OSF HealthCare Telebehavioral Health Program with Regroup: Direct Patient Care and Primary Care Provider Consultation
OSF HealthCare is a large regional health system comprised of 13 hospitals and just over 100 primary care, specialty, and urgent care clinics. Included within these locations are three critical access hospitals, three Rural Health Clinics (RHCs) and many other sites serving rural and semi-rural areas in Illinois and Michigan. Our recent webinar highlights Regroup's partnership with OSF and how they've implemented integrated telepsychiatry services to improve access to behavioral health services.
Read on to download the webinar and see how Dr. Hossam Mahmoud and Luke Raymond, Director of Behavioral Health at OSF answered the questions asked during the live event.
The vast majority of OSF's service locations are located within behavioral health shortage areas, which creates significant barriers in accessing care, particularly psychiatric treatment, where many of its locations have zero psychiatric providers located within a reasonable distance from patients’ homes. Significant travel and costs associated with treatment create an environment wherein many primary care providers become the de facto psychiatric providers for their communities and are often faced with treating high acuity patients with complex medical and behavioral health problems. This often leads to patients experiencing rapid exacerbation of their symptoms that necessitate an emergency room visit and potential inpatient psychiatric admission.
What challenges did Regroup and OSF face during the early stages of the program?
Like any new process being implemented at any organization, initially, program stakeholders at OSF had a difficult time changing physician behavior and getting them to "buy in" to the services being delivered by Regroup. Additionally, getting clinicians licensed and credentialed in the state where services are being delivered can tend to be a challenge depending on the state's telehealth requirements. One challenge facing all healthcare organizations across the country is a limted pool of high-quality clinicians. Although telepsychiatry helps bridge the access gap, technology and this type of care delivery does not change the amount of available clinicians delivering these services.
What are the privacy and security requirements for telemental health and does software like Skype and FaceTime meet these requirements?
Skype does not meet these requirements unless it is the Skype for Business version of the video platform. Regroup’s current understanding is that Apple does not sign Business Associate Agreements with healthcare entities, so technically FaceTime is not HIPAA-compliant. However, FaceTime doesn’t store data, in which case it doesn’t need to have full HIPAA protections in place. While healthcare entities have been known to use both of these types of services, Regroup always recommends using a HIPAA-compliant platform to ensure the highest levels of security and communication between patients and clinicians.
What are situations best-addressed face to face vs. a telehealth session?
For the vast majority of patients, telepsychiatry is the only option. There are a few instances where telepsychiatry is not a viable option for patients. These instances include those with severe autism, advanced dementia, or those that have been diagnosed with psychotic tendencies. Regroup’s Medical Director is a licensed psychiatrist and has successfully hospitalized patients via a telepsychiatry session.
How do you mitigate risks such as suicide or homicide that may arise during a telemental health session?
Through an integrated care model, patients are seen at the healthcare facility, clinician collaborates closely with in-person staff, communicate directly with the staff, communicate with the patient's designated contact.
What states can Regroup provide services in? Can they be provided internationally?
Regroup currently works in 27 states and has the ability to deliver behavioral health services in all 50 states and U.S. territories. Delivering telehealth services internationally varies on the region, whether it is a Regroup clinician or another provider. The general rule of thumb is that the clinician must be licensed where the patient is located.
Do you have arrangements directly with patients?
Regroup does not have any arrangements directly with patients. By partnering with a wide variety of healthcare entities including hospitals and health systems, federally qualified health centers, community mental health clinics, tribal wellness centers, and correctional facilities, Regroup is able to help increase clinical capacity at these locations and reach more patients. To maintain continuity of care for patients, they continue to receive these needed services at familiar care sites. This approach also improves collaboration between the Regroup teleclinician and the patient's on-site care team.
How are psychiatric emergencies handled?
Psychiatric emergencies through this program are handled in a collaborative way. Once the telepsychiatrist identifies that the patient may be a danger to self or others or is needing a higher level of care, they identify the designated emergency contact person at the OSF site where the patient is located. OSF staff will arrange for transfer to the emergency room while the telepsychiatrist remains on the video with patient and staff throughout this process to provide assistance if needed.
What do primary care providers report as their greatest benefit from cooperating with this program?
Primary care providers at OSF have seen tangible outcomes through the telepsychiatry program. One key benefit for PCPs is quick access to expert support when managing psychiatry conditions to reduce external referrals and wait times for patients needing to see a psychiatrist. By having access to Regroup behavioral health specialists as part of the integrated approach, they have also been able to treat patients earlier that may have otherwise gone long periods of time without a proper diagnosis.
To learn more about the partnership between OSF HealthCare and Regroup, or to learn about Regroup's model of telepsychiatry for both direct patient care and primary care consultation, contact us today.