Ideally, making the move to telehealth would be a well-thought-out process for behavioral health organizations. However, the coronavirus pandemic has required a quick switchover by many behavioral health hospitals, certified community behavioral health clinics, federally qualified health centers, substance use and mental health facilities, and 12-step programs.
Telehealth has been around for decades, but its use has grown rapidly in recent years, especially since the coronavirus disease outbreak. From 2014 to 2018, provider-to-patient use of telehealth in nonhospital settings grew 1,400%, according to claims data analyzed by FAIR Health. In terms of hospitals, about 35% used telehealth in 2010, according to the American Hospital Association, and about 76% of hospitals had adopted telehealth by 2017.
A 2018 study by the Behavioral Health Workforce Research Center at the University of Michigan found that 47% of respondents used telehealth for behavioral health services. Of those who used telehealth, the most common types of providers using the service were psychiatrists (78%), mental health counselors (33%), social workers (24%), psychologists (16%), and addiction counselors (12%).
Even more healthcare organizations are now adopting telehealth technologies to protect their patients, clients, and staff from COVID-19. Government regulations have been temporarily relaxed in light of the pandemic to allow healthcare providers to provide services amid restrictions designed to slow the spread of COVID-19.
While telehealth can clearly benefit patients and practitioners, setting up a telehealth system can be daunting. Barriers, such as Medicare and Medicaid coverage, regulations, inadequate broadband service, resistance to the use of advanced technology on the part of staff and patients, fears over disruptions in workflow, and general uncertainty can prevent implementation of telehealth services.
Fortunately, resources abound to help behavioral health organizations overcome barriers to telehealth implementation and improve the care and services they provide.
Basic Tips for Offering Telehealth Services
1. Determine your goals
Think about why you are initiating telehealth services and how this format will affect your client base. Some reasons cited by behavioral health agencies in the Behavioral Health Workforce Research Center study were:
- Improving the quality of care
- Enhancing operational efficiency and workflow
- Serving new patients
- Expanding into a larger geographic area
2. Identify the services you plan to offer
Your goals in implementing telehealth will influence the types of services you provide. These may include:
- Connecting patients with care providers and referrals
- Assessment information
- Care consultation and coordination
- Medication management and monitoring
- Public health information, targeted texts, and notifications
3. Pick the right type of tools to suit your needs
Once you have decided how your organization will use the system, you must ensure that the system you choose has all the features you need. Consider how you will connect with patients and provide information to support your clients. Common types of telehealth in behavioral health include:
- Live videoconferencing—Direct, two-way video-based conference between a patient and the healthcare provider
- Mobile health—The use of smartphones, tablets, and other smart devices along with health-based software apps that can monitor patient status in terms of medication intake, mood, pain levels, and more
- Remote patient monitoring (RPM)—Frequently used for senior living and people with disabilities living independently, involves collecting a patient’s health data in one location then electronically sending it to a healthcare professional for monitoring and review
Of course, you will want to be sure the system integrates appropriately with your existing scheduling and notification systems.
As you think about the features your organization desires, remember to consider the capabilities of your patient population in terms of technology use and connectivity.
4. Find affordable and easy-to-use telehealth software
Look for software that is easy to use for both practitioners and patients, and ensure that it aligns with HIPAA regulations. To prevent slowdowns in the workflow, the system must be easy for staff to adopt. Furthermore, patients must find it simple to access the system, or they will refuse to participate.
Software should support a variety of devices, so that patients and staff can use smart phones, desktop computers, laptops, or tablets. The quality of service should facilitate, not hinder, the care your organization provides.
Cost will be a consideration, so make sure you compare features, usability, and price tags for several options. Security features are paramount to keep patient data safe and meet HIPAA regulations.
5. Loop your staff into the process
Ensure that your healthcare team is included along the way as you plan for adding telehealth and go through the system selection process. An important part of the planning is to confirm that staff members are equipped with appropriate technology and reliable internet service wherever they will be providing care.
Before going live, ensure that you have more than one person well trained in all the features of the system. Provide training and documentation to all staff who may need to use the system or assist patients in accessing it.
Encourage your staff to do practice runs with other staff members, friends, and family to test the system during the pilot stage.
6. Prepare your patients
Determine any potential roadblocks and challenges patients may encounter when using a new telehealth service. Obstacles can include:
- Confusion in setting up the system
- Slow bandwidth or limited access to the internet
- Use of outdated devices
- Limited experience in using technology
While these obstacles can be especially challenging for patients with intellectual or developmental disabilities (IDDs), using telehealth can be rewarding in many ways for these individuals. Adults with IDDs often have difficult-to-treat conditions, trouble expressing their symptoms, and frequently experience problems accessing care or receiving adequate care. At times, they may lack attention to wellness, preventive care, and health promotion. Telehealth services can make that type of information readily available to all clients.
Support the Learning Curve
When clients encounter challenges with using the system the first few times, remind staff members to use a reassuring tone and have straightforward guidance on hand to assist those they serve. For best results, start with patients who have some experience using technology and are comfortable learning new systems.
Create a list of technical FAQs. Take a survey of your staff and patients to determine the most frequently asked questions. Then adapt your technical guidance based on questions and challenges, and provide refresher training as needed.
Implementing a telehealth system into your organization’s processes can help your staff and patients connect in new and meaningful ways. Using these types of innovative services can broaden your reach and the support you can provide during the COVID-19 pandemic and beyond.