Telepsychiatry. Are they just talking heads?. or is it truly a viable treatment option?

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1 Telepsychiatry Are they just talking heads?. or is it truly a viable treatment option?

2 Why was Telepsychiatry started in Cambria County? Long wait time to see a Psychiatrist Limited availability of Child/Adolescent Psychiatrists Travel 60 miles/ inconvenience Unable to recruit to the area

3 The Mental Health Steering Committee took the Lead Consumers Family members Provider Administrators County Administrators Managed Care Representatives

4 First Stumbling Block

5 Found a Source Integrated Children s Service Initiative $30,000 was all that was needed Equipment for 3 offices

6 The Equipment Audio- Polycom DDX 7000 series equipment Audio Error Concealment (smooth verbal communication without interruptions) Video- true High Definition Polycom EagleEye HD Camera degree panning radius Lost Packet Recover (smooth continuous video without interruptions)

7 Other Considerations Real Time Two way interactive audio-video transmission Dedicated, secure line for transmission Zoom capability

8 The Program Description Submitted to Department of Public Welfare Office of Mental Health and Substance Abuse Services Detailed 30 page document Specific Services to be provided Staff Requirements Equipment Agency Collaboration Stakeholder Input

9 Program Description cont. Medication Policies Confidentiality Medical record Patient Rights Training & Licensing Quality Improvement Financial Information

10 Services Provided All Service codes have a prefix of GT Consultation Evaluation Individual Psychotherapy Psychiatric Diagnostic Interview Pharmacological Management Equipment and Technology- Q Code

11 Staff Psychiatrists- Board certified and licensed to practice in the Commonwealth of Pennsylvania located at a remote site Mental Health Professional- assist and communicate with the practitioner and patient, set up, answer questions, follow-up, located at the licensed outpatient clinic Case Manager Either the Psychiatrist OR the consumer must be at a site licensed to provide Psychiatric services

12 How it Actually Works Medical records are maintained at both locations Progress notes, reports, etc. are exchanged electronically via secure encryption Mental Health Professional is with the consumer during the session Case Manager is available if needed following the session Scripts are sent electronically to a pharmacy of the consumer s choice

13 Is it Worth the Cost??? Reimbursement rate for services provided by a Psychiatrist is $240/ hour Q code charge for technology is $15 per event No reimbursement for the Mental Health Professional

14 Basic Income and Expenditure Income and Expenditure Psychiatrist Insurance Reimbursement Technology Insurance Reimbursement TOTAL Psychiatrist Wage Mental Health Professional Wage Cost of Technology TOTAL Gross Surplus $240 per hour $60 per hour $300 per hour $155 per hour $25 per hour $1 per hour $181 per hour $119 per hour

15 It s a Win Win Situation

16 Everyone Gains Most importantly, the member gets the service they need so they can lead a productive quality life The provider has a net financial gain The insurance company pays a little more on the outpatient side of things but ultimately saves by reduced inpatient costs

17 Let s Look at the Data

18 Cambria County s program started in July, 2009 Data from July, December, Distinct Members 1,175 telepsychiatry appointments Data was gathered via appointment tracking forms and surveys completed by members and providers

19 Appointment Tracking Telepsychiatry appointment tracking data, July 2009 December 2010 Service type N Percent Medication management % Evaluation % Missing 17 1% Appointment attendance N Percent Attended % Cancelled % No show % Missing 1 <1% Member age group N Percent Adult % Child / adolescent (under 18 years old) % Missing 6 1% Total appointments scheduled 1,175

20 Satisfied Customers Client satisfaction survey average scores (overall and by age group and gender) Questions Average Score Children (<18) Age Group 1. I felt that I could talk about anything with the doctor The doctor was able to address my needs today I was not nervous about using this new way of receiving care Adults (18+) Female Gender Male 4. I was not embarrassed or self-conscious during the telepsych session I had no difficulty hearing what the doctor said over the video system I had no trouble seeing the doctor over the video system Telepsychiatry makes it easier for me to get psychiatric care The care I received through telepsychiatry was as good as a regular in-person visit I was comfortable with using telepsychiatry for my psychiatric appointment Overall, I was very satisfied with today s appointment Overall average scores

21 Satisfied Providers Provider/clinician satisfaction survey results average scores Average scores 1. The client(s) and the psychiatrist seemed comfortable interacting with each other over the video system The clients needs were able to be addressed today through the use of telepsychiatry The clients and the psychiatrist had no difficulties hearing what was said over the video system The clients and the psychiatrist had no trouble seeing each other over the video system I thought that the interaction through telepsychiatry was as good as a regular in-person visit I was comfortable with using telepsychiatry for the clients psychiatric appointments Overall, I was satisfied with today s appointments. 4.5 Overall average score 4.3

22 Questions

23 Contact Information Cindy McLaughlin, CEO Behavioral Health of Cambria County Thanks

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