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Considerations in Telehealth and “Telemental Health”

The benefits of telehealth are obvious. Your organization can provide greater access to health care and mental health services without necessarily expanding your physical facilities. Given the inherent risk of missed, late or inadequate appointments when caring for individuals with mental health issues, telehealth holds great promise. In fact, the American Psychiatric Association coined the term, “telemental health” in its toolkit for creating and managing a telehealth program.

Meanwhile, the statistics on telehealth indicate a massive shift toward this new, innovative way to access health care. Up to 20 percent of Americans would rather see a health care professional through telehealth systems than an in-office visit, found the Advisory Board Company’s 2016 Telehealth Survey, says mHealthIntelligence. Furthermore, telehealth is expected to grow at a 14.3-percent compound annual growth rate through 2020, reports Becker’s Health IT & CIO Review.

However, there are real challenges to implementing a telehealth program, and your organization needs to take a few things into consideration first.

What Type and Level of Care Will You Provide Via Telehealth?

The first issue focuses on barriers to implementing a telehealth program for general health and human services, general health care or mental health care. Your organization must determine what type of services to offer through telehealth programs. The key lies in understanding which types of care can successfully be managed through telehealth.

An ideal program should work to provide care for persons served with an established history in your organization. Unfortunately, states may have placed stipulations on whether you can even serve individuals with whom you have not previously treated or seen. In other words, has your organization provided care for a person previously, and if so, does the condition fall under your state’s specific guidelines or laws governing telehealth?

For example, Texas only recently passed legislation, SB 1107, reports the Texas Legislature Online, allowing individuals to receive initial care through a given practitioner. Previously, individuals using telehealth were limited exclusively to telehealth care treating known, managed conditions.

Given the vast rural areas of the Lone Star State, this new legislation will have a positive impact on individuals in need of care who cannot reasonably go to a physical care facility. Nationally, up to 20 percent of Americans living in rural areas could receive care for health issues that were not previously managed because of distance from a proper practitioner or care facility.

Does Your Staff Have the Experience Needed to Operate a Telehealth Program?

Increased access to health care begs the question, “Can your staff handle seeing more individuals?” When more people connect with health care providers or professionals, even social workers and other health and human services’ workers, you need a strong, experienced staff.

This means communication skills must be emphasized in all training programs for all employees working in telehealth systems. A miscommunication between physicians, social workers or any person in the care team could lead to serious consequences for those served. The other side of this conversation must address workload too.

Health care professionals’ workloads should reflect reasonable workloads. The perceived simplicity of managing care through the internet makes it easy for supervisors and administrative professionals to overload workers. Being able to provide care while traveling or during non-traditional work schedules does not mean you can make employees work beyond acceptable, safe and legal schedules.

You may need to create new departments and staff schedules to handle increased use of health services through telehealth systems.

What Type of System Will Your Organization Use?

One of the challenges in telehealth remains the system itself. Will your organization create its own system, or will you work with a vendor that provides telehealth systems?

If you opt to create a system from scratch, you will need to consider the costs of implementation. These include hardware and software costs. Depending on your current use or planned use of electronic health records (EHRs), you may need to upgrade health record practices too. Not seeing someone in your physical facility means all information from an individual’s health record should be easily accessible and searchable.

Therefore, EHR use is essential to implementing a telehealth program, especially for those with severe conditions, like major mental health disorders, dual diagnoses, chronic health conditions or other extensive health problems.

Network resiliency and security fall under this consideration as well. Your system will need an advanced security system to ensure information transmitted between persons-served and health professionals adheres to all HIPAA privacy requirements, reports Fred Pennic of HIT Consultant. You may also want to consider upgrading the bandwidth used by your facility, which may include upgrading Wi-Fi routers, Wi-Fi access points and in-house servers.

Because of the challenges and burdens placed on your internal IT department when implementing a telehealth or telemental health system, working with an experienced vendor may be preferred. Such partnerships will help your organization get telehealth services to those in need and mitigate risks in bringing health visits into the virtual world.

What’s Next?

The push toward expanding access to health care through telehealth is growing stronger. The District of Columbia and 29 states now require health insurers to cover telemedicine services. To help your organization prepare for the possible future of national-mandated access to telehealth services, you need to take these considerations seriously.

Start with training your staff on how to provide care remotely, emphasizing the role of communication and being thorough with all interactions. Because telehealth can lead to seeing an even greater array of health and medical conditions, make sure all staff have completed additional training on recognizing possible signs of mental health conditions as well.

Of course, training can be classified as one of the best practices for implementing a telehealth program. Therefore, Part II of this series will explore the top best practices for making telehealth a success in your organization.

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