Clinical Telemedicine Blog

Telepsychiatry, The Right Time But Not Yet In Enough Places

By Chris Pick

This week I was reading a January 2012 TRENDWATCH from the American Hospital Association entitled “Bringing Behavioral Health into the Care Continuum:  Opportunities to Improve, Costs and Outcomes.”  While I work with and around the problem every day it makes me pause whenever I see some of the numbers. 

….among children mental health conditions were the 4th most common reason for admission.

….27% of Americans will suffer from a substance abuse disorder in their lifetime.

….in 2009, more than 2 million discharges from community hospitals had a primary mental health diagnosis

….in the past year, 34 million adults had comorbid mental health and medical conditions

Here is what it means:

Patients with comorbid mental health and medical conditions experience higher healthcare costs, with much of it attributable to higher medical, not mental health, expenditures. Individuals with comorbid conditions are at a heightened risk of returning to the hospital after discharge. 

There is a critical shortage of behavioral healthcare treatment capacity. According to the report, 55% of US counties have no practicing psychiatrists, psychologists, or social workers. Only 27% of community hospitals have an organized inpatient psychiatric unit, while state and county hospitals are closing to financial constraints.  Emergency department visits and resulting problems like boarding are on the rise.

With health care parity for mental health, healthcare technology advances, and public and government pressure to reform and recreate healthcare delivery, telepsychiatry is quickly becoming a solution. It allows the too small pool of psychiatrists, who are not evenly geographicly distributed, to meet the growing national mental health challenges.  We see the armed forces, the Veterans Administration, rural counties, managed care and many entities using telepsychiatry to reach no, low or special needs access areas.  Specialists in substance abuse, child psychiatry, mental retardation, and geriatrics can reach dispersed patient populations in need of a higher level of specialization. 

Increasingly we are seeing hospitals, who previously did not have or could not maintain sufficient on demand coverage,  identify and take advantage of the improved quality, cost, and outcomes that telepsychiatry offers.  The new questions become:

-What is the benefit to the care of the co-morbid patient when the hospitalist has a Psychiatrist to consult? 

-What is the benefit to the hospital that has no mental health services but has patients whose primary diagnosis is a mental health condition being brought to the Emergency Department and admitted to the hospital?

-What is the benefit of being able to diagnose, stabilize, manage, and direct to appropriate treatment the patient who is undiagnosed, untreated, or suffering from exacerbated mental health symptoms?

-What is the benefit when a child, elderly person, substance abuser comes to the hospital with an acute mental health problem and a specialist in that field is there to help?

-What is the savings when a psychiatrist is almost instantly available to determine capacity, treat emergent and urgent cases, and provide specialized recommendations?

Increasingly, as telepsychiatry is being used in the hospital setting, outcome studies all show that with early intervention, assessment, and treatment there is reduced cost of care, LOS, readmissions, staff burden and risk; and there is increased quality, services, and satisfaction. 

My work deals with the problems of how to address the mental health challenges that our hospitals and their communities are facing. Every day I show hospitals that telepsychiatry is a tool to decompress ED’s, provide needed specialty treatment, and reduce the costs hospitals bear while trying to meet the needs of the people they serve.  Can we afford not to address this growing problem?  There is still a ways to go in improving the national landscape for telepsychiatry (new prescribing laws and national licensing, reimbursement and medicare coverage, and so on…), but in your community the answer may already be here.

Topics: telemedicine, healthcare, Emergency Medicine, Physicians, telemedicine solutions, Specialists On Call, SOC, hospitals, telepsychiatry, emergency departments, emergency department, On Call Coverage, Telepresence, Specialty Physician Shortage, Patients, Emergency Psychiatry, telehealth, psychiatry

3rd Annual Specialists On Call Physician Conference

By Amy Levitt

Author: Joe Peterson, M.D.

SOC again embarked on the beautiful grounds of the Cypress Villas Golf Resort in Orlando Florida for our third annual Physician Telemedicine Conference. This Continuing Medical Education (CME) conference, held October 15-16, at the Grand Cypress Resort in Orlando, Florida, was designed for healt care professionals to gain familiarity with new technology, treatment techniques and diagnostics for patients with neurological emergencies.

In addition to the lectures and discussions, several awards were given out at the conference in recognition of milestones and hard work achieved by Specialists On Call customers and physicians.

    • The Nurse Champion awards were presented to both Debra Motz, BSN, MS, regional stroke coordinator, Baptist Health System, TX, and Tammie Stefenko, RN, stroke coordinator, Baptist Hospital of Pensacola, FL, for their personal dedication and championship of stroke, neurology care and telemedicine program.

    • The System Partner Award was presented to Bon Secours Health System for advancing patient care in the treatment of acute illness using telemedicine services.

    • The SOC Clinical Excellence Award went to Dr. Carlos Villar, MD, for his creativity, drive and devotion, which has helped define the new and emerging field of emergency neurology.


Other highlights of the conference include:

    • Keynote Speaker: Michael De Georgia, MD, FACP, FAHA, FCCM, discussed theories from his book Struck Down: The Collision of Stroke and World History.

    • Stephan Mayer, MD, FCCM, presented “StepWise Management of Elevated of Intracranial Pressure: Modern Thoughts on an Ancient Problem ”

    • Albi Penalver, MD, discussed  ”The World of Emergency Psychiatry”

    • Anne Leonard, MPH, RN, CCRC, FAHA, presented “Primary Stroke Centers: The Current Opportunities and Remaining Barriers to Universal Implementation”

    • Evan Allen, MD, MBA, discussed “Telemedicine and Emergency Neurology: From Vision To Reality”


Plans have already begun for the 4th annual conference. Information will be updated as it becomes available.

Topics: telemedicine, Stroke, Primary Stroke Centers, Neurologic Emergencies, Emergency Psychiatry, Uncategorized, Continuing Medical Education