How to solve the shortage of psychiatrist in rural areas? Question 6: How to solve the shortage of psychiatrist in rural areas?

Solution: Tele psychiatry?

Can it be done? There are problems of course. Lack of high speed internet connections HIPAA requirements State requirements

Can it be done? Not all patients would have PC cameras Not all would even have computers

New questions How do we bring high speed internet connections to rural areas? How do we make it secure and HIPAA/State compliant? How do we make it easy to use?

We don’t! Instead we bring the patients to the high speed connections Where the technology is already HIPAA/State approved And we design the interface to be as easy as possible.

Was the solution always there? We asked ourselves, is there a way to use what is already available? My team and I made a list of all the Health Professional Shortage areas (HPSA’s) in Georgia.

Was the solution always there? We found 213 facilities located in 147 counties just in our state. For now we excluded correctional facilities Leaving 189 facilities located in areas of need.

Time to work for it Given the time we had available we decided to use a random sample of 1/3 of the counties. 62 facilities were divided up amongst the team and we began making phone calls

What did we ask? We had very simple questions: Does the facility have access to a high speed internet connection over 5mb per second? Do they have a teleconference room on the premises? If so, how often is it use?

The use ranged from 10% to 100% What did we learn Only 57 facilities reported having access to high speed internet greater than 5mb per second. Of those 36 also reported having a teleconference infrastructure in place. The use ranged from 10% to 100%

What did we learn This meant that 92% of the facilities located in the HPSA’s have access to a high speed internet connection 64% already have a teleconference infrastructure already in place and most aren’t even using them.

We can bring tele psychiatry to those in need. We can use this We can bring tele psychiatry to those in need. We need to partner with the medical facilities that are already servicing these areas. We need to be able to offer a product that will help all of the 92% of facilities with high speed connections.

The business model

Step one: Contract with current industry vendors to supply software for those with a current teleconference infrastructure in place and hardware for those who need both.

Step Two: Contract with the medical facilities to provide the software and hardware needed ,as well as installation and support.

Contract with the psychiatrist Step three: Contract with the psychiatrist

But what about the patient? As stated earlier, the solution needs to be simple to use. We designed a very easy to use interface that links to the patient portal.

Demo time

Demo time

How does everyone get paid Luck for us, the state of Georgia has a parity law which allows the physician to charge the same for a tele psychiatry visit as they would for a regular office visit. This service also provides the physician with more clients than are in their immediate area. They are able to help those in the most need.

How does everyone get paid The medical facility is able to charge the insurance provider, Medicare or Medicaid a facility fee for being the originating facility. Because the user interface is linked to the patient portal they drive up their meaningful usage numbers each time the patient uses the site.

How does everyone get paid The vendor is paid for the products we sell through our contractual agreement. This includes an annual subscription fee for the use of their software.

How does everyone get paid Our company is paid by selling the vendors software and hardware. Annual subscription fees paid by the physicians as well as the hospitals

Where do we go from here? Georgia’s parity law is a significant milestone in our ability to bring tele psychiatry to the HPSA’s, but there are still several regulations that need to be changed before we can help everyone.

Where do we go from here? The two most significant of these are: Physicians are not allows to prescribe controlled substances for tele psychiatry sessions. Physicians must be in the stated of Georgia

Where do we go from here? These two state regulations prevent the physician’s from being able to help the patient as fully as they would one who was in their office who may need prescribed drugs to get better. And they severely limit the number of available physicians to only those who are within our borders while ignoring the availability of those outside of the borders who want to help.

While we have a solution that brings tele psychiatry to the rural areas, we are not able to do it for everyone. 92% is a good start but we strive for 100% and as high speed internet become available to these areas we will be there to assist them.

Finally, the state regulations need to be changed. They are currently limiting the assistance that can be provided despite the solutions we come up with.

Thank you