in Delaware Laura Marvel will present a case study detailing the organizations’ development of a telepsychiatry program for RHD’s ACT teams in Wilmington and Dover, Del., the first program of its kind in the nation. Marvel, who has spent the past 15 years working in Delaware’s mental health system, was a driving force behind the creation of the program. Dr. Sellinger provides 32 hours of scheduled telepsychiatry services per week to RHD’s Dover program from her home office in New York.

Using 4G-enabled laptops and tablets, RHD social workers can bring remote telepsychiatry providers directly to the homes of individuals with severe mental illness participating in RHD’s ACT programs. These in-home visits are used in conjunction with office visits where a telepsychiatrists is also a part of the care team.

ACT programs bring together counselors, psychiatrists, registered nurses, case managers and vocational specialists to help individuals whose mental health conditions cause them significant challenges in working, maintaining social relationships, living independently and managing their health. These providers work with individuals to identify what is preventing them from living a successful life and facilitate independence. The ACT model of care was developed in the early 1970s and was widely adopted in communities across the countries by the end of the decade.

In 2012, Delaware awarded ACT contracts in Dover and Wilmington to RHD, a national human services nonprofit organization, with the goal of discharging consumers from inpatient units and providing them with intensive, 24/7 outpatient care. However, Delaware’s shortage of available psychiatry providers, which reflects national shortages, made it challenging for members RHD’s ACT provider team to come together regularly.

To address this problem, RHD took a unique approach, partnering with InSight the next year to incorporate telepsychiatry into their ACT programs.

The two organizations created a telepsychiatry pilot with two groups of 100 individuals, who were transported to RHD’s two ACT offices to meet with a psychiatrist via videoconference. By using telepsychiatry, RHD maintains a team approach to care, and psychiatry providers maximize the number of individuals they see, since they no longer have to spend time traveling from site to site.

Once RHD and InSight established the efficacy and acceptability of telepsychiatry with individuals in the office-based pilot program, they expanded the program to be able to meet individuals in the community. Instead of bringing individuals to see a telepsychiatrist in their offices, RHD could bring the telepsychiatrist to individuals in their homes or other community spaces using 4G-enabled laptops and tablets.

Today, RHD’s Delaware ACT programs use telepsychiatry both in and outside of their offices. Dr. Sellinger sees individuals in their homes a few times a week via telepsychiatry. She says that iPads have helped increase the volume of in-home telepsychiatry encounters and that individuals love it when she comes to them via the devices.

Seeing individuals in their home environments helps more accurately assess their needs, says Dr. Sellinger. “When you see them in their home, you see if it’s clean or messy, and their family is there,” Dr. Sellinger says. “You really get a sense of what’s going on with them.”

Dr. Sellinger can then use these environmental and social cues as clinical indicators to help her prescribe the best possible treatment for that particular individual.

“Despite the fact that individuals and Dr. Sellinger do not meet in the same location, both parties tend to forget that they’re seeing each other through screens,” says Kathleen Gainey, a registered nurse at RHD’s ACT office in Dover who works with Dr. Sellinger. “It’s as if she’s there in person,” she says of Dr. Sellinger and her ability to connect with individuals.

In-home telepsychiatry from InSight isn’t limited to ACT programs. InSight’s Inpathy network makes it possible for consumers to connect with behavioral health professionals, including many psychiatrists from home.

InSight and RHD’s ATA presentation will take place on May 17 at 4:15 p.m. in room 205A.

InSight will also have two booths at ATA, booth 1909 and booth 515.

For more information, to connect with InSight at ATA, or to schedule a time for a meeting with an InSight representative, contact Olivia Boyce at oboyce(at)in-sight(dot)net or 770.713.4161.

InSight Telepsychiatry to Present at American Telemedicine Association Annual Conference

Screen Shot 2016-06-24 at 1.18.59 PM

May 15, 2016 | InSight Telepsychiatry leaders, providers and partners are presenting this week at the American Telemedicine Association’s Annual Conference and Trade Show in Minneapolis. Their presentations, which will address practicing telebehavioral health in a variety of settings and marketing telebehavioral health to consumers, will draw on InSight’s experience as the leading national telepsychiatry service provider organization.

MINNEAPOLIS — Representatives from InSight Telepsychiatry will give presentations on a variety of telepsychiatry topics during the American Telemedicine Association’s (ATA) Annual Conference and Trade Show May 15 to 17.

On May 17, two InSight providers will present during one of ATA’s 75+ peer-reviewed sessions. The session, called How-To Telemental Health in Non-Institutional Settings, will feature “Fast-Paced Work from the Comfort of Home: Clinical Considerations for Crisis Telepsychiatry,” presented by Doug Ikelheimer, MD and “ACT Now for Innovation: Develop a Telemental Health Program for ACT Teams,” presented by Shelley Sellinger, MD.

Dr. Ikelheimer, a board-certified psychiatrist, will draw on his experience as an InSight on-demand telepsychiatry provider to discuss the benefits of challenges of working in an emergency department (ED) from home.

On-demand telepsychiatry providers offer much-needed psychiatric expertise that can reduce the amount of time consumers in crisis wait for proper care. Dr. Ikelheimer’s presentation will review the steps that need to be taken to establish a successful emergency telepsychiatry program and examine case studies in which individuals were able to receive timely, appropriate care through telepsychiatry in emergency departments.

Dr. Sellinger, also a board-certified psychiatrist, will present a case study that details InSight’s partnership with Resources for Human Development (RHD) to establish a telepsychiatry program with mobile capabilities for two assertive community treatment (ACT) teams in Delaware. The program is the first in the nation to use telepsychiatry in an ACT program and serves as a model for implementing telepsychiatry into ACT programs nationwide.

The program brings a combination of on-site and in-home telepsychiatry services to individuals whose mental health conditions prevent them from working or living independently. With 4G-enabled tablets and laptops, RHD social workers to travel to individuals’ homes or other community spaces to connect them with a remote psychiatry provider.

Laura Marvel, the Unit Director for RHD’s Delaware assertive community treatment teams, will present alongside Dr. Sellinger.

InSight Marketing and Communications Manager Olivia Boyce will present the e-poster, “Telemarketing: It’s Not What You Think — A How-To Guide for Promoting Direct-to-Consumer Telehealth,” on May 15.

Additionally, InSight Business Innovations Manager Scott Baker will moderate the session, “Effectiveness of Automated Speech Recognition Apps,” on May 17. The session will focus on the use of speech recognition apps in behavioral health services, including telepsychiatry.

ATA 2016 is the industry’s leading event for insights into the latest telemedicine and mobile health trends.

InSight is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through innovative applications of technology.

For more information and to connect with InSight at ATA, visit booth 1909 or booth 515, where InSight will exhibit alongside Carenection, a telehealth marketplace that offers a scalable, unified telemedicine solution for organizations and systems implementing telehealth. To schedule a time for a meeting, contact Olivia Boyce at oboyce@in-sight.net or 770.713.4161.

Hospital to Decline Inpatient Psychiatric Unit Grant

Screen Shot 2016-06-30 at 4.33.17 PM

ptleader

April 27, 2016 | By Allison Arthur

Jefferson Healthcare may return a $1.5 million grant it was awarded to build a seven-bed inpatient psychiatric facility and instead, head in a less costly direction that involves two safe rooms and telepsychiatric consulting services.

Jefferson Healthcare CEO Mike Glenn told hospital commissioners April 20 that the cost of building a seven-bed unit would be $2 million–$2.5 million on top of the $1.5 million grant and result in annual income losses of $2 million.

After receiving the grant last year from the state Department of Commerce, hospital officials had lobbied for an additional $1 million in capital funding. The hospital was notified recently that its request wasn’t in the state’s budget.

Hospital Commissioners Jill Buhler, Matt Ready and Kees Kolff thanked Glenn for trying to find a “way to yes,” as Glenn had phrased his hope for the project in early March.

A formal vote on Glenn’s recommendation to return the funding is expected at the May 18 board of commissioners meeting. If the board votes to decline the funding in mid-May, Glenn said, it would go back into a fund earmarked for mental health programs, and some other organization could apply. If the board were to wait longer, Glenn said, the money would go into the state’s general fund.

Instead of moving forward on the inpatient facility, Glenn proposed construction of a two-bed crisis and stabilization unit, which would include the development of programming and a policy and procedure manual as well as continued partnership with Jefferson Mental Health Services.

DISAPPOINTMENT

Commissioner Buhler said Glenn and others had done a “noble and exhaustive” effort and that hospital officials fought for it, too.

Glenn wondered aloud about the merit of “dangling a $1.5 million grant” in front of small hospitals to build a $4 million inpatient facility that would then result in annual losses of $2 million.

That’s when Ready spoke up, saying he, too, applauded the work of hospital officials for “slaving away” to try to make things work. He said the way health care is funded is essentially “criminal.”

As Glenn had explained in March, a concern is Jefferson Healthcare’s status as a critical access hospital (CAH). It’s a designation that helps keep the rural hospital afloat, bringing in more revenue for care than other hospitals might get. But not so with an inpatient psychiatric unit, officials learned.

And although the state had provided money for startup costs of an inpatient unit, the hospital would have had to spend more than the state gave it not only to design and build the unit, but to pay for staff and maintenance. And with the unit, the hospital wouldn’t have received the same level of reimbursement from Medicare as it does now for other services it provides, officials said.

Glenn called it a “penalty,” and said it was unlikely the funding challenges of a critical access hospital would change soon.

He also said that while the state has seen increased funding for mental health projects in the past few years, the state faces a $2 billion–$3 billion shortfall for funding education and so the revenue stream for mental health programs might start to dwindle.

Currently, there are no hospitals in the state with the CAH designation that have inpatient psychiatric units; Jefferson Healthcare would have been the first.

AN OPTION, TELEPSYCH

Seeming to sense earlier this year that “getting to yes” was going to be difficult, Glenn and former Chief Nursing Officer Joyce Cardinal visited Olympic Medical Center in Port Angeles, which has two “safe” rooms, which are used for temporary inpatient psychiatric care.

A mental health task force has already started to work on guidelines for the safe rooms as well as a design for converting two existing acute-care units into safe rooms.

The task force includes registered nurses and others on the Jefferson Healthcare staff, but not Dr. Sue Ehrlich, a psychiatrist. Ehrlich divides her time between Jefferson Healthcare and Jefferson Mental Health Services. Officials said she had been consulted, although she hadn’t been named to the task force; she could not be reached for comment by Leader press time.

No one from Jefferson Mental Health Services spoke out at the meeting. Glenn said the two entities are continuing to collaborate and may be hiring more help together.

The in-hospital task force also has started to look at telepsychiatric consulting services, including one operated by Swedish Medical Center from 7 a.m. to 7 p.m., and one called InSight Telepsychiatry.

Current Chief Nursing Officer Jackie Mossakowski said that telepsychiatric programs have worked elsewhere.

She said that nurses and staff at Jefferson Healthcare have had concerns about safety and such issues as using restraints to protect patients. A safe room where someone could sit and watch a patient going through a mental health crisis is needed, she said.

Mossakowski said goals for the safe rooms would be: increased resources for staff and patient; consistent care; better treatment options, including using less restraint; and increased consultation to improve medication management and help patients through their crisis.

She said it often takes 24-48 hours to stabilize someone in a crisis.

BOARDING QUESTION

To bolster the idea of moving from a seven-bed inpatient facility to a unit with two safe rooms, Glenn also noted that the number of acute psychiatric care (APC) clients in Jefferson County has dropped in the past few years and that roughly 1.5-2 patients a day in Jefferson County seek inpatient care.

Steve Workman, an advocate for people with mental health issues, noted that the state was trying to get away from “boarding” people in hospitals and he said that the two safe rooms seemed like “psychiatric boarding enhanced.”

“The enhancements are particularly profound,” responded Glenn, noting that having a psychiatrist available to consult with staff would be an improvement over what the hospital staff has now, which is a shared psychiatrist.

Glenn also said Jefferson Healthcare has been improving its access to care for people in crisis.

In 2012, according to market-share statistics Glenn presented, St. Joseph Hospital in Bellingham, Fairfax Hospital in Kirkland and MultiCare Auburn Medical Center saw 50 percent of patients from Jefferson County who needed inpatient psychiatric care.

In 2014, those hospitals had 22 percent of the patients, and Jefferson Healthcare’s “market share” had more than doubled to 22 percent as well, up from the 8 percent the hospital had had two years earlier.

After the meeting, Glenn said that the health care system spent roughly $2,500 to assist in the grant application and spent another $3,000-$5,000 to assist developing the grant and a feasibility study. It is unlikely that money can be recouped.

Glenn also said he expects the room revisions to cost less than $100,000. Glenn said he knew going in that it would be difficult to develop a seven-bed facility, but there was hope it could be pulled off. He said that he, too, was disappointed he couldn’t “get to yes.”

See the original article at ptleader.com.

Telepsychiatry and Mental Health

Picture2

Picture1

April 20, 2016 | By Joshua Kendall

See the original article at Undark.org.

Patients who cannot access mental health services — or who are not comfortable seeking help — increasingly do so remotely.

In the wake of the Gulf oil spill in 2010, many rural Louisiana residents became emotionally distressed. With few mental health clinicians practicing in the area, psychiatrists at Louisiana State University decided to try something novel. They set up a video connection between their New Orleans office and small primary care clinics in towns like Hackberry, which sits over 200 miles away and has a population of just over 1,000.

“I treated several crabbers and shrimpers from Hackberry who couldn’t work, were falling into debt and were very depressed,” said Dr. Shih Tan Gipson, a psychiatrist at Boston Children’s Hospital who recently completed her residency at LSU. “With regular therapy sessions, along with medication, I was able to help them get their lives back on track.”

This approach, known as telepsychiatry, has been around for more than a half a century; in 1959, the State of Nebraska used two-way closed-circuit television between the Nebraska Psychiatric Institute and the state mental hospital to aid in the teaching of first-year medical students. Advances in technology over the last 20 years have made telepsychiatry systems much easier to set up and it is now starting to be widely adopted.

Picture2

Telepsychiatry allows patients who cannot access mental health services or are not comfortable seeking help to consult with clinicians via videoconferencing.

The U.S. Department of Veterans Affairs, which began experimenting with ‘telemental health’ in 1995, has been a pioneer in using this method. The VA has already administered over 2 million video mental health sessions with patients and the pace continues to pick up every year. In 2015, 380,000 sessions were conducted using video. At present, about 8 percent of all mental health patients at the VA use telemental health. The VA is now beginning to expand beyond its hub model — in which therapists treat patients at hundreds of community-based clinics across the country — to using phones and tablets.

“We treat patients with every type of DSM-5 diagnosis,” said Dr. Linda Godleski, a professor of psychiatry at Yale and director of the VA’s National Telemental Health Center.

Surveys show that patient satisfaction with this method is about 95 percent. In addition to being able to reach patients in underserved areas and provide easy access to national experts, telemental health has other advantages as well.

“Patients with severe disorders such as schizophrenia often feel more relaxed and are more likely to open up,” Godleski said.

Telemental health has also proved to cut health care costs. In a 2012 survey published in the journal Psychiatric Services, Godleski showed that access to telemental health service reduced hospitalization admissions of VA patients by about 25 percent.

Not everyone embraces the idea that mediated interactions between clinicians and patients are always beneficial, or that they function similarly to in-person therapy. In her 2015 book “Screen Relations: The Limits of Computer-Mediated Psychoanalysis and Psychotherapy,” British psychotherapist and psychoanalyst Gillian Isaacs Russell, PhD., for example, raised questions about the loss of certain non-verbal cues, and pointed to the lack of research comparing the various pros and cons of both in-person and screen-mediated therapy.

Still, most clinicians believe that the technology is now good enough to enable them to spot many standard non-verbal cues, and some states, including New York, have begun to establish formal telepsychiatry standards and guidelines.

While the private sector has been much slower to take advantage of this new technology, the industry leader, Insight Telepsychiatry, which has been in operation since 1999, reports steady growth. In 2015, it had 150,000 patient encounters — a 50 percent increase over 2014. The company now offers services to hospitals and community mental health clinics in 26 states, compared to the nine states it operated in just three years ago.

This year, the American Psychiatric Association set up a telepsychiatry committee, which works to break down two major obstacles to broadening its scope. One involves licensure: Clinicians must be eligible to practice in the same state in which their patients reside. The other involves reimbursement, given that in some states, insurance companies provide little or no coverage. The APA is currently working with doctors in various other fields to make it easier for clinicians to obtain licenses in multiple states. To date, 12 states have signed on to the Federal State Medical Board Interstate Licensure Compact which provides an expedited pathway to licensure and another 14 have introduced similar legislation.

“In 10 years, telepsychiatry may well become a core component of psychiatric care,” said Dr. Peter Yellowlees, a member of the APA committee who teaches psychiatry at the University of California, Davis. “For people under 40, connecting with therapists on screens seems both reasonable and normal.”

See the original article at Undark.org.

St. Joseph’s Villa and InSight Telepsychiatry Bring Psychiatric Care to Children in Crisis Stabilization Unit

InSight St Josephs Villa

April 19, 2016 | St. Joseph’s Villa of Richmond, Va. works with InSight Telepsychiatry to bring telepsychiatry services to their Crisis Stabilization Unit, an innovative program in a unique setting that diverts children in mental health crisis from unnecessary hospitalization.

RICHMOND, Va. — St. Joseph’s Villa is collaborating with InSight Telepsychiatry to bring telepsychiatry to children receiving mental health services at their facility. St. Joseph’s Villa (SJV) provides children and their families with a variety of social services. One of SJV’s many innovative and effective programs is their Crisis Stabilization Unit (CSU), where children experiencing mental health crises can go to receive treatment in an environment that feels like home — all with the goal of preventing costly, unnecessary hospitalization. Since opening in 2012, the CSU has served nearly 500 children and has successfully diverted nearly 90 percent of them from hospitalization. InSight has helped the CSU work toward this goal for nearly two years.

Located in a repurposed cottage with spacious bedrooms and recreation areas, SJV’s CSU’s six-bed facility acts as a hybrid between a residential home and a hospital. This hybrid model allows SJV to offer clinical services, including telepsychiatry, while giving children in crisis a less restrictive environment than that of traditional residential treatment centers.

A first-of-its-kind facility in central Virginia, the CSU was a runner up in the Innovative Practices Award presented by the Council on Accreditation to spotlight organizations that bring lasting change to the lives of vulnerable individuals through unique, forward-thinking initiatives.

Telepsychiatry allows children in the CSU to see psychiatry providers through videoconferencing. With the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to staff in rural and underserved areas. When the CSU opened in partnership with the Richmond Behavioral Health Authority (RBHA) Region IV, SJV found that it was challenging to locate a qualified local child psychiatrist. In terms of mental health providers, several of the counties SJV’s CSU serves are Designated Health Professional Shortage Areas, according to the U.S. Health Resources and Services Administration.1 Ultimately, SJV turned to telepsychiatry as the solution for bringing psychiatric care to their facility.

Telepsychiatry isn’t just a means of bringing access to care. The telepsychiatry medium is able to help these children express themselves better, says Craig Hedley, SJV’s Director of Community Partnerships. “Kids are used to Skyping, but they can be intimidated by adults. Children can relate to them better through a TV screen, which provides them a layer of safety and protection,” he says.

The CSU collaborates with an InSight telepsychiatrist for about 15 hours a week of regularly scheduled services. The telepsychiatrist, Dr. Ashika Kapoor, helps onsite providers assess children’s symptoms and manage their medications.

“There are unique challenges to working at a crisis stabilization unit, but I really enjoy being a part of a team approach,” Dr. Kapoor says. “The staff at St. Joseph’s Villa are a wonderful group of individuals who do amazing work together as a team.”

According to Hedley, Dr. Kapoor is a flexible asset to this team-oriented approach and goes out of her way to help the team help the children for which they care.

“Dr. Kapoor is extremely invested in our program,” Hedley says. “Her responsiveness is incredible.”

The relationship between the InSight telepsychiatry provider and onsite staff is vital to the success of SJV’s CSU program.

“InSight believes in the importance of partnering with innovative, like-minded organizations and working hard to find the right fit between our psychiatrists and our partners,” says Geoffrey Boyce, Executive Director of InSight. “Integrating Dr. Kapoor onto the St. Joseph’s Villa CSU team has been a wonderful success.”

InSight Telepsychiatry is the leading national telepsychiatry service provider with a mission to increase access to appropriate behavioral health care. Telepsychiatry has been proven an effective and cost-conscious way to bring psychiatric care to children.2 Forty percent of InSight’s telepsychiatry providers are child and adolescent psychiatrists.

“The partnership between InSight and St. Joseph’s Villa shows how we can combine modern technology and personal touch to offer a meaningful and potentially life changing service to patients and families in their time of need,” says Dr. Kapoor. “Together we are able to help children and families through a difficult time in their lives and provide them with opportunities to succeed.”

 

[1] http://datawarehouse.hrsa.gov/tools/analyzers/HpsaFind.aspx

[2] Myers, K. M., Valentine, J. M., & Melzer, S. M. (2008). Child and Adolescent Telepsychiatry: Utilization and Satisfaction. Telemedicine and EHealth, 14(2), 131-137. doi: 10.1089/tmj.2007.0035

Spectrum Health & Wellness Partners with InSight Telepsychiatry to Increase Access to Psychiatric Care in Franklin County

Screen Shot 2016-06-30 at 4.52.27 PM

December 18, 2016 | Spectrum Health and Wellness of Chambersburg, PA has launched a new program to enhance their existing psychiatric services with telepsychiatry providers from InSight Telepsychiatry. This innovative program will ensure that individuals seeking psychiatric treatment at Spectrum Health & Wellness have access to the quality psychiatric care they need.

Chambersburg, PA— Spectrum Health & Wellness is pleased to announce that they now have increased psychiatric coverage in their outpatient behavioral health services. Spectrum Health & Wellness, LTD offers a range of psychiatric and behavioral health services including psychiatric evaluations and psychotherapy in a community setting.

The new scheduled telepsychiatry services allow coverage for psychiatric evaluations, follow-up consultations and medication monitoring for Franklin County residents.

The program is a result of a collaboration between Spectrum Health & Wellness and InSight Telepsychiatry. When an individual comes to Spectrum Health & Wellness requiring psychiatric care, the onsite staff can now connect them with a remote telepsychiatry provider from InSight for regularly scheduled services. InSight’s telepsychiatry provider will be available in regularly scheduled blocks of time to meet with healthcare consumers for services or with onsite staff for consultation.

The relationship between the InSight telepsychiatry provider and onsite staff is vital to the success of this program. Since June 2015, telepsychiatry provider Melanie Pointer, MD has been working with the Spectrum Health & Wellness team.

“InSight believes in the importance of integrating our services into the existing model of care and works hard to find the right fit between our psychiatrists and the partners they serve,” says Geoffrey Boyce, Executive Director of InSight. “Integrating Dr. Pointer onto the Spectrum team has been a wonderful success.”

“Dr. Pointer has been a wonderful complement to our telepsychiatry services. She quickly related to both our unique member population and our staff. Her professionalism and dedication to our agency is beyond comparison,” said Dinen Sanders, Clinical Director at Spectrum.

Because of the option to utilize remote providers, telepsychiatry and other telemedicine services represent unprecedented access to specialists who are typically difficult to staff in rural and underserved areas. A striking 96% of US counties, including Franklin County, where Spectrum Health & Wellness is located, have a shortage of psychiatric prescribers . With the new telepsychiatry program, individuals will not only have more access to high-quality care, but to care that’s appropriate for their specific needs.

Sanders says the program is focused primarily on being able to offer the same quality of care as the onsite doctor services, but with a quicker turnaround time for the patient who is willing to accept telepsychiatry services.

“We’re excited that this program will reduce the stress put on our internal team and help the people we treat get care that meets their needs. “

“Because we’re rural, our system of care has to make use of every viable option,” says Sanders. “Since implementing this program we’ve seen a definitive increase in the amount of people we are able to help.”

InSight Telepsychiatry is the leading national telepsychiatry service provider with a mission to increase access to appropriate behavioral health care.

The Value of Telepsychiatry in the ED – 6 Benefits to Cutting Psychiatric Boarding Through Telemedicine

Screen Shot 2016-06-24 at 5.13.01 PM

Picture5

August 15, 2015 | By Olivia Boyce and Christopher Adams

Originally published in Telemedicine Magazine.
One solution that is helping to reduce psychiatric boarding in EDs across the country is on-demand telepsychiatry.

Hospitals throughout the nation are plagued with psychiatric patients boarding in their emergency departments (EDs). The wait times for psychiatric patients to see a psychiatrist for that evaluation can take hours or even days. A report of 300 ED directors found that 41 percent of EDs have a wait time of over two days to see a psychiatrist.[1]

One solution that is helping to reduce psychiatric boarding in EDs across the country is on-demand telepsychiatry.

“The goal of on-demand telepsychiatry evaluations is for the remote psychiatrist to decide on the most appropriate and least restrictive level of care,” says Dr. Jim Varrell, Medical Director of InSight Telepsychiatry, the largest private telepsychiatry company in the U.S.

“By having a psychiatrist available to do the assessment, on-demand telepsychiatry programs help hospital systems avoid inappropriate admissions, shorten length of stays and improve overall ED patient flow,” explains Dr. Varrell.

1. Shorten ED Wait Times

According to Dr. Varrell, with on-demand telepsychiatry, psychiatric assessments are able to occur within about an hour of a request on average. Since psychiatric patients typically spend over three times longer in the ED than medical patients,[2] telepsychiatry’s timeliness means that psychiatric patients are able to move on to the next level of care much more quickly.

This improvement results in shortened wait times for all patients within the ED, and ultimately an increase in revenue for the hospital system.

2. Increase Hospital Revenue

A study done on the impacts of psychiatric boarding found that boarders prevent an average of 2.2 bed turnovers which results in a lost opportunity cost for the hospital of $2,264 per psychiatric patient.[3] By implementing telepsychiatry and improving the rate of bed throughput, a hospital is ultimately able to increase revenue.

3. Reduce Inappropriate Commitments

Another way telepsychiatry programs are adding value to hospital systems is by reducing costly inappropriate commitments.

South Seminole Hospital in Longwood, Fla. is an Orlando health facility that implemented a telepsychiatry program in November 2014. Through videoconferencing, South Seminole’s ED staff accesses a telepsychiatrist when they have difficult cases or when they need to determine whether an individual who came in under Florida’s civil commitment law, merits psychiatric hospitalization. According to the hospital’s data, during the first six months of the program, one third of the involuntary commitments assessed by telepsychiatrists were rescinded.[4]

“Telepsychiatry allows us to make sure that the psychiatric patients in our ED move on to the most appropriate treatment, whether that is hospitalization or community-based care quickly,” says Charles Webb Manager of the ED at South Seminole Hospital. “When patients don’t have to wait as long for care, they are able to get on a path to better health sooner.”

4. Improve Compliance with Joint Commission Standards

Access to timely care means that hospitals are more likely to be able to meet standards for patient care set by regulating bodies like The Joint Commission who advocate that patient boarding times not exceed four hours.

“When hospitals are able to reduce psychiatric boarding from say 14 hours to under four, there are other financial benefits,” explains Dr. Varrell. “The average sitter for a psychiatric patient costs $15 per hour. By cutting 10 hours from the time a psychiatric patient waits for care, that’s $150 per patient saved on just sitter costs.”

5. Empower and Support Onsite Staff

At a more operational level, the implementation of a telepsychiatry program is reported to better empower onsite staff to handle psychiatric patients. For example, after a telepsychiatry program had been in place for several months at Chester County Hospital in Pennsylvania, the hospital saw an increase in their clearing and placing psychiatric patients without telepsychiatry because staff reported greater confidence in their abilities to assess difficult cases knowing that they had a specialist available for consult or assessment when needed.[5]

Dr. Varrell explains that this case study is an example of why collaboration between remote and onsite staff lends itself to the most effective telepsychiatry programs. “Telepsychiatrists are most effective when they establish a rapport and team-approach with the onsite staff. The remote psychiatrists benefit from onsite staff sharing difficult-to-collect information like odor or agitation in the waiting room while the onsite staff benefits from having the expertise of a team of psychiatrists who they know and trust on-call.”

 6. Expand Psychiatric Capacities Within Hospitals and Beyond

Because telepsychiatrists are able to work from remote or home offices and don’t have to be in-person at the emergency department, it is much easier to staff difficult hours like weekends, nights and holidays.

Ultimately, establishing an ED telepsychiatry program can set up a health system to more effectively manage the psychiatric needs of an entire community or population. In addition to using telepsychiatrists within EDs, many systems are also expanding programs into other settings within the hospital and beyond.

“It’s important to design a telepsychiatry system with growth in mind from the beginning,” explains Dr. Varrell.

For example, hospitals are using telepsychiatry on their med/surg floors and on their inpatient units for weekend and overnight rounding.

Within communities, telepsychiatrists commonly serve community mental health centers, outpatient clinics, correctional facilities, primary care offices and other settings where it is difficult to staff and retain onsite physicians.

More creatively, newer direct-to-consumer models of telepsychiatry are gaining popularity as a convenient way to access services and follow-up care outside of a traditional setting and potentially from home or another private space. Some health systems and insurance companies are beginning to refer psychiatric patients leaving the hospital to in-home telehealth options that make them more likely to attend their follow up appointments and less likely to end back up in the hospital.

“Telepsychiatry can be challenging to implement because it’s a change and it requires the buy-in of many parties,” says Webb. “But ultimately, the return on investment is clear.”

Sources

[1] Schumacher Group. (2010) Emergency department challenges and trends. 2010 survey of hospital emergency department administrators.

[2,3] Nicks and Manthey. “The Impact of Psychiatric Patient Boarding in Emergency Departments.” Emergency Medical International. 2012.

[4] Orlando Health Telepsychiatry Data 2014-2015.

[5] Cuyler, Robert. Chester County Hospital Emergency Psychiatry Case Study, 2012.

 

Originally published in Telemedicine Magazine.

Telepsychiatry 101 | What Healthcare Organizations Need to Know

telepsychiatry 101

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 Leader Predicts Major Industry Changes

telepsychiatry leader predicts

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.

InSight Telepsychiatry Launches New Telepsychiatry Resource-Driven Campaign for ACOs, Health Systems and Hospital Systems

ACOs press release

March 27, 2015 | InSight Telepsychiatry, the leading national telepsychiatry service providers have launched a new campaign aimed at helping health systems, hospital systems and ACOs utilize telepsychiatry best practices to expand their psychiatric capacity and increase access to care.

Marlton, NJ— InSight Telepsychiatry is launching a special campaign on telepsychiatry for large healthcare systems, large hospital systems and accountable care organizations (ACOs). Telepsychiatry, or the application of technology to field of psychiatry, can help healthcare organizations increase their psychiatric capacity and increase access to care.

InSight has been working with large health systems, hospital systems and ACOs for several years and has learned a number of lessons along the way that they apply to new programs. Their experience proves that connecting an entire system through telepsychiatry results in better outcomes, reduced costs and increased consumer engagement. The InSight team has compiled many of their best practices into the resources created for this campaign.

The campaign to connect healthcare organizations with viable, usable telepsychiatry-related resources includes a live webinar series and a white paper series as well as opportunities to meet and discuss an organization’s specific needs through easily competed registration on the InSight website.

Resources will offer insight into individualized telepsychiatry program design, improving ED throughput with on-demand assessments, evaluating direct and indirect cost benefits in different settings, overcoming regulatory and protocol barriers to new programs and engaging consumers to facilitate care across a community.

For large hospital systems, registration is now open for the live webinar, “Reducing Readmissions and Improving ED Throughput with Sustainable Telepsychiatry Strategies” on April 1st at 2PM EST. Interested parties can also download a copy of a white paper, request a meeting with a telepsychiatry expert or request a complimentary ROI audit for their organization.

For large health systems, registration is now open for the live webinar, “Reducing Readmissions, Improving ED Throughput and Expanding Behavioral Health Services Across a System Using Sustainable Telepsychiatry Strategies” on April 2nd at 2PM EST. Interested parties can also download a copy of a white paperrequest a meeting with a telepsychiatry expert or request a complimentary ROI audit for their organization.

For ACOs, registration is now open for the live webinar, “Improving Behavioral Health Services Across a System Using Sustainable Telepsychiatry Strategies” on April 3rd at 2PM EST. Interested parties can also download a copy of a white paper, request a meeting with a telepsychiatry expert or request and complimentary ROI audit for their organization.

InSight is the telepsychiatry arm of the CFG Health Network, a broad based healthcare provider dedicated to increasing access to care via innovative applications of technology. Its current leaders, Dr. Jim Varrell MD, Medical Director and Les Paschall, CEO established the CFG Health Network in 1997. CFG’s first model for telepsychiatry was developed with South Jersey Hospital of southern New Jersey in 1999.

InSight is now the leading national telepsychiatry provider company with a mission to increase access to behavioral health care. InSight is currently delivering services in 23 states and rapidly expanding into new states and settings across the country. InSight employs over 200 psychiatric prescribers who serve partner organizations throughout the nation and also runs Inpathy, an online network of behavioral health providers who conduct services entirely online.

Telepsychiatry Can Help Increase Access to Psychiatric Care in Rural Illinois

Screen Shot 2016-06-30 at 4.43.04 PM

bulletin

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

Picture4

Picture3
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.

St. Anthony Hospital Expands Its Telemedicine Program With Telepsychiatry

Insight and St. Anthony

June 19, 2014 | St. Anthony Hospital’s newly launched telepsychiatry program provides eight rural Oklahoma hospitals with needed access to a child and adolescent psychiatrist and aims to improve psychiatric services across the state. St. Anthony’s telepsychiatry program is an expansion of their existing telemedicine program, the largest in the state, which has been used for radiology, cardiology, endocrinology, and dermatology for the past 4 years.

Telepsychiatry Delivers Help to Far-flung Patients

Portrait of psychiatrist Dr. Daniel Martinez, who runs a telepsychiatry program to serve clients in rural areas and to help alleviate waiting lists, Wednesday, October 2, 2013 in Lombard. He is in his offices at Comprehensive Clinical Services.  (Chuck Berman/Chicago Tribune)  B583231690Z.1 ....OUTSIDE TRIBUNE CO.- NO MAGS,  NO SALES, NO INTERNET, NO TV, CHICAGO OUT, NO DIGITAL MANIPULATION...

trib
October 23, 2013 | By Kay Manning, Special to the Tribune
See the original article at the Chicago Tribune.

Practice is increasingly used to serve people in rural areas, the deaf and military veterans.

The 17-year-old girl had just been released from a Streamwood hospital after threatening suicide, psychiatrist Dan Martinez remembers.

 

He asked the girl to look her caseworker in the eye and promise that she would not harm herself.

 

She did, Martinez said. But watching her on a large-screen TV in Des Plaines as the teen spoke from a youth facility about 100 miles west of there, he was unconvinced. He asked her if she really meant it and when she hesitated, he tweaked the commitment — from open-ended to not hurting herself for a week, and if she had suicidal thoughts, to reach out to him, her parents or her caseworker.

 

“I told her, we’re not mind readers,” said Martinez, who was using telepsychiatry to treat youths sent to the facility in Nachusa, Ill., for substance abuse or behavioral issues.

Portrait of psychiatrist Dr. Daniel Martinez, who runs a telepsychiatry program to serve clients in rural areas and to help alleviate waiting lists, Wednesday, October 2, 2013 in Lombard. He is in his offices at Comprehensive Clinical Services. (Chuck Berman/Chicago Tribune) B583231690Z.1 ....OUTSIDE TRIBUNE CO.- NO MAGS, NO SALES, NO INTERNET, NO TV, CHICAGO OUT, NO DIGITAL MANIPULATION...

Portrait of psychiatrist Dr. Daniel Martinez, who runs a telepsychiatry program to serve clients in rural areas and to help alleviate waiting lists

Telepsychiatry, which connects patient and doctor through technology, is poised to expand in Illinois under legislation being negotiated to mandate its coverage by private insurers.

 

 

Used for years to treat military veterans, the deaf and patients in rural areas where

psychiatrists tend to be scarce, telepsychiatry is increasingly being considered for other underserved areas — including poorer parts of cities like Chicago — as a way to provide needed mental health services and reduce medical costs.

 

It’s also used in prisons, where the number of inmates with mental health issues is steadily growing. A recent report on Illinois’ youth prisons in response to a class-action lawsuit filed by the American Civil Liberties Union found the system to be violating the constitutional rights of youths by failing to provide adequate mental health care.

 

Insurance coverage of mental health issues, including substance abuse, has been spotty, but that changes under provisions of the Affordable Care Act taking effect next year. Insurance plans offered in the new marketplaces must have a core set of services and include behavioral health treatment, counseling and psychotherapy.

 

Studies by the U.S. Department of Veterans Affairs and others have shown telepsychiatry to be as effective as face-to-face treatment and sometimes more efficient in monitoring medications and symptoms because sessions are easier to schedule and involve other doctors, parents and caregivers.

 

Private companies and nonprofits — such as Lutheran Social Services of Illinois, which operates the Nachusa facility — offer telepsychiatry. So do psychiatrists in private practice and primary care physicians, who treat the majority of mental health patients.

 

Still, telepsychiatry has been held back, say proponents, because of the expense and security of videoconferencing equipment, licensing requirements and the lack of reimbursement for patients with private insurance. Legislation proposed in Congress in late September addresses one of those hurdles. It would allow the treatment of Medicare patients via telemedicine without doctors being required to have multiple state licenses, which has been a financial and administrative burden.

 

And in Illinois, the Illinois Psychiatric Society and Blue Cross Blue Shield have drafted a bill that would mandate the coverage of telepsychiatry by private insurers. Now, doctors treating Medicaid patients can be reimbursed, but patients who pay premiums can’t choose telepsychiatry and recover the cost, said Meryl Sosa, executive director of the society.

 

“So they get less care if they have private insurance,” she said.

 

Blue Cross Blue Shield, which has about half of the private insurance market in Illinois, sees the trend toward telemedicine, said Dana Popish, director of government affairs, and “because it affects our business, we wanted to be involved. When something new is coming out, we want to make sure it’s implemented properly.”

 

The shortage of psychiatrists is well known — with an estimated 70 percent of rural counties in the state lacking any — which leads to care by nonmental health specialists or no care at all. Lutheran Services stepped in to help at the Nachusa home because no psychiatrist could be found to visit there, Martinez said.

 

“I’ve worked in rural Illinois, and often patients get less quality care and are seen less frequently,” said Martinez, who operates Comprehensive Clinical Services, based in Lombard. “To ask individuals to travel one to two hours is impractical and unreasonable.”

 

Vets Got Support

 

Geography played a big role in why veterans decades ago were offered telemedicine, which includes counseling by psychologists or social workers. The VA recognized that specialists in substance abuse and post-traumatic stress disorder tended to be at facilities in metropolitan areas while many patients sought help at smaller clinics.

 

“Telemental health services have revolutionized mental health care delivery in the U.S. Department of Veterans Affairs by expanding access to services through use of remote videoconferencing,” said a 2012 article in a psychiatric journal outlining results of a study of almost 100,000 veterans using telemedicine from 2006 to 2010.

 

The study found that psychiatric admissions to hospitals decreased by an average of 24.2 percent among patients six months after beginning remote videoconferencing compared with the six months before. In addition, the days of hospitalization dropped by an average of 26.6 percent for those who had to be admitted. The study’s authors suggested more detailed study of the cost savings and outcomes of telemedicine patients compared with those getting face-to-face care.

 

Quality and frequency of care have long been reasons why telepsychiatry is effective for the deaf and hard of hearing, said Lisa Foster, a clinical therapist at Advocate Illinois Masonic Medical Center’s behavioral health services department.

 

“Use of a videophone has really given us an option to continue to provide services to the deaf and hard of hearing who truly need mental health and psychiatric medication services, but cannot secure transportation or find services closer to home,” Foster, who is hard of hearing, wrote in an email.

 

Clients for the center’s deaf and hard of hearing program, for which she works, are in Chicago and the suburbs.

 

While the psychiatrist in the program does not use American Sign Language, a licensed ASL interpreter sits in on sessions. There are too few such interpreters, she said, and if they had to travel throughout the region for appointments, fewer people could be seen.

 

With “deafness an invisible disability that is often overlooked,” Foster said, it’s important that therapists be sensitive to issues particular to the deaf, something generally not possible in offices or facilities serving few deaf patients. Concentrating services and specialists in one place and connecting them to patients via technology is very efficient, she said.

 

Telepsychiatry takes some getting used to, said Martinez and Olivia Boyce, marketing coordinator for InSight Telepsychiatry LLC, a New Jersey-based private provider.

 

“We offer training on how virtual encounters are slightly different,” Boyce said. Doctors have to look into the camera and learn to compensate for not having the ability to see — or smell — details such as whether the patient has poor hygiene. “But we’ve found it’s as effective as face to face,” Boyce said. “Children, in particular, are very receptive; they use technology for everything.”

 

Martinez said he’s learned to pay more attention because this “”is a setting where one needs to be glued to the TV.”

 

He’s mastered the controls to allow him to observe a patient from closer up than if he maintained typical personal space in a room.

 

“This is never ideal and should never substitute for face to face,” he said. “But I’ve come to feel very comfortable and in some ways better,” because he has more information — from a nurse, case manager or parent, if the patient is a child or adolescent.

 

“I have never felt like the patient or family had qualms about inadequacy of the service,” he said.

 

Martinez believes the system he uses to communicate is secure. Yet he is dissuaded from using telepsychiatry in his private practice, where he supervises 10 psychiatrists, because of the cost of the equipment and the measures needed to ensure security.

 

He and others do see telepsychiatry evolving, especially in underserved urban settings and in hospital emergency departments where mental health patients either have to wait hours for an evaluation or are admitted without one because of uncertainty over their condition. In an era of cost containment, quicker and more precise evaluations make sense, Martinez said.

 

InSight Telepsychiatry was hired earlier this year to provide consultations 24/7 for patients in the emergency departments of hospitals in two Illinois cities — Galena and Freeport — as part of a pilot program funded by a grant channeled through the Metropolitan Chicago Healthcare Council.

 

And, according to Boyce, MCHC and InSight recently have developed a “telepsychiatry solution to support the substantial demand for services at Chicago-area hospitals.”

 

School Had Help

 

Advocate Illinois Masonic provided telepsychiatry services to Ames Middle School in Chicago’s Logan Square neighborhood for about three years until the spring, when grant funds ran out. The need was great, said Odalinda Avila, who was a counselor with Illinois Masonic at the school for five years.

 

“There were a lot of issues in these families that were struggling with limited finances,” Avila said, with students suffering attention deficit hyperactivity disorder, depression, dysfunction and the inability to handle certain situations.

 

Up to 20 percent of children and adolescents in the U.S. are said to suffer from significant mental health disorders and it’s estimated only 1 in 5 is receiving treatment, experts say.

 

A psychiatrist was brought in when the problems of an Ames student were affecting school and interrupting sleep, Avila said. If medication was advised to stabilize the situation, a parent had to be involved, but often that didn’t happen, causing treatment to be truncated.

 

“There was a lot of frustration on my part, the school’s part and the child’s part,” Avila said. “There was a real need to reach out to parents and educate them. Some were just not involved, and in some Latino families, there were myths and stereotypes on what it means to take medication.”

 

Denise Shaeffer, a clinical psychologist and coordinator of outpatient services for Illinois Masonic’s behavioral health services, said telepsychiatry at the school’s medical clinic seemed like a good answer, but in the end it was underused.

 

“Of those who used it, they overwhelmingly loved it,” Shaeffer said, but too few parents of students referred for the services followed through and there was no care in the summer.

 

Carroll Cradock, a psychologist and telemedicine consultant in Chicago, was involved early on with trying to bring telemedicine to school-based clinics.

 

“The need is growing in urban areas,” she said, because of language barriers, transportation issues and the very real fact that some children find it dangerous to cross gang boundaries to try and reach a mental health clinic. “Some kids will use school-based services because they don’t have to go somewhere else,” she said. “They think of the school clinic as their medical home.”

 

Telemedicine also helps adult patients in urban areas, she said, by integrating mental health care with medical care. She cited a new mother who may have post-delivery physical issues and postpartum depression. Her care for both can be coordinated via technology.

 

Dr. James Varrell, medical director of InSight Telepsychiatry, has been using the technology for almost 15 years and also knows the possibilities.

 

“The increased access to care from telepsychiatry makes it easier to address behavioral health concerns before they reach a level of crisis or tragedy,: he said in an email. “Telepsychiatry may seem like an innovative model of care today, but in a few years, it will be commonplace.”

 

 

See the original article at the Chicago Tribune.

North Point Behavioral Health Introduces Telepsychiatry Program To Enhance Mental Health Care In St. Clairsville and Bethesda, Ohio

North Point 2012

June 26, 2012 | Bethesda, Ohio – North Point Behavioral Health has always been committed to providing comprehensive mental health care that improves quality of life and reduces the effects of mental illness, addiction and trauma on community members.

At the beginning of the July, North Point will launch a new telepsychiatry program that will further enhance their behavioral health services.

The Delaware Rural Health Initative (DRHI) Annual Conference Emphasized Telemedicine As a Tool for Increasing and Improving Behavioral Healthcare

DRHI 2012

June 1, 2012 | Over 140 people attended the annual conference entitled “Continuing the Journey Towards Access & Excellence in the Southern Delaware Mental Health System.” Medical, governmental, educational, and business leaders updated attendees on innovations in relevant Delaware healthcare realms. The conference served as the forum for Secretary of the Department of Health and Social Services Rita Landgraf to officially announce that Delaware will begin to reimburse for telemedicine starting July 1. In the spirit of this announcement, many of the presentations, including one from leaders at InSight Telepsychiatry, stressed technology as a tool for improving rural health care.

 

Adolescents Respond Positively to Behavioral Healthcare Delivered through Televideo Equipment

DART 2012

May 22, 2012 |

Three months ago, the Developmental Adolescent Residential Treatment Program (DART) at Hope Network began beaming in a remote psychiatrist to do intake evaluations and follow up medication management for their young residents. Both staff and consumers are pleased with the level of care provided via telepsychiatry from InSight Telepsychiatry; Young people find safety and amusement in seeing psychiatrists on a television screen rather than in person, while staff enjoys the efficient and consistent physician telepresence.

Other Telebehavioral Health Services

shutterstock_60412354

shutterstock_60412354

In addition to psychiatry, InSight can offer all other levels of behavioral health services through telehealth. InSight has a large network of behavioral health providers including counselors, therapists, social workers and psychologists who we work with to service the comprehensive behavioral health needs of any organization or individual, all through telehealth. With InSight’s Inpathy division, individuals can directly access these professionals from the comfort and convenience of their own homes or other private spaces. Insurance companies, employers and EAPs can also partner with InSight to offer Inpathy behavioral health services to members or employees.

 

 

Telepsychiatry for Primary Care Centers

primary care telepsychiatry


primary care telepsychiatry
InSight provides telepsychiatry services to primary care centers, outpatient offices and a variety of other settings across the nation. Primary care offices can utilize telepsychiatry or telebehavioral health providers for consults, treatment team meetings, regularly scheduled co-located behavioral health appointments and more. 

 

Scheduled Telepsychiatry Positions

routine telepsychiatry

scheduled telepsychiatry

InSight’s scheduled telepsychiatrists work regularly scheduled hours and build lasting relationships with a consistent patient base. Scheduled telepsychiatrists work with diverse consumers who often would not receive psychiatric care without telepsychiatry. Scheduled telepsychiatrists work with onsite professionals to fully integrate behavioral health into the larger system of care of the facility and the community. InSight is hiring psychiatrists and psychiatric nurse practitioners for scheduled telepsychiatry positions in multiple states.
Scheduled Telepsychiatrist Job Description

To start the process, read through our InSight Employment FAQ, then Connect with us!