I am sure if you are a physician or an owner of mental health service you probably might have used some form of telemedicine software during the pandemic and may be continuing to use it still. I am not talking about simply having it as an option parallel to in-patient visits here but taking this serious into building a fully integrated in-person and virtually enabled care delivery models that "hybridize" care delivery based on clinical appropriateness and other factors such as convenience and cost.
As AMA(American Medical Association) states "The integration of new virtual care solutions such as video visits, remote monitoring, asynchronous telehealth, continuous and passive sensors, and augmented intelligence (AI) into digitally-enabled care models offers the potential to address the quadruple aim of enhancing patient experience, improving population health, improving health care professionals’ work-life and reducing costs"
How Behavioural Health is moving towards TeleHealth
Mental health telehealth was off to a slow start but after the pandemic things have changed a lot. We see health insurance companies and policymakers of the state and health associations relaxing terms to accommodate virtual visits. Psychiatry calls for physical examination much less often than most other medical specialities, making it ideal for telehealth.
A recent national poll conducted during the pandemic found that while 82% of respondents who had a telehealth visit were satisfied, nearly two-thirds (64%) would have preferred an in-person visit
Medicare, Medicaid programs and commercial payers are actively expanding coverage for virtually-delivered behavioural health services permanently following the pandemic.
Research done by AMA on Virginia Commonwealth University Health - Telepsychiatry during Covid-19 shows how they continued to use telehealth after Covid-19.
A group of U.S. senators are calling for an expansion of mental health telehealth. "The pandemic made clear that telehealth is a game-changer, particularly so Americans can get mental health care when they need it," U.S. Sen. Ron Wyden, D-Oregon, chair of the Senate Finance Committee.
The committee released a legislative discussion draft on May 26 with proposals to:
1. Remove Medicare's in-person requirement for mental health services.
2. Make telemedicine benefits for mental health more transparent to Medicare beneficiaries.
3. Preserve audio-only mental health care for people on Medicare.
4. Support and promote Medicare and Medicaid provider expansion of telemedicine offerings for mental health.
5. Incentivize states to use their Children's Health Insurance Programs to offer telehealth for mental healthcare in schools.
"Whether for rural communities, urban areas or tribes, telehealth has undoubtedly expanded access in underserved areas, improved care coordination and integration, and provided more privacy to patients to combat stigma," Finance Committee ranking member U.S. Sen. Mike Crapo, R-Idaho, stated.
More Advantages of Telehealth
Well-integrated digitally-enabled care brings in a lot of value over in-person only care and parallel in-person and virtual care. Based on the clinical need and appropriateness visit can be either in-person or virtual. Another main aspect is coordination where virtually integrated care teams can connect with the patient seamlessly and in real-time as needed without the need to be physically present.
When it comes to speaking about their mental health issues, some are uncomfortable meeting in person whereas telepsychiatry can be received in the privacy and comfort of their homes. This also helps patients to connect more easily without having to get ready and take the commute reducing friction to care.
Research has also found patients and clinicians have found it more humanizing and effective the fact that they do not need to wear personal protective equipment during virtual visits has fostered more meaningful clinician connections.
Because of the improved convenience of conducting a virtual visit no-show rate has also decreased considerably. A December 2021 study found that in pandemic-era telemedicine, the no-show rate at one Ohio clinic was only 7.5%, compared with a 30% no-show rate for in-person office visits before the pandemic.
Other than these some indirect benefits are,
- New Patient Acquisition
- The patient retention rate is high
- Increased capacity due to more availability
Final Thoughts
By this point, I hope you understand how serious this technology is getting. It may still seem overwhelming having to adapt to these new technologies, but the longer-term benefits are much more satisfying for both you and the patients. AMA return on health report clearly states this "Though the existing body of evidence regarding the value of virtual care has grown substantially in recent years, it is narrowly focused on short-term measures of financial value. There remains scant literature regarding the long-term effects of virtual care, such as improvements in access to care, clinical outcomes, the impact on the patient and clinician experience, the potential for operational efficiencies, or the impact on health equity"
