Emergency Department Urgent TeleMental Health Care

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Reynard Hutchinson
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1 Emergency Department Urgent TeleMental Health Care Margarita Loyola, Telehealth Manager Mya Aylott, Telehealth Analyst Global Telehealth, 2015

2 Presentation Overview Introduction Island Health Telehealth Next Steps Lessons learned Expansion Mental Health Urgent consults Campbell River Port McNeill Results Timely assessments Improved access Summary Questions

6 Population: 765,000 Acute Care Beds: 1,500 Residential Beds: 6,200 Health Professionals: 17,000

10 22 enabled communities About Island Health Telehealth 1,800 C02e tons gas emissions prevented 58 Telehealth enabled locations clinicians using Telehealth 90 staff trained to use the digital stethoscope 6.8 million kilometers of patient and provider travel prevented 17,500 successful Telehealth sessions 2,500 ferry trips prevented 600 patients would not have traveled to receive care if Telehealth wasn t available 83% reduction in psychiatry wait times to Mt. Waddington

11 Urgent Mental Health What is the need for Urgent Mental Health? Psychiatrists are mainly located in Victoria High risk communities often don t have a psychiatrist. VI North VI West Campbell River Miscellaneous Mental Disorders listed as 2 nd highest inpatient reason in High Emergency Department Use VI North was ranked first for overall mortality, and first for several causes of death including drug induced deaths, suicides, alcohol related Mental deaths, disease diabetes and disorders and 1321 per are 1,000 chronic responsible people lung compared for disease. the most to Island patient Health days average of 369 per 1,000

12 When a person with a mental disorder is admitted involuntarily under the BC Mental Health Act There isn t always a psychiatrist available to assess the Patient and provide advice on a care plan In some TELEHEALTH communities So the Patient may be transferred to a facility in another community where a psychiatrist is available (if a bed can be found there) Hospital with Psychiatrist If no bed can be found, the Patient can be held involuntarily for up to 48 hours for stabilization and then released without having received support from a psychiatrist

13 What if we add Telehealth? TELEHEALTH

14 A person with a mental disorder is admitted involuntarily under the Mental Health Act There isn t always a (local) psychiatrist available to assess the Patient and provide advice on a care plan Physician in Emergency Dept With Telehealth Initial discussion over TELEHEALTH the phone On call Psychiatrist Patient in Emergency Dept or Observation Room

15 Benefits TELEHEALTH 3 Earlier discharge Patients can be released if deemed appropriate 2 Decreased Patient Transfers Transfers happen only if warranted 1 Treatment & Care Planning Can be started in a timely manner

16 Port McNeil Campbell River Pool of Psychiatrists on call Victoria

17 Port McNeill Port McNeill 7 hour drive one way to Victoria Campbell River Victoria

18 Port McNeill Port McNeill 7 hour drive one way to Victoria Campbell River Victoria

19 Port McNeill Port McNeill 7 hour drive one way to Victoria Campbell River Victoria

20 Campbell River 3 hour drive one way to Victoria Port McNeill Campbell River Victoria

21 Victoria Psychiatrists on call providing care from three hospitals. Port McNeill Campbell River Victoria

22 Results Timely Assessments Collaborative Care Equitable Access From this There is huge potential Campbell Port McNeill1/Week River Port McNeill 1/Month Port McNeill Patient is released 52 /year! 4 Patients successfully seen 12 / so year! far Patient is transferred if a bed is available Other Campbell communities River Both within I interviewed times I was the asked to see appropriate cases that it was both reasonable and gratifying for me to evaluate, and I concluded with the sense I had done something useful. 5Patients Island Health patient, By using and the was to Telehealth this able to our successfully Sointula, involve patient This the was Zeballos, process physician. assessed Tahsis, saved We by a us Tofino, seen decided psychiatrist considerable so Port far treatment Alberni, which helped time and and also us Parksville that formulate transport admission the course issues. to a hospital of care Dr. was Jim appropriate Sacamano, and Psychiatrist required. Crisis nurse and advise around medications. Dr. Crisis John nurses Copen, in Campbell Psychiatrist River Victoria

23 Summary Urgent Psychiatry successfully implemented Expanding to more communities The Future Port McNeill Campbell River Tofino Urgent Telehealth For other specialties

24 Thank you for your attention!

END OF LIFE PROGRAM PRIORITIES UPDATE

END OF LIFE PROGRAM PRIORITIES UPDATE June 2014 Island Health End of Life Program Priorities Update 2014 Page 1 Background: Every year, approximately 6,000 people die of natural causes on Vancouver Island.