Primary Care Offices Improve Behavioral Health Care with a New Telepsychiatry Program

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Community Care of the Sandhills (CCS) will use telemedicine to integrate psychiatry into primary care locations. In an effort to centralize health care and bring quality behavioral health care to patients in remote areas, the Community Care of the Sandhills has partnered with InSight Telepsychiatry, LLC to pilot one of the first primary care telepsychiatry programs in the nation.

Many primary care doctors report that they struggle to provide psychiatric resources for their patients. The care options patients do have are in distant locations with long wait times, making psychiatric care costly, time consuming and impractical.

Communities throughout the nation face a shortage of psychiatric clinicians. For example, three of the seven counties in Community Care of Sandhills's (CCS) territory do not currently employ psychiatrists. Additionally, many of CCS’s primary care doctors report that they struggle to provide psychiatric resources for their patients. The care options patients do have are in distant locations with long wait times, making psychiatric care costly, time consuming, and impractical.

“The Sandhills region has a tremendous need for qualified behavioral health providers. This telepsychiatry program is going to connect patients to behavioral health care professionals right from their primary care office,” said Dr. Robin Cummings, Medical Director of CCS.

Telepsychiatry is psychiatric care delivered via video conferencing technology. It has been proven as an effective way to address issues of access to mental health care in underserved communities, particularly in specialty areas like child and adolescent psychiatry or substance abuse services. A study of child and adolescent psychiatry patients who received telepsychiatry care at an outpatient facility in Kentucky found that 100 percent of children and 98 percent of parents were satisfied with the quality of care provided by telepsychiatry.1

Telepsychiatry has been used to increase the behavioral health options in hospitals and outpatient offices throughout the nation for over thirteen years, however, CCS’s use of telepsychiatry in primary care offices is one of the first programs like it in the nation. This innovative application of telepsychiatry means that patients can receive medical and behavioral health care in one centralized location.

“We have had extremely positive results with our telepsychiatry programs in other applications and locations throughout the nation, and we are very excited to see the increased access and improved levels of patient care that we anticipate to come from CCS’s primary care telepsychiatry program,” said Geoffrey Boyce, executive director of InSight Telepsychiatry, which is the service provider that will connect patients to remote psychiatric clinicians.

InSight has been providing telepsychiatry services throughout the country for the past 12 years and their industry experience proved helpful for the implementation of the primary care telepsychiatry program. Five years ago InSight established a partnership with Aetna insurance to pilot the integration of telepsychiatry within local pediatric offices. InSight is adapting this model for North Carolina’s primary care facilities.

“By integrating behavioral and physical health through programs like telepsychiatry, CCS hopes to empower patients to effectively manage their own health care,” said Susanne Whiting the behavioral health coordinator at CCS.

According to Dr. Cummings, a number of Sandhills primary care physicians report that many patients who come in for medical treatment also struggle with mental health issues. “Traveling an hour to see a behavioral health specialist is just not feasible for many families,” said Dr. Cummings. “Patient’s physical ailments are exacerbated by behavioral health problems, but primary care doctors are not trained to comfortably and effectively treat behavioral health issues. That’s where telepsychiatry comes in.”

The first phase of the telepsychiatry program started this week with Sandhills Pediatrics (Southern Pine) and ABC Pediatrics (Dunn), both large pediatric practices with significant need for behavioral health care in their populations. In the coming weeks, FirstHealth Family Care (Ellerbe), FirstHealth Family Care (Raeford) and FirstHealth Richmond Family Medicine will be added. Expansion throughout CCS and into other North Carolina care networks is expected to follow.

Easter Seals, a mental health service provider in North Carolina and Virginia, will provide the pediatric behavioral health care via telepsychiatry, and FirstHealth, a private health care network, will provide the clinicians for the adult psychiatric care.

CCS also anticipates that primary care telepsychiatry will reduce their rates of skipped appointments, in addition to increasing quality of care.

“When patients can just go to their primary care office to receive treatment from different medical specialties, they feel more comfortable. It is also much easier for primary care physicians to hold patients accountable for their health care needs because the physicians can easily monitor patient attendance and progress at psychiatric appointments,” said Dr. Cummings.

CCS’s telepsychiatry program follows the Behavioral Health Integration Initiative (BHI) that was approved in February of 2010 by the Division of Medical Assistance (DMA). This initiative called for an increase in the integration of behavioral health services in primary care practices.

About InSight
InSight Telepsychiatry, LLC is a national leader in delivering telepsychiatry services. InSight provides its partners with a network of telepsychiatry clinicians who augment existing in person services to bring evaluation and care where consumers may otherwise go without. By enabling psychiatric evaluations to be done by the highest level of professional available, InSight’s services help every patient quickly receive the least restrictive and most appropriate level of care. InSight is a part of the CFG Health Network.

Reference 1: Blackmon, Lee Ann, M.D., Kaak, Otto H., M.D., and Ranseen, John, Ph.D. (1997). Consumer Satisfaction with Telemedicine Child Psychiatry Consultation in Rural Kentucky. Psychiatric Services, 48 (11): 1464-1466.

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Liz Ryan
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