Vision for the Future: Blending Telehealth and On-Site Behavioral Health Teams

Many providers used to view telehealth with a skeptical eye. Now, however, the future of telehealth looks much brighter. Why is that?

Prior to the coronavirus pandemic, the behavioral health field faced major obstacles to providing quality care, including long wait times for appointments, not enough providers to meet the demand for services, and cost restrictions in relation to reimbursement. Due to stay-at-home orders being mandated on such short notice, rapid changes to providing care were essential.

Although telehealth services were already being utilized in some locations, the pandemic forced many other providers to implement these services overnight. Many providers felt uncertain about how to effectively collaborate with their colleagues while working remotely. Others had concerns about how the use of telehealth would disrupt their workflow. These rapid changes, coupled with a fear of the unknown, naturally created some resistance to transitioning fully to telehealth.

However, the overall acceptance and popularity of telehealth has grown. The American Psychiatric Association (APA), among other associations, has advocated that congress permanently lift certain restrictions on telehealth services beyond the pandemic. The APA believes telehealth is extremely beneficial not only during times of emergency, but also during “normal” times. If restrictions are lifted, researchers could study the impacts of services more extensively and evaluate which services should be made permanent following the pandemic.

Since many providers are advocating that telehealth is here to stay, how can providers fully utilize this service in the future?

Provider collaboration is possible to the future of telehealth

Dr. Liberty Eberly, D.O., Chief Medical Officer and Co-Founder of innovaTel Telepsychiatry, and Lauren Lashbrook, Director of Strategic Partnerships at innovaTel Telepsychiatry, stated in a Relias webinar that “it is possible to have collaboration between remote and on-site providers.” Thanks to advances in telehealth technology, providers can meaningfully collaborate with each other despite working remotely.

While the communication style can vary organization-to-organization, most behavioral health clinics are intentional about keeping telehealth providers connected. Eberly says:

“Throughout my day, I have frequent contact with the nurse or medical assistant that I work with that day. Sometimes I’m calling, sometimes I’m texting, or e-mailing paperwork back and forth. We are working together all day long to meet our patients’ needs.”

Eberly and Lashbrook’s recommendations for keeping provider collaboration running smoothly include the following:

• If providers are connecting virtually into a clinic, they can stay connected to the clinic all day long so that on-site providers can see that they are available and connect as needed.
• If clients no-show or cancel an appointment, clinicians can keep that time open for other providers to have the opportunity to connect and collaborate.
• If all providers are remote, set up a weekly treatment team meeting to help everyone connect virtually.
• Consider keeping in touch via other communication channels, such as a chat feature through the EHR or a secure messaging platform.

Integrating telehealth into your workflow

Another concern providers have about the future of telehealth is how to integrate telehealth into their organizational workflows. “The goal of successfully implementing telehealth is to mirror your existing workflows,” Eberly states. While the mode of communication is different, it is possible for all other workflows to stay the same or be similar to what the organization is used to doing.

Lashbrook states that “technology allows us to connect everyone together so we can facilitate the workflows that would have traditionally been there in a face-to-face visit.” Even after the end of this pandemic, many clinicians are hoping to continue this convenient method of care. Even though stay-at-home orders are lifted, providers are still able to easily integrate telehealth permanently into their organization.

Eberly and Lashbrook note the following ways telehealth can be integrated into existing workflows:

• If clients will be coming into the office, choose a room for holding telehealth appointments and set it up with the appropriate technology
• If clients will continue to use telehealth at home, have nursing staff connect with them ahead of time to make sure they can successfully access their appointment
• Schedule appointments in the EHR just as it would be done with in-person appointments; notate whether the appointment is “in person” or “telehealth”
• Use software that will allow providers and clients to electronically sign documents and securely send and store these documents online
• Prescribers will continue to document and prescribe any medications electronically in the EHR just as they would in-person
• Insurance claims will be billed by the organization just as they would in-person

Keep in mind that the first few times telehealth sessions take place, the process may not run flawlessly. Like anything new, it is a continuous learning process in which providers will benefit greatly by maintaining a positive mindset and willingness to try again. In Eberly’s experience, many clinicians and patients initially did not think they would like it, but with a little enthusiasm and optimism, they did.