Joint telehealth, in-person behavioral health appointments decreased patients' time to care, increased utilization

The Genoa Healthcare-led investigation did not observe any significant changes in medication adherence or readmission.
By Dave Muoio
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A study conducted by pharmacy and outpatient telepsychiatry provider Genoa Healthcare found that rural, Medicaid-covered behavioral health patients received quicker and more frequent care when their in-person visits were supplemented with a telepsychiatry appointment.

These results from 242-patient investigation, published in the Journal of Rural Mental Health, suggest that this hybrid approach to mental health care could increase access and utilization among this population. Improvements in medication adherence and readmissions associated with the intervention, however, were not significant.

“Providing adequate psychiatric care to our rural population is among the top challenges in our behavioral health system because of scarce resources,” Christy Power, VP of health services at Preferred Family Healthcare in Hannibal, Missouri, whose patients were studied in the analysis, said in a statement provided by Genoa. “We’ve only begun to scratch the surface of telepsychiatry as an important tool in the rural mental health provider’s toolbox, but the potential is tremendous.”

TOPLINE DATA

During the 11 months immediately following their first outpatient visit, patients in the intervention group (n = 62) were, on average, within 16.4 days versus an average of 23.6 days for those who only received in-person care (n = 23.6). Two-thirds of those receiving hybrid care logged at least one outpatient encounter per months, as opposed to 50.3% among controls. Emergency department visits, antipsychotic medication adherence and readmission rates were similar among both groups.

Patients in the intervention group were 2.13 times more likely than controls to have any psychiatry outpatients visits. In addition, telepsychiatry comprised at least a quarter of the visits for 27.4% of patients in the intervention group.

HOW IT WAS DONE

The retrospective analysis enrolled adult Medicaid patients in Missouri who had received a telepsychiatry visit following a hospitalization or emergency department visit resulting for substance use disorder or behavior health concerns. These participants were matched with patients who had similar levels of sickness and other demographic characteristics, but had only received an in-person appointment.

All were conducted by a psychiatrist or an advanced nurse practitioner with mental health disorder expertise. Each telepsychiatry appointment was assisted by a staff member who would setup the call for the patient, and then leave the room.

WHAT’S THE HISTORY

Behavioral health is becoming an increasingly established subset of the wider telehealth industry.

For instance, it’s been more than two years since MDLive announced that it would be offering virtual psychiatric services to patients in all 50 states. It is also being used by the Department of Veteran’s affairs. Similarly, the Department of Veterans Affairs has been using telemedicine to treat multiple mental health conditions including OCD, sexual trauma and addiction. And, just the other week, Forefront Telecare capped of a $15 million Series A for its behavioral telehealth services.

IN CONCLUSION

"We recommend future studies that explore combining telepsychiatry with other interventions to determine effective ways health systems and the government can leverage telepsychiatry to make a positive impact on medication adherence,” the researchers wrote. “With the high prevalence of [serious mental illness] in the US and lack of access to mental health services in rural areas, utilizing technology to facilitate care by connecting providers and patients may be an integral component to decreasing adverse mental health outcomes across the country."

Focus on Patient Experience

In May, we'll talk to the thought leaders and first-movers reimagining how and where — Hint: outside their perimeter — and report on how they're to activate if not delight the people they treat.

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