TelePsychiatry News & Information


Secure Telehealth featured in National Council Magazine PDF Print E-mail

Nebraska law enforcement officials are using Secure Telehealth in their vehicle laptops to allow mental health evaluations of at-risk individuals on the spot.  

The evaluating counselors are made available through the Targeted Adult Service Coordination Program, begun in 2005 to provide crisis response assistance to law enforcement and local hospitals dealing with people struggling with behavioral health problems. The counselors respond to law enforcement calls to provide consultation, assistance in recognizing a client’s needs and help with identifying resources to meet those needs. The no-charge service is offered to 35 sheriffs, municipal and other departments in 16 rural counties in the southeast section of the Cornhusker state.

Read the article in National Council Magazine here

 

 

Last Updated on Thursday, 17 March 2016 10:04
 
Telepsychiatry helps S.C. ER's Address Care Shortages PDF Print E-mail

 

 

 
 
Oct. 1, 2013   |  
 Greenville Online
 

COLUMBIA — Officials say a state telepsychiatry program supported by the Duke Endowment has been used thousands of times in hospital emergency rooms since it was installed in 2009.

In an effort to meet the critical shortage of psychiatrists in South Carolina’s underserved areas, the state’s mental health agency utilizes real-time, state-of-the-art video-and-voice technology that connects qualified psychiatrists to participating hospitals throughout the state, according to the governor’s office.

These consultations have increased the quality and timeliness of assessment and initial treatment of patients, officials say, reduced the length of stay in emergency departments for many patients, and allowed participating hospitals to direct critical personnel and financial resources to other needs.

“From the very beginning, we made it clear that South Carolina had a moral responsibility to correct longstanding issues and restore the public’s confidence in the Department of Mental Health,” said Gov. Nikki Haley. “The department lacked the appropriate funding and it was clear that our citizens were needlessly suffering. With partners like Duke Endowment and cutting edge advancements like the Telepsychiatry Consultation Program, we are now delivering mental health care where it’s needed, when it’s needed, while improving overall patient care and reducing costs and that is exactly the way it should be.”

An ongoing study of the program’s impact on medical costs by the University of South Carolina School of Medicine has determined that there is an overall medical cost savings of more than $1,700 per episode of care for patients receiving treatment via telepsychiatry, according to Haley’s office. The study has also found that patients discharged following an SCDMH telepsychiatry consultation have a significantly higher rate of accessing mental health aftercare in the community, thereby reducing their risk of readmission to an emergency department.

“The program saves money, but it’s biggest benefit is that it helps patients. Not only are many patients able to leave the emergency room sooner and return to their families, but even those patients who remain hospitalized are benefiting from the treatment recommendations of an experienced psychiatrist,” said SCDMH Director John H. Magill.

Since March 29, 2009, SCDMH has completed approximately 16,800 telepsychiatry consultations with hospital emergency departments, Haley’s office said. The SCDMH Telepsychiatry Consultation Program currently provides comprehensive consultations to 18 South Carolina hospital emergency departments.

“We are proud to be part of developing this national model and bringing it to fruition,” said Minor Shaw, Chairman of the board of The Duke Endowment. “The Duke Endowment recognizes the value of new technologies that will improve lives and strengthen communities just as DMH’s telepsychiatry program does.”

Last Updated on Wednesday, 02 October 2013 08:53
 
telepsychiatry and rural health PDF Print E-mail

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Telehealth Powers Population Health Management PDF Print E-mail

HD Insights Blog - Health Directions

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Infographic: Telehealth Powers Population Health Management

 
 
 
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Telehealth, Telemedicine, Infographic, Population HealthHealthcare is hanging up land lines and plugging into videoconferencing, virtual visits and smartphones to fortify care management and expand reach to remote and vulnerable populations, according to 2013 market data from the Healthcare Intelligence Network. 

Telehealth, also known as telemedicine, is the remote provision of health care services enabled by technology. A continuum of successful telehealth applications have been demonstrated over the last twenty years, ranging from the transmission of digital photographs and patient histories for diagnostic consultation, to remote monitoring of physiologic data for chronic disease management, to interactive patient physical examination using medical video endoscopes and ultrasound over high-definition videoconferencing links. The common tie among these varied applications is that technology is used to improve access to health care services independent of geography.

The telehealth in population health management infographic is excerpted from 2013 Healthcare Benchmarks: Telehealth and Telemedicine and was produced by The Healthcare Intelligence Network.

Population Health, Telehealth

 

 
Hi Its your Doctor PDF Print E-mail

From the New York Times September 5, 2013

By EZEKIEL J. EMANUEL

MY father, a pediatrician, kept all his medical equipment in a black leather bag. He used to take it on house calls. My brothers and I would frequently tag along to watch him treat patients. He would remove stitches from over an eye or look into a throat and ears, providing a few pills to start a regimen of antibiotics for an ear infection.

Sometime in the late 1960s, he stopped making house calls. Instead, my father began routinely sending patients to the hospital emergency room.

And he wasn’t alone. In 1930, house calls accounted for 40 percent of physician interactions. By 1980, that number had dropped to 1 percent.

But after a half-century, the house call is making a comeback. The available data on house calls are spotty at best. But one study estimated that in 2010, about 4,000 physicians conducted more than two million house calls. Some do what my father did: attend to urgent but not emergency situations, taking care of people with stomach pain, fever, cuts needing stitches and the like. These kinds of urgent-care problems are best treated by a house call, but account for about 40 percent of the nearly 130 million annual visits to emergency rooms.

Companies like Microsoft and Costco provide similar house calls to their employees in the Seattle area. Carena, a private company under contract for the service, sends out doctors or nurse practitioners to assess the situation with the assistance of computer software. The software uses algorithms to help them differentiate between cases that are safe to handle at home and those that require the emergency room.

Marta Monteiro

In addition to dealing with urgent matters, the house calls let providers teach patients how to deal with chronic problems they might have, like diets for diabetics, care that is always easier in the privacy of a home. The cost is around $500 a visit, which may be covered by their employer’s health plan. Beginning in 2010, Carena began offering “virtual” house calls, allowing people to use a webcam to get medical attention. Those calls are available to both employees of companies and, increasingly, individuals who aren’t employees but who are willing to pay the $85 cost per call, less than the hundreds of dollars it would take to have a rash seen at an emergency room. According to Carena, about 75 percent of those calls are resolved via the webcam, and only 25 percent require an in-person visit with a doctor or a trip to the emergency room.

Other house calls are more like office visits, but done at home, often for frail older patients. Many of those people suffer from multiple diseases — heart conditions, emphysema, diabetes, arthritis, dementia — that make getting to the doctor’s office difficult. And those are the people whose care is often billed to Medicare, so if they don’t see health care professionals regularly, their next stop could easily be the emergency room and a hospitalization. The Department of Veterans Affairs has pioneered this kind of house call.

The Affordable Care Act began financing a project in 2012 to determine in what setting house calls can be most effective. Doctors who make house calls share in savings if they provide quality care and reduce costs.

There are small studies that indicate these primary care visits can decrease hospitalization rates by more than 60 percent and save around 25 percent in total costs — all with extremely high patient satisfaction.

A third kind of house call is really an extension of the hospital. Transitions from hospitals are fraught with problems — patients not taking medications or following doctors’ instructions — and around 20 percent of Medicare patients are readmitted within 30 days of discharge. But hospitals have had little incentive to provide care in the home after treatment because they make money from the readmissions. The Affordable Care Act now imposes penalties on hospitals that have high readmission rates for conditions like heart failure and pneumonia. To avoid the penalties, hospitals are increasingly deploying nurses on these types of house calls.

Finally there is what is called Hospital at Home. Begun at Johns Hopkins in Baltimore, this program takes patients who would otherwise be admitted to a hospital for conditions like urinary and skin infections, pneumonia and heart failure, and instead sets up hospital-type services in the patient’s home. Intravenous antibiotics, oxygen, breathing treatments, even diagnostic tests like EKGs and X-rays are done at home. Physicians visit patients each day. Nurses visit once or twice a day, and monitor the patients remotely.

Studies show that patients treated at home do just as well in terms of recovery as patients admitted to the hospital, and maybe even better when it comes to how quickly they get better and how well they avoid common complications. And they save money. In a study in New Mexico involving more than 500 patients, there was a 19 percent cost savings. In a study at the University of Pennsylvania and at the Veterans Affairs medical center in Philadelphia, there was a 43 percent savings.

So fire up your DeLorean. Health care is headed back to the future. House calls are a sign that we will all see our health care going back to the “old days” when, like my father, the doctor came to our homes, giving us real personalized medicine — and saving money at the same time.

 
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