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InSight Telepsychiatry to Present at the National Council Conference

WASHINGTON, DC – InSight Telepsychiatry, the leading national telepsychiatry provider organization with a mission to increase access to behavioral health care, will be presenting at the 2018 National Council Conference held in Washington, DC from April 23 – 25, 2018. Select InSight representatives are presenting two workshop posters, as well as speaking on a panel discussing telebehavioral health strategy.

On Monday April 23 InSight’s Northeast account executive, Dan Khebzou, is presenting a workshop poster:  “ACT Now: Expanding an Assertive Community Treatment Program Using Telebehavioral Health.”

Khebzou’s Assertive Community Treatment (ACT)  presentation will describe how telepsychiatry can be used to support ACT programs. When Delaware became the first state to merge telepsychiatry with ACT in 2014, it was a partnership between the national human services nonprofit organization, Resources for Human Development, and InSight. The option to supplement ACT programs with telebehavioral health is significant because it offers a clearly defined model, and is clinically appealing to practitioners, financially appealing to administrators and scientifically appealing to researchers. This presentation will give c-suite executives and healthcare administrators an overview of how telebehavioral health can support ACT teams, provide lessons learned from both organizations and show how this program could be replicated in other communities, and learn how one program used telebehavioral health to serve more patients through ACT.

On April 24, InSight’s Mid-Atlantic account executive Aaron Lawler will be presenting a workshop poster with the director of community partnerships of St. Joseph’s Villa, Craig Hedley. The presentation, “Addressing Crisis in a Community Setting: Using Telepsychiatry to Provide Crisis Stabilization Services for Vulnerable Children and Adolescents,” will be centered on the unique benefits of telepsychiatry for children and adolescents in crisis. Lawler and Hedley will describe the opportunities for integrating telepsychiatry into a unique community setting and population, as well as the best practices for supporting a crisis stabilization unit for children via telehealth.

Additionally, InSight CEO Geoffrey Boyce will sit on a panel on April 24. The panel discussion, “Creating a Telebehavioral Health Strategy,” will focus on how organizations can integrate telehealth into their current services and future strategies to add value at the consumer, provider, organizational and community levels. The panel will reiterate the significance of creating those strategies, evaluate the challenges and nuances of integrating telebehavioral health into the outpatient setting, as well as explore how organizations can design and implement a successful long-term telebehavioral health strategy at their organization. Other panelists include Jonathan Evans, CEO of InnovaTel, Samir Malik, executive vice president and general manager of Genoa Telepsychiatry. It will be moderated by Joe Parks, MD, medical director of the National Council of Behavioral Health.

Visit booth 447 during the conference to connect with InSight and learn more information about its outpatient services. InSight’s programs for outpatient organizations are run through its scheduled services division. With scheduled telepsychiatry, InSight assigns a consistent provider or small group of providers to serve a regular caseload of consumers. These providers are available in set blocks of time to do anything that a traditional in-person telepsychiatry provider would do.

To schedule a time to meet with an InSight representative, contact Stephanie Clark at sclark@in-sight.net or 240.252.9286.

Delaware Takes Its ACT to the Next Level

A Delaware ACT team conducts a weekly briefing with its telepsychiatrist.

Delaware is known as the “First State” since it was the first colony to ratify the United States Constitution, but that motto can also apply to another bold step undertaken in the state more recently. A few years back, Delaware became the first state to merge telepsychiatry with assertive community treatment (ACT).

Two teams managed by the nonprofit Resources for Human Development (RHD) have been using telepsychiatry since 2014. The teams are known as RHD Kent ACT2 and RHD New Castle ACT2 and are based in Dover and Wilmington, respectively.

For some, it may seem an odd pairing. A core aspect of ACT—a proven therapy for severe mental illness such as schizophrenia—is the idea of face-to-face contact. Multidisciplinary ACT teams meet with patients both in clinics and in their communities (at home, at work while on lunch break, or at another similar location in the community) to help patients recover and reintegrate into society.

Could this model still work if the ACT psychiatrist was present via an iPad or similar device?

“I had some concerns about telepsychiatry coming in, since I thought many clients wouldn’t want to talk to a television, but it has not been a problem at all,” said Shelley Sellinger, M.D., a New York–based psychiatrist and mental health consultant for the Kent ACT team. “A couple of patients had some wariness initially, but they warmed quickly. I even had one patient with television-related paranoia, but he was totally fine with the arrangement.”

Laura Marvel, director of RHD Kent ACT2, agreed. “It doesn’t matter if the psychiatrist is in person or on a screen,” she told Psychiatric News. “If we have access to a good doctor, it doesn’t matter where the doctor is.”

The incorporation of telepsychiatry was born out of necessity. In 2012, Delaware awarded ACT contracts to RHD to help provide better outpatient care to people with severe mental illness such as schizophrenia. RHD found out quickly that getting psychiatrists involved was difficult given the time commitments; in addition to traveling across the state to make scheduled or emergency house visits, ACT team members meet weekly to discuss patient progress.

Around that time, Dan Khebzou, an account executive with the telepsychiatry firm InSight, was meeting with RHD administrators in Philadelphia to discuss service options. He heard about the difficulties RHD was having in hiring psychiatrists for the newly formed ACT teams and suggested the telepsychiatry option.

“I’ve encountered resistance in using telepsychiatry for vulnerable populations from regulators; they cite issues such as licensing, technical problems, or handling civil commitments through video,” said Khebzou. “But Delaware was willing to embrace telepsychiatry, so it presented an opportunity to prove this model.”

After a successful pilot program, RHD moved full steam ahead with telepsychiatry in 2014, and the program is still going strong today, Marvel said. Besides patient acceptance, she said that other ACT team members—which include case coordinators, nurses, and social workers—are on board with the technology. They have not seen Sellinger’s participation via video during their weekly team meetings as hindering the team dynamic.

If anything, Sellinger said, the remote aspect can help build some relationships with the team. “I can conduct most assessments remotely as well as in person, but there are elements that are difficult, such as testing AIMS (Abnormal Involuntary Movement Scale) or rigidity,” she said. “In these cases, the on-site nurses are my eyes and ears, and we communicate about what’s going on. In addition, they will let me know about hygiene if it’s pertinent, so they also are my nose.”

There are occasional technical glitches as well, but Marvel said the teams have established back-up plans to reach Sellinger in case of some malfunction with the video monitor used in the clinic or the iPad used on the road. “I’ve found Dr. Sellinger is as accessible to me or the team as an on-site person would be,” she said. “Sometimes even more so; maybe there is a sense of overcompensating since she can’t be physically present.”

“ACT is a wonderful way to provide care to persistently ill folks who might not be able to get care otherwise,” Sellinger said. “However, it is a demanding job to go into communities every day and work with these individuals, and it can lead to psychiatrist burnout. This telepsychiatry model has allowed me to continue to practice and give care longer than I might have otherwise.”

Original article published on Psychiatric Times

InSight Applauds Changes to Delaware Telemedicine Guidelines Supporting Further Access to Behavioral Health

July 6, 2015 | Delaware recently amended its legislation to mandate parity for private insurers’ coverage of telemedicine services and to further clarify the scope of practice for several kinds of healthcare providers. The legislation was put forward and promoted by a team of leaders and regulators from several notable Delaware organizations.

With recent regulatory changes, Delaware will now require private insurers to reimburse for telemedicine services at the same rates for which they cover in-person services. They also have expanded the scope of practice provisions of telemedicine service delivery for a range of health care providers licensed in Delaware.

The changes were put forth as two amendments to House Bill 69, the “Delaware Code of Relating to Telemedicine Services,” and were sponsored by House Rep. Bryon Short and Sen. Bethany Hall-Long in the Senate. The amendments were the result of collaboration from several key players in healthcare best practices and legislation including the Delaware Medical Society, the Division of Substance Abuse and Mental Health, the Delaware House of Representatives and the Delaware Telehealth Coalition.

House Bill 69 was introduced this past March and passed by the House in early April and by the Senate in early May, both by unanimous votes. The amendment changes will go into effect January 1, 2016.

The bill synopsis cites multiple factors as motivating reasons to support and promote greater use of telemedicine and placed particular emphasis on expanded access to behavioral health services. “Geography, weather, availability of specialists, transportation, and other factors can create barriers to accessing appropriate health care, including behavioral health care, and one way to provide, ensure, or enhance access to care given these barriers is through the appropriate use of technology to allow health care consumers access to qualified health care providers.”

“The gist of the legislation really is about parity, where an office visit or a visit through your health-care professional provided through an approved electronic means is treated the same in terms of reimbursement from the insurance company,” Rep. Bryon Short, primary sponsor for the bill, said.

The other change to the telemedicine code expanded practice standards for physicians who practice telehealth as well as physician’s assistants, mental health counselors, marriage and family therapists, psychologists and several other types of health care providers as well. The amendment makes technical corrections referring to health services corporations and code references, adds the Advanced Practice Registered Nurse profession and includes definitions of several key terms for understanding telemedicine regulations.

“While the mandate for private-pay reimbursement is terrific, what stands out most about this bill is that it seeks to explicitly remove ambiguity or doubt that telemedicine is a valid form of practice for multiple professions,” Dan Khebzou, a member of the Delaware Telehealth Coalition and account executive with InSight Telepsychiatry said.

While many states have updated their language about telemedicine in the last few years, Delaware’s changes are unique in that they provide clear guidelines for appropriate use. “This bill is particularly forward thinking in that it clarifies telemedicine use for so many professions,” says Khebzou.

Delaware has been a particularly telemedicine-friendly state since House Bill 69’s first passing in 2004, but received an “F” in a 2014 study of telemedicine use under private insurance coverage by the American Telemedicine Association. The changes to this legislation demonstrates a willingness to take recommendations for improvement seriously and positions the state as a leader in the widespread adoption of a telemedicine.

Along with House Rep. Bryon Short and leadership from the Delaware Telehealth Coalition including, Andrew Wilson of the Delaware State Medical Board, Carol Morris of the Delaware Department of Health and Social Services and several other members of Delaware’s leadership organizations worked together to ensure that the language added in the amendments was sufficient and appropriate for meeting the goals of both the parties involved in writing the legislation and those of organizations and regulatory bodies who would be affected by it.

Contributions from the Delaware Medical Society ensured that the amendments stayed in line with regulations from organizations like the Division of Professional Regulation and the Delaware Department of Health and Social Services.

“The Delaware Medical Society’s support of this bill puts them ahead of the curve when compared to their peer medical societies in other states who have yet to acknowledge the inevitability of telemedicine as a rapidly-growing trend in healthcare,” said Geoffrey Boyce, Executive Director of InSight.

Delaware already has several telemedicine programs that will benefit from the changes in House Bill 69.
InSight Telepsychiatry has partnered with healthcare organizations throughout the state that have recognized an acute need for telemedicine, and particularly telepsychiatry services. The programs range from hospital emergency departments to substance use treatment facilities for children and adolescents to federally qualified health centers.

As part of a Governor’s Initiative to get more psychiatric care into underserved regions, a pilot program with several community health centers utilizes psychiatrists from InSight Telepsychiatry for psychiatric consultation.

The updated legislation will make it easier for Delaware to make decisions about incorporating other new developments in healthcare access more readily. In writing the amendments, special consideration was given to leaving room for further expansion of telemedicine use down the line while being mindful of the original scope of the bill.

“With mandated private insurance reimbursement and updated language covering the scope of practice for many health care providers, it will be easier for consumers and the providers who treat them to embrace telemedicine as a practical solution to issues of proximity and availability for appropriate healthcare services,” says Boyce.