Telemedicine tools like smartphones, two-way video, email, and wearable technology are becoming increasingly common in many healthcare settings. In 2014, the Healthcare Information and Management Systems Society (HIMSS) led a study that found that 46 percent of more than 400 hospitals and medical practices said they used at least one type of telemedicine.1 Additionally, the Academy of Integrative Health & Medicine (AIHM) found that 33 percent of U.S. healthcare practitioners offered healthcare services via telephone, video, or webcam visits, and another 29 percent planned to do so in the next few years.2
This type of flexibility and interconnectivity is helpful for both providers and patients. For providers, the trend toward telemedicine offers a new avenue of connecting with patients, and potentially a new revenue stream. On the patient side, the ability to connect and share data with a healthcare provider without having to travel for appointments can make a big difference in compliance and communication. Additionally, research has found that patients may be more comfortable sharing sensitive information via telehealth rather than an in-person setting.
Unique issues in behavioral healthcare
One area of medicine where telehealth tools can play a particularly helpful role is in behavioral healthcare. To understand the potential these tools have in changing the way behavioral health cases are managed, let’s examine two common scenarios in our current system:
First, consider a patient who is admitted to the hospital with appendicitis and undergoes an appendectomy. After a short stay in the hospital, the patient is discharged with a care plan. The patient may not adhere to every last item in the care plan, but chances are this will not have a significant effect on recovery. If the patient is recovering satisfactorily at his or her follow-up appointment, the care team will consider the case successful.
Now, consider a different patient with a behavioral health issue. This patient is admitted to the hospital for alcohol addiction and undergoes a detox. After a short stay in the hospital, the patient is discharged with a care plan. Unlike the appendectomy patient, the patient with alcohol addiction must pay extremely close attention to his or her care plan. If the patient does not adhere to every item, chances are this will have a significant effect on recovery.
Adherence in behavioral health cases is much more vital to success than it is for a typical patient. But the burden of adherence is put on patients at a time when they are most in need of assistance. This helps explain why recidivism is so high in behavioral healthcare. Many patients are discharged from a facility with the expectation that they will be responsible for coordinating their own follow-up care.
Integrating telemedicine for better results
Recognizing the issue, more and more healthcare providers and payers are looking into systems that invest in supporting behavioral health patients after discharge, and telehealth tools often play a big role in these solutions. With care plan management provided remotely by clinicians specializing in behavioral health, patients get valuable assistance navigating the challenges that might otherwise hinder their recovery. For example, a care plan manager can speak with a patient to ensure that she has a method of transportation to attend meetings or go to the pharmacy, and can follow up on a regular basis to ensure the patient is following her clinician’s recommendations. The patient also gains more opportunities to ask questions and request adjustments to the plan. Additionally, in the event that the patient begins having problems with adherence, the care plan manager can possibly identify this issue much earlier than if the patient were not receiving regular telehealth support.
On the provider and payer end, offering this level of support can not only drive greater success in individual cases, it also generates the data needed to continually refine treatment recommendations and individual care plans. By applying modern analytics to the information that is gathered in a phone call between a care plan manager and a patient, payers and providers can better understand the true long-term health indicators and outcomes. This is critical as the American healthcare system moves further toward a value-based reimbursement model.
Initial applications of these principles have shown very promising results. In North Carolina, for example, the Albemarle Hospital Foundation developed a telepsychiatry program in 2011 that resulted in a 47 percent reduction in patients’ length of stay in the ER, and a 35 percent reduction in 30-day recidivism rates. The program’s success was a major contributor to the state legislature’s creation of a statewide telepsychiatry program for hospital emergency departments.
Statistics show that one in four Americans experiences a mental illness or substance abuse disorder each year, and nearly half of all Americans will develop a mental illness during their lifetime.3 Given the prevalence of these issues, the healthcare community must innovate to offer technology that makes it easier for patients to get in touch and be “seen” by a professional. Greater application of telehealth options will give patients a better way to receive truly personalized care, and will also give the care team and payers the data needed into support patients now and in the future.