Direct-to-Consumer Telehealth: The Disruptive Solution to the Behavioral Health Provider Shortage

By Scott Baker, MBA, Business Innovations Manager | August 09, 2017 – Original article on Oliver Wyman Health

The link between behavioral health and medical outcomes is well understood. Providing behavioral health services can help keep some medical conditions in check and prevent hospitalizations and readmissions. However, more than half of US counties are currently without any psychiatrists, resulting in large care gaps and wait times of up to 3 to 6 months. As a result, many patients seek mental health services from primary care providers, who often lack both time and specialized psychiatric expertise to treat such conditions. A more dire situation arises when patients are discouraged from seeking treatment altogether, which can lead to further deterioration or crisis situations.

Amid this provider shortage and growing behavioral health crisis, telepsychiatry is emerging as an effective tool to meet providers’ referral needs. In addition, direct-to-consumer (D2C) telepsychiatry is becoming a more widely utilized treatment option—one that can fill gaps in care at a time when the need for services far outpaces provider supply and address issues before they escalate.

By enabling provider-patient interaction at any time from any location, D2C telehealth helps increase access to care and promotes a more comprehensive response to patient needs, whether physical or behavioral. Making care more convenient often leads to earlier interventions that help ensure patient needs are addressed before issues escalate and require higher-cost interventions.

D2C telepsychiatry: A natural fit for telehealth

The American Telemedicine Association defines telehealth as “the remote delivery of healthcare services and clinical information using telecommunications technology.” The more popular forms of telehealth rely on real-time videoconferencing to deliver services and address patients’ needs, emulating the kind of in-person exchange and connectivity experienced in a provider’s office setting. Continued growth of D2C telehealth underscores the attractiveness of the videoconferencing model, as patients—increasingly empowered in their own care choices—seek direct access to providers and alternative options to more conveniently manage their care.

When it comes to telehealth for behavioral health, telepsychiatry is now used for evaluation, consultation, and treatment throughout the care continuum, and it can be found in settings that range from acute inpatient settings and emergency departments (EDs) to community-based care environments and in-home referrals from primary care doctors and discharge planners.

D2C telepsychiatry takes the burden off primary care providers and expands referral options in areas lacking adequate psychiatric services. With additional providers available, patients are empowered with greater choice, rather than limited by what is within a drivable radius. Beyond primary care providers, community-based professionals such as referral coordinators, benefit managers, and discharge planners can leverage this option to help consumers access qualified behavioral health specialists in a timely manner.

Collaborative care between telepsychiatry providers and patients’ primary care and regular providers can also extend the value proposition of D2C telepsychiatry by improving coordination, increasing clinical exchanges and connecting a patient’s community of caretakers for more holistic care.

The advantages of D2C

D2C telepsychiatry delivers inherent advantages for both patients and providers, including:

Flexibility. Consumers can schedule appointments outside of traditional weekday time slots, including nights and weekends, and can often find available appointments within a few days of their request.

Convenience. Services can be accessed from any private location leading to better continuity of care. For example, consumers can continue treatment with the same psychiatric provider during life transitions, such as moving to a new city for college.

Privacy. Like in-person care, telepsychiatry protects the privacy of patients. In fact, confidentiality may be heightened since appointments are accessed from home, eliminating the potential that patients will see someone they know in a waiting room—a concern that keeps many from seeking out treatment.

High-quality care. Telepsychiatry meets the standard of traditional in-person care for diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. Along with all major national healthcare associations, the American Psychiatric Association supports the use of this model.

Implementing telepsychiatry

Healthcare organizations interested in utilizing D2C telehealth and telepsychiatry should, of course, consider situational nuances prior to determining the best course of treatment. Conditions such as anxiety, depression, stress, life transitions, childhood mood disorders, and ADHD align well with D2C telepsychiatry. However, it is not appropriate for patients who display suicidal, homicidal, delusional or paranoid symptoms.

In addition, providers should keep in mind that while most people have access to reliable internet connections and smart devices that can support telepsychiatry, not everyone has this luxury. Prior to making referrals, providers should assess a patient’s ability to follow through with the telepsychiatry option.

The potential of D2C telepsychiatry

D2C telehealth models, and specifically telepsychiatry, represent a disruptive care delivery movement that is laying the groundwork for a more connected community and collaborative care continuum. By improving access, these forward-thinking models of care promote early intervention, addressing issues before they escalate and require higher-cost interventions. Ultimately, it’s an optimal framework for improving outcomes and empowering consumers in their care.

By James Varrell, M.D. | Jul. 07, 2017 – Original article on NAMI.org/Blog

Anna struggled to leave her home because of her severe anxiety and depression. Because her psychiatrist’s office was more than an hour away, the stress of commuting often made Anna’s symptoms worse. Anna needed a more practical treatment option and believed there had to be one out there. In her search, she discovered telepsychiatry.

Telepsychiatry is a growing and clinically effective way to provide mental health care via online video calls. One of telepsychiatry’s newest applications called direct-to-consumer (D2C) telepsychiatry is quickly becoming a popular solution for many struggling to find convenient and effective care. D2C telepsychiatry allows providers to deliver mental health care to individuals in their homes (or any other private space) using computers, tablets or phones.

For Anna, and the millions of people living with mental health conditions, this innovative option takes away the stress of commuting to and from an in-person office setting. Telepsychiatry sessions are also far easier to fit into busy schedules. With telepsychiatry, Anna could have her sessions at home after her children had gone to bed. Most importantly, Anna could now receive consistent treatment, empowering her to better cope with her conditions.

The Benefits of Telepsychiatry

Unfortunately, Anna is not alone. More than 55 percent of U.S. counties are currently without any psychiatrists at all. Even in areas that do have mental health professionals, there are simply not enough providers to go around. And because most psychiatrists are concentrated in cities, many people outside these areas, like Anna, endure long commutes to reach the nearest psychiatrist with available appointment times.

For those who share Anna’s experience, D2C telepsychiatry offers an alternative. Here are some of the many ways a person can benefit from telepsychiatry:

  • Convenience. Anyone can schedule appointments—even outside of traditional workweek hours—and can easily attend sessions using any computer, tablet or smartphone with a webcam in any private space with a reliable internet connection.
  • Increased access to care. Telepsychiatry expands choices for providers beyond those who are within driving distance. Any licensed provider in the individual’s state can offer services to them, allowing individuals to connect with the provider most appropriate for him/her.
  • High-quality care. With more providers to pick from, a person can choose someone who best fits their personality, needs and schedule. Reputable D2C telepsychiatry programs train their licensed providers in best practices of delivering care appropriately and effectively through telehealth. Technical support is also available for pre-session test calls.
  • Privacy. Telepsychiatry removes the fear of running into someone you know in the waiting room, while also protecting your information and following state and federal regulations. Many D2C telepsychiatry providers have annual audits to ensure their encryption systems meet HIPPA standards—this is how telepsychiatry providers differ from Skype or FaceTime.

Telepsychiatry makes it possible for people like Anna to receive care in a comfortable, familiar environment. This new form of treatment has the capacity to improve the lives of millions by increasing access to mental health care across the country.

 

James R. Varrell, M.D. is a child and adolescent psychiatrist who has been practicing telepsychiatry for 18 years and is the Medical Director of InSight Telepsychiatry. InSight’s direct-to-consumer division that accepts patient referrals for psychiatry and therapy is called Inpathy.