Telepsychiatry Consultation Program Achieving Tomorrow, Today South Carolina Department of Mental Health (DMH) Division of Medical Affairs Innovative Trends In Healthcare: Telepsychiatry Services in Hospital Emergency Departments, A Behavioral Health Solution Telepsychiatry Consultation Program Achieving Tomorrow, Today Last Update: 1/11/2016

Overview the Problem – Patient Back-up in the Hospital Emergency Departments (EDs) the Partnerships – The Duke Endowment, SC Department of Health and Human Services, USC School of Medicine, and the SC Hospital Association the Proposal – Video Consults to Hospital EDs the Purpose – Increased Access to MH care Last Update: 12/11/2016

Primary Goals Increase the Quality of Care Provide Timely Psychiatric Assessment Rapid Initiation of Treatment Reduction in Length of Stay (LOS) Comprehensive Discharge Planning Savings to the Hospital and Community Last Update: 12/11/2016

Remote Site Locations Last Update: 07/22/2015

Clinical Office Locations Columbia, SC (2) Anderson, SC Aiken, SC (2) N. Charleston, SC (8) * * FUTURE Spartanburg, SC * Charleston, SC (4) Last Update: 12/11/2016

Consultation Process Patient Presents in ED ED Case Physician Requests Consult Psychiatrist Reviews CIS, SCHIEx, EMR Patient Consulted via Two-Way Video Cart Video Encounter is Completed Psychiatrist Electronically Signs Consult Recommendations Sent to ED and Local Mental Health Center or Substance Abuse Hospital Dispositions the Patient Last Update: 12/18/2015

Dashboard - Time Comparing end of March 2009 (pre-Telepsychiatry) to end of March 2015 for Mental Health Patients in Hospital ED’s: 85% Reduction in Patient Wait Times for MH Assessment (2.5 days to 9.3 hours) Last Update: 07/29/2015

Turn-Around 13-15 consults every 17 hour day (December 2016) Current program results: 34% recommended for discharge the same day (24-48 hours) of consultation Last Update: 12/18/2015

Satisfaction Surveys Last Update: 2/20/16

Survey Results – Patients Positive Impact on Patients… 100% of ED Staff state Telepsychiatry is an efficient use of Patient’s time 92% state Patients appear comfortable during consultations 84% state Patients are cooperative during the consultation Last Update: 07/2015

Survey Results – ED Doctors Benefits to the Emergency Departments… 83.4% of ED Physicians state Telepsychiatry is an efficient use of ED Staff’s time; 100% of ED Physicians state they are satisfied with the availability of Telepsychiatry; 100% of ED Physicians state they are satisfied with the thoroughness of consults; and, 83.3% of ED Physicians state they are satisfied with disposition recommendations Last Update: 07/2015

Survey Results - Administration Efficient Use of Hospital Resources… 70% of Hospital Administrators state the program is an efficient use of hospital funds 80% would recommend the program to other Hospitals 60% would be interested in additional uses of the platform for other medical specialties Last Update: 07/2015

R01 Grant Research Collateral Impact: Reallocation of Resources by ED’s to ED-appropriate care Reduced Commitment Rate to BH Inpatient Beds Reduction in Average Inpatient LOS Produced Savings of $3,006 in BH Inpatient Settings per Care Episode Equals (approx.) $35+ M in BH Inpatient and Community Medical Savings Last Update: 12/18/2015

Website Last Update:2/1/16

Community Site Locations Last Update: 2/28/2016

For more information, please visit: www. scdmh For more information, please visit: www.scdmh.org/telepsychiatry Contact: Ed Spencer, M.Ed., MSW 803 898-8579 ed.spencer@scdmh.org Tracy Turner 803 898-8503 tracy.turner@scdmh.org Last Update: 12/18/2015