Models of Telemental Health

Models of Telemental Health

Telemental health services are delivered in a range of settings to patients with varying degrees of mental illness. Whether it be hospitals, assisted living homes, primary care physician offices or even patient homes, telemental health services can be integrated into most, if not all, clinical practice systems. Aside from clinical settings, patients can access care right from their homes with direct to consumer platforms that function as virtual provider offices. 

The following is a description of two types of telemental healthcare: the clinic-clinic model and the clinic-home model.

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How Do I Know if Telemedicine is Right For Us?

Over the past few months of talking with different organizations about the ways that 1DocWay helps hospitals, nursing facilities, and clinics, I’ve heard different variations of the same concern: is telemedicine right for us?

Some people think their facility might be too small to benefit from telemedicine, or their organization doesn’t have the technical expertise to adapt to a telemedicine system. There are concerns about managing the security and compliance needs in an organization that already has constraints on IT personnel and resources.

These are smart questions and in any business decision it’s important to assess the risks of moving forward.

In the last 24 months 1DocWay has helped over 50 facilities adopt telepsychiatry and every day more FCHQs, primary care clinics, and nursing homes are choosing telepsychiatry. When deciding whether telemedicine is right for your organization, consider some of these facts:

  • Most facilities adopting telepsychiatry have no IT department at all or up to one person managing all of IT for that facility.
  • Over 90% of the facilities that we work with are able to get telemedicine up and running with less than 5 hours of investment needed for technical set up and training.
  • Over 90% of the facilities that we work with don’t require any new purchases of hardware or software; they’re able to leverage existing technology as long as it was purchased within the last 3 years.

If you’re still not sure if telemedicine is right for your organization, reach out for a free consultation. We can talk about what the risks may be for your specific facility to move forward. Then, let’s review what the risks are of not moving forward!

Integrated Telepsychiatry

Integrated Telepsychiatry in the Medical Home and ACO: Perform Like a Champion

First off, a huge congratulations to the U.S. Women's Soccer Team on their capture of the World Cup. It is particularly satisfying to see a group of individuals who have worked most of their lives to perfect a skillset come together as a group to achieve at such a high level.

Now, the U.S. healthcare system can learn something from the Women's Soccer Team. In team sports, it's not only the skill of the individual that prevails, it is also the extent to which the Team has a system and a plan, and the degree to which the players buy into and execute that system and plan.

At least two "systems" appear to bring promise of organizing skilled clinicians into health care teams that can produce at a high level and reasonable cost: Patient Centered Medical Homes and Value Based Contracting. As an example, the Boston Consulting Group analyzed recent claims data from 3 million Medicare members in either traditional fee-for-service Medicare or in Medicare Advantage (value based payment) environments.

As displayed below, using three widely accepted measures of health care success, their analysis demonstrated clear performance superiority for the MA programs.

As noted by the Robert Graham Center for Policy Studies in Primary Care and Family Medicine, as well as by many other health care analysts, in order for Medical Homes (and, by extension, clinics in value based contracts) to achieve their goals, they must have behavioral health services readily available and fully integrated. Where behavioral health specialists are not readily and timely available - significant swaths of the U.S. landmass - telemedicine and telehealth linkages serve an essential purpose.

While fee-for-service Medicare pays for telemedicine only in certain rural and similar locations, CMS has made it clear that Medicare Advantage programs are free to pay for these services in any setting in which they deem it to be clinically and fiscally prudent - urban or rural. Abundant data demonstrate the clinical and cost value of widespread and integrated availability of these behavioral health services (see, e.g., Chiles et al, Blount et. al, Cummings, et. al) and, thereby, their central place in realization of the Triple Aim.

If you are in a Medical Home setting, a value based contract, or are a health plan offering pay for performance incentives, we hope you are already cognizant of the foregoing and have taken steps to make behavioral health services readily and timely available for your patient base. Perform like a champion!