Sy Saeed, M. D., FACPsych, Professor and Chairman Department of Psychiatric Medicine Brody School of Medicine - East Carolina University Director

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1 Sy Saeed, M. D., FACPsych, Professor and Chairman Department of Psychiatric Medicine Brody School of Medicine - East Carolina University Director North Carolina Statewide Telepsychiatry Program (NC-STeP)

2 57 hospitals in network 40 hospitals currently live 17 additional hospitals scheduled to go live within next two months These hospitals have equipment and have already been trained, we are just waiting on credentialing. Four Clinical Providers Hubs Coastal Carolina Neuropsychiatry Cone Health Novant Mission

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4 Timeline Seven referral sites "Go Live" (total in network= 45). ECU submits quarterly performance report and financial statements to DHHS Office of Rural Health and Community Care. DHHS Office RHCC submits annual report on the operapon and effecpveness of Statewide Telepsychiatry to the LOC on Health and Human Services and the Fiscal Research Division before November 1. Result 57 hospitals in network (40 hospital and another 17 hospitals scheduled to go live within next two months Completed. Completed. Sustainability program created. Completed.

5 Hospitals with NC- STeP Live Hospitals with NC- STeP in the Process of Going Live

6 Hospitals with NC- STeP Live Hospitals with NC- STeP in the Process of Going Live

7 Total Number of ED Telepsychiatry PaBents by hospital - for October - December Number of Telepsychiatry PaPents by Hospital

8 Total Number of ED Telepsychiatry PaBents by hospital - for January - December Number of Telepsychiatry PaPents by Hospital

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10 Washington 0% Wesley Long Cone 1% Bladen 2% Nash 0% Lenoir 6% Wilson 4% Wayne 4% Moses Cone 4% Annie Penn 2% Hospital EDs and Percent of Use - October - December 2014 Med Center High Point 0% Novant Kernersville 0% McDowell 5% Transylvania Blue Ridge 2% 2% St. Lukes 0% Yadkin 1% Albemarle 5% Beaufort 8% BerPe 2% Carteret 8% Chowan 5% Duplin 10% Carolina East 1% Randolph 10% Outer Banks 5% Lexington 6% Edgecombe 6% MarPn 1%

11 Nash 1% Wayne 5% Wesley Long Cone 1% Washington 0% Wilson 5% Bladen 1% Lenoir 5% Moses Cone 2% Annie Penn 1% Hospital EDs and Percent of Use - January - December 2014 Med Center High Point Transylvania St. 0% Novant 1% Lukes Blue Kernersville 0% Ridge 0% 1% McDowell 5% Albemarle 8% Pungo 0% Yadkin 0% Beaufort 3% BerPe 1% Carteret 11% Chowan 3% Carolina East 1% Duplin 8% Randolph 18% Edgecombe 4% Outer Banks 4% MarPn 3% Lexington 7%

12 Percent of ED PaBents by Discharge DisposiBon October - December % 0% 5% 45% 49% Home Transfer Admit Against Medical Advice Other

13 Percent of ED Telepsychiatry PaBents by Discharge DisposiBon January - December % 0% 5% 3% 39% Home Transfer Admit Against Medical Advice Other

14 70% percent of patients Had a LOS of 30 hours or less Number of patients with a LOS in this category Median Length of Stay for Oct 2014 Dec 2014 = 18.9 Hours

15 62% percent of patients Had a LOS of 30 hours or less Number of patients with a LOS in this category Median Length of Stay for Jan 2014 Dec 2014 = 23.6 Hours

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17 IVCs - By Release Status October - December % 81% IVCs - percent not released IVCs - percent released

18 IVCs - By Release Status January - December % 79% IVCs - percent not released IVCs - percent released

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20 NC- STeP CHARGE MIX CALENDAR YEAR 2014 (based on inibal status) Blue Shield, 4.9% Self- Pay, 32.0% Commercial, 9.8% Medicaid, 12.0% Medicare, 21.7% Other, 19.5%

21 NC- STeP CHARGE MIX PROJECT INCEPTION TO DATE (based on inibal status) Blue Shield, 5.1% Commercial, 10.3% Self- Pay, 33.3% Medicaid, 11.3% Medicare, 21.7% Other, 18.3%

22 Satisfaction surveys were conducted in January 2015 with 4 groups Emergency Department Physicians Hospital Emergency Department Staff Hospital CEOs/COOs Consulting Psychiatrists (in the HUB) o Invitations to participate were sent via electronic mail o Surveys were completed online via Qualtrics software o Each group was given a different survey (with different questions) based on their role in the telepsychiatry program The following number of individuals from each group responded o Emergency Department Physicians (12 responded) o Hospital Emergency Department Staff (15 responded) o Hospital CEOs/COOs (14 responded) o Consulting Psychiatrists (in the HUB) (7 responded) For each group, one summary question is selected for an overall satisfaction rate.

23 ConsulBng Psychiatrists (in the HUB) reported high levels of sabsfacbon with the program

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25 Hospital CEOs/COOs report that quality of care in the ED has improved. They would recommend this program to others, and pursue addibonal uses of this technology

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33 NC- STeP is either ahead of schedule or on Pme with all of the legislapvely defined Pmelines. 57 hospitals in network 40 hospitals currently live 17 addiponal hospitals scheduled to go live within next two months These hospitals have equipment and have already been trained, we are just waipng on credenpaling.

34 1961 total Telepsychiatry Assessments were conducted under the program during this three month period (including both inipal and follow- up assessments). The Median Length of Stay for all ED papents who received telepsychiatry services was 18.9 hours. Average Length of Stay was 30.3 hours.

35 The Average Length of Stay for ED papents who received telepsychiatry services and were ulpmately discharged to home was 22.8 hours. For papents who were transferred to another facility, it was 36.6 hours. 817 ED papents who received telepsychiatry services had an IVC in place during their ED stay. 153 of those papents did not have an IVC in place when they were discharged, or 18%. Of the ED papents who received telepsychiatry services, 48% were discharged to home. 44% were discharged to another facility.