Guide to Launching a Telepsychiatry Program

Telemedicine programs

Experiencing a provider shortage, and considering telepsychiatry for the first time? Confused where to start? e-Psychiatry’s 2020 Guide to Telepsychiatry will help you learn about the effectiveness of telepsychiatry, how to launch a program, how to select providers, what types of technology to use, telepsychiatry reimbursement, and more. 

Telepsychiatry Clinical Outcomes

Across 21 studies, telepsychiatry has shown similar diagnostic accuracy and similar patient outcomes for conditions such as depression, bipolar disorder, alcohol use disorder and more. Four recent clinical trials have shown similar or superior outcomes for medication management services conducted via telepsychiatry over face-to-face visits. Quoting one study from the American Journal of Psychiatry, “Contracting with an off-site telemedicine-based collaborative care team can yield better outcomes than implementing practice-based collaborative care with locally available staff.”

Fewer Missed Appointments & Increased Patient Satisfaction

Telepsychiatry has also been shown to reduce no-show rates. One Study reported that “Research has established that increase in patient satisfaction leads to decrease missed appointments, 7%-10% missed appointments compared to non-telepsychiatry rates of 35%-42% of missed visits. A Veterans Administration study showed over 90% patient satisfaction rate!

Telepsychiatry Cost-Savings

Even better, telepsych has been shown to be less costly and deliver superior ROI than face-to-face care. Telepsych especially helps in reducing indirect costs of care such as clinic space needed to conduct sessions, administrative support, and transportation. 

Conduct a Needs Assessment

  • Has your facility recently lost a provider? It can be hard finding available providers in your local area. Telemedicine helps you choose from a large pool of providers from across your entire state. Telemedicine helps remove geographical barriers to timely staffing.
  • Has your facility been sending away patients? Are you seeing a large potential revenue stream going to waste? Does your facility focus on urgent care and lack behavioral health resources? 
  • Are your psychiatrists or Nurse practitioners overworked?

Determine Which Settings the Care Will be Provided In

Determining the setting in which the care will be provided in is important for determining the type of telepsychiatry technology to be used, and how you will schedule your telepsychiatry provider. 

Inpatient telepsychiatry

Emergency Department: Often providers will be scheduled for on-call and nightly services. In terms of technology, usually telemedicine carts equipped with a laptop works best in this setting 

Outpatient: Usually facilities leverage block scheduling for outpatient appointments. Often laptops connected to a larger TV screen are setup in a small room in your facility for the patient sessions. 

Determine How You Will be Scheduling Your Provider

How will the provider be scheduled? On call, block scheduling, or individual consults?

How often/When will the provider be used? Daily, weekly, nightly, weekends?

Medicare & Medicaid Reimbursement

Medicaid reimburses for telemedicine in most states. To see if your state medicaid program reimburses for telemedicine contact us here

Medicare’s fee for service program will cover services delivered through a medical facility located in a rural Health Professional Shortage Area (HPSA) originating site, or outside of a Metropolitan Statistical Area (MSA) . Telemedicine services covered through this program include: real time communication (Videoconferencing or phone), remote patient monitoring, and store-and-forward communications (Messaging). 

Beginning on January 1, 2019 CMS removed the originating site fee geographic condition for patients seeking addiction treatment, under the ‘Substance Use-Disorder Prevention that Promote Opioid Recovery & Treatment (SUPPORT) for Patients and Communities Act. CMS also added an individual’s home as a permissible originating telehealth service services site for a substance use disorder or co-occurring mental health disorder.

Telemedicine Parity Laws

Many states have now passed telemedicine parity laws, which mandate that private or commercial payers reimburse for telemedicine services the same way they would reimburse for in-person care. Interested in learning if your state has passed parity laws? Contact us here.

Implementing Your Telepsychiatry Program

Assign a Member of your IT team to oversee the implementation of your telepsychiatry platform: The IT team member should be in charge of acquiring the appropriate hardware (PC, speakers, screen, etc), setting up the appropriate firewall settings, confirming your facility has appropriate wireless connection speed, conducting tests with your provider, and more. 

Setting: Where will the technology be placed or where will the appointments be conducted? Often times, only a small room is needed for patient consults. In an ED setting, consider using bedside consults. Make sure to check the network connection in whatever area you will be conducting the sessions from. 

Train Your Nurses and Providers on Using the Telepsych Platform: Usually all this requires is a singular implementation demo, where the telepsychiatry company or service provider shows your team how the telepsychiatry platform works. Make sure to cover how the scheduling, messaging, and videoconferencing functionality works. Typically the telepsychiatry company or services provider will provide detailed informational guides which will further assist in training. 

Confirm how your Provider will Document Notes in Your EMR: Different telepsychiatry systems handle note-taking in different ways. Most of the time, your provider will document directly into your facility’s EMR. 

Choosing a Telemedicine Platform

Telemedicine equiptment

HIPAA Secure? Make sure that your telemedicine platform provider, provides you with a business associate agreement (BAA). Check to confirm that you’re telemedicine platform provider has 256 bit encryption at-rest and in-transit. Make sure that their servers are SOC-2 compliant. 

Peripheral Devices Needed? Some facilities prefer to simply use a laptop to conduct the telepsych sessions. Other facilities choose to purchase add-on, or peripheral, screens, cameras, speakers, or, microphones,

Branded or White Label? Certain telemedicine platform providers like e-Psychiatry offer the ability to customize your telemedicine platform. Customization includes a branded URL for your organization, with your organization’s logo or branding.  

Ready to Launch a Telepsych Program? Shoot us an email at clientservices@e-psychiatry.com or contact us here.

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