Ohio s Telepsychiatry Project DISABILITIES

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Agnes Wood
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1 Ohio s Telepsychiatry Project OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES WRIGHT STATE UNIVERSITY IN COLLABORATION WITH ODMH AND ODJFS

2 Goal of this Project To provide access to high quality psychiatric care and community mental health services for people affected by co-occurring mental illness/ developmental disabilities residing in remote areas throughout Ohio.

3 Secondary Goal To encourage collaborative relationships between local DD Boards and MH Boards in order to bridge the gap in services to those with complex issues, and better prepare community agencies to see the whole person and their role in providing needed supports in all aspects of a person s life.

4 Psychiatric Services Directed By: Dr. Julie Gentile, MD Wright State University Consumer Advocacy Model 6 S. Patterson Blvd. Dayton, OH 45402

5 Telemedicine as an Emerging Trend Definition Telemedicine uses communication networks for delivery of health care services and medical education from one geographical location to another. It is deployed to overcome issues like uneven distribution and shortage of infrastructural and human resources.

6 Facts In rural communities ~50% of mental health care is provided by primary care physicians Patients may have to travel long distances or forgo such services altogether. In CA, AZ and CO, telemedicine has reduced isolation of patients with SMD Telemedicine helps disseminate skill set to PCPs Many patients prefer to go to a PCP clinic for appointments as opposed to a MH clinic (decreased stigma)

7 Facts Increasing data shows reliability/validity are similar to face to face interaction Reduction in travel time, costs, ER visits and hospitalizations Not necessary to be tech savvy Established programs use buffet menu (phone, , MD-MD, MD-patient, etc)

8 Facts Success has been shown in child psychiatry, depression, dementia, schizophrenia, suicide prevention, PTSD, panic disorder, substance abuse, eating disorders, and smoking cessation Mental health particularly well suited due to little need for hands on procedures and interventions Hailey et al 2008

9 Facts Effectiveness shown in delivering Cognitive Behavior Therapy for anxiety and depressive disorders as well as in patients with traumatic brain injuries (Norm et al 2006) Distancing effects can increase disclosure and honesty due to increased sense of security

10 Facts Telemedicine is currently being utilized in: clinics, hospital emergency departments, patients homes, group homes and nursing homes, homeless shelters, hospices, schools, forensic facilities and in military combat zones

11 All mental health services that can be delivered faceto-face can be delivered via Telemental Health. Telemental Health has a number of important benefits for patients, clinicians, provider organizations, and communities. The most important of these can be summarized succinctly: Telemental health is a cost-effective way to improve access to specialty mental health services in rural and underserved communities.

12 Wooten 2006 Telepsychiatry is arguably the most successful realtime telemedicine application. Formal evidence of its efficacy and effectiveness Main benefits: increased access to care, costeffective, enhanced educational opportunities, improved outcomes, better quality of care

13 Simms et al 2011 May be more effective after building a relationship and therapeutic alliance with patient in person Research shows alliance is not compromised by use of videoconferencing Medium made some patients feel less embarrassed and more able to express difficult feelings Clinicians length of time in the field affected their openness to the new technology

14 Key Benefits for Patients Better integration of specialty mental health care into patient s general health care Improved access to specialty MH services for assessment and ongoing treatment Reduced costs (travel, time, etc) Reduced wait time Improved continuity of care/follow

15 Key Benefits for Rural Clinicians Improved access to mental health specialists for consultation Improved quality of mental health care for patients Reduced professional isolation Improved access to continuing medical education Improved continuity of care and follow up

16 Ohio s Telepsychiatry Project Intent is to reach remote areas or those with limited geographical access to psychiatric services Initial offering is to all but the top 13 counties based on size Those ineligible for initial project may be considered once initial target group is saturated, or in future expansions Child Psychiatry services will be added as they become available and initial project is successfully underway

17 Ohio s Telepsychiatry Project Required Criteria for Individuals Referred: At least 18 years of age with co-occurring mental illness/developmental disabilities Medicaid Enrolled Self/Parent/Guardian consents and agrees to participate fully

18 Priority Given to Individuals: Moving from a Developmental Center/Behavioral Health Hospital to community At risk of Institutionalization At risk of losing current placement Danger to self or others Currently using an aversive plan that includes physical restraint (Note: These are not requirements for referral. If slots are limited referrals will be prioritized based on these factors.)

19 Expectations of County DD Board Identify CB contact person to coordinate services Arrange staffing/transportation to initial intake visit/ face-to-face follow up visits if needed at WSU s CAM Dayton Office Provide access to a computer and webcam or teleconferencing equipment Ability to monitor vital signs (BP/pulse/body weight) on day of appointments Accept lead role in coordinating access to emergency services as deemed necessary, to include hospitalization Develop a collaborative relationship with local MH Board in order to best support the person s full range of MH needs

20 Projected Outcomes Up to 120 individuals served through Telepsychiatry Project by the end of FY13 Improved MH/DD collaboration on local level Increased capacity for local communities to serve those with complex issues Data collection to provide long-term success rate in improved patient health, reduced hospitalizations/ crisis placement, overall cost of supports, etc.

21 Send Referral Packets To: Nicole Duff, PCC LSW LCDC III Outpatient Services Coordinator Wright State University Pam Berry, Senior Policy Advisor Ohio Department of Developmental Disabilities (614)

Ohio s Telepsychiatry Project

Ohio s Telepsychiatry Project OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES WRIGHT STATE UNIVERSITY IN COLLABORATION WITH ODMH/ODJFS/ODDC Goals of this Project To provide access to high quality psychiatric