1. Telepsychiatry: Cost Effective Solution to Integrated Care
Dr. Liberty Eberly, Physician Engagement Director
Jonathan Evans, President and CEO

2. Telepsychiatry Overview
Telepsychiatry is being provided in a wide variety of settings – Community Mental Health Centers, Inpatient Hospitals, Residential Treatment, Skilled Nursing, etc.
Initially, it is usually implemented as a means of cutting down drive time for direct care providers serving rural locations but other benefits present themselves (i.e. training, supervision, consultation, etc.)
Technology costs have dropped significantly making telepsychiatry service line implementation a no-brainer for administrators and executives
Younger psychiatrists are choosing telepsychiatry as a primary means to practice medicine for reasons like better work life balance

3. The Innovative Value-Based Strategy
Behavioral health conditions are nationally recognized as a major contributor to health outcomes and utilization
Comorbidity of behavioral health has a direct impact to overall health care costs
Telepsychiatry may be the key element you are missing to support your comprehensive integrated care service delivery model
May require more than one slide

4. Impact of Behavioral Comorbidities
Increasing acuity with significant co-morbid medical issues and associated poly-pharmacy:
Patients with treated MH/SUD cost 2-3 times more ($400 PMPM compared to $1,000 PMPM)
Most of the added cost is in facility-based costs (ER and inpatient) for medical care
Only 14% of individuals with insurance are receiving treatment for mental health or substance abuse disorders

5. A Conduit for Integrated Health Care Delivery
Telepsychiatry allows delivery of quality care across geographic boundaries and populations.
Treatment outcomes and patient satisfaction scores are essentially the same as traditional psychiatric care.
Enhances health care delivery in rural, urban, and correctional settings.
Supports collaborative integrated care models.

6. Psychiatry and Primary Care
Consultative model
Sees patients in consultation in his / her office – away from primary care.
Co-located model
Sees patients in primary care
Collaborative model
Responsibility for a caseload of primary care patients and works closely team of PCPs and behavioral health providers.
SOURCE: Raney, L. (June 2014). The Evolving Role of Psychiatrists in the Era of Healthcare Reform

7. Extending Psychiatric Expertise to Larger Populations
Caseload-focused psychiatric consultation supported by a care manager
Better access
PCPs get input on their patients’ behavioral health problems within a days /a week versus months.
Focuses in-person visits on the most challenging patients.
Regular Communication
Psychiatrist has regular (weekly) meetings with a care manager.
Reviews all patients who are not improving and makes treatment recommendations.
More patients covered by one psychiatrist
Psychiatrist provides input on 10 – 20 patients in a half day as opposed to 3-4 patients.
“Shaping over time”
Multiple brief consultations.
More opportunity to “correct the course” if patients are not improving.

8. The Value Behind Telepsychiatry
Avoid inappropriate admissions by reducing psychiatric onboarding in emergency departments
Shorten wait times and reduce length of stays
Staff difficult cases with a telepsychiatrist or get timely determinations for most appropriate treatment, whether hospitalization or community-based
Meet standards of patient care for boarding times
Follow-up after hospitalization capacity by expanding community-based capacity with direct-to-consumer models
Empower onsite staff to handle psychiatric patients by having a specialist available for consult or assessment when needed – less tangible but actionable
May require more than one slide

9. Patient issues are resolved 83% of the time through use of telehealth
Return on Investment
Alliance for Connected Care study assessing the feasibility of telehealth concluded:
Providers save an estimated $126 per telehealth visit versus in office visits
Patient issues are resolved 83% of the time through use of telehealth
More than half of doctors themselves are willing to see patients over video
May require more than one slide

10. Significant Need for Care

11. Questions? Comments?

12. Thank You! Dr. Liberty Eberly, Director of Physician Engagement
InnovaTel Telepsychiatry
Thank You!
Jonathan Evans,
President and CEO