Beyond the Emergency Department

3 Ways to Create Momentum for Inpatient and Outpatient Telepsychiatry Programs

by Jack Williams, President, Virtual Medical Staff

 

Our company has spent years providing Telepsychiatry services to hospitals with significant patient needs in each facility’s Emergency Department (ED).

This type of emergent coverage meets many needs but the single most pressing one is to improve patient throughput – that is, to ensure psychiatric patients in the ED are seen faster. By doing this, extended wait times of 24 or more hours in those ED’s are reduced significantly – often as low as a handful of hours.

When our telepsychiatrists assist in Inpatient (IP) and Outpatient (OP) settings, however, these services come with a different set of problems to solve. In both cases, the first problem to solve is access to physicians. Hospitals of all sizes simply do not have enough psychiatrists available to see their patients – whether those admitted into hospitals or patients referred to system clinics for follow up care.

With this solution, though, comes some challenges. The initial adoption rate for Telepsychiatry in IP and OP settings can initially be a slow process. One reason is some misgivings that sometimes presents from staff physicians, with the assumption that these virtual physicians provide a lesser degree of patient care, or that these virtual physicians may pose a threat to their own job stability.

Once it’s proven that the virtual patient care is strong, however, and that no jobs are in jeopardy, these programs quickly gather a great deal of momentum.

So, how best to create momentum for IP and OP Telepsychiatry programs? Read on.

 

1. Identify Multiple Clinical Champions at Each Participating Hospital

The single most critical step to ensure success for virtual programs in IP or OP Telepsychiatry is this: identify on-site clinicians who champion the move to virtual patient care. Then embrace them. Include them. Ask for their opinions, suggestions, and input. Get their buy-in.

When on-site clinicians support the move to complement their own efforts with additional help from virtual physicians, the success of the virtual programs skyrockets. The programs start on time and as intended, and they promptly make measurable and positive impacts for all facilities that use these virtual doctors.

There is no downside.

Include the medical staff in the decision to add virtual care, but also in the best ways in which to use virtual physicians most effectively. The return on this investment is limitless.

 

2. Train Existing Staff on the Specifics of IP and OP Telepsychiatry

The scope of IP Telepsychiatry is fairly standard – one physician typically provides virtual care at one hospital. This is best thought of as “virtual rounding” – assessing patients from one bed to another, just as an on-site physician would. The only difference being the virtual approach.

In contrast, OP Telepsychiatry can occur at many different hospitals or clinics simultaneously. Or it can be scheduled care, one clinic at a time. Both work very well. Either way, it’s best thought of as virtual physicians addressing low acuity behavioral health needs, including anxiety and depression. Each of these needs comprise a large portion of the services a virtual psychiatrist brings to Outpatient care.

Transparency in how both IP and OP Telepsychiatry work will remove any skepticism that may be aimed at these two virtual care models.

 

3. Use Patient Satisfaction Surveys for OP Telepsychiatry

Outpatient Telepsychiatry includes a very significant element of scheduled medication management. That is, OP Telepsychiatrists provide an essential service in seeing patients on a regular basis – often monthly – and ensuring that any medication prescribed is working properly. This also allows for adjustments on an ongoing basis.

Typically, this OP service line also requires scheduling patients in advance – often one to three months month in advance.

As a result, it naturally lends itself to online patient satisfaction surveys as the patients exit the facility. There are two reasons. One, the patients are seen by the same doctors regularly, on scheduled visits. Two, the surveys are a natural thing to request, but not require, as patients end their encounters.

And for any systems ready, willing, and able to allow the patients to remain at home for OP care – which is an emerging trend for progressive health systems – an online satisfaction survey is a simple effort for wiling patients.

Heads up: look before you leap. It’s wise to verify that these surveys are allowed by both the facility by laws and by all relevant state statutes. (There are states in the U.S. that do not allow patient satisfaction surveys.)