Ohio s Telepsychiatry Project

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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 care and community mental health services for people affected by co-occurring mental illness/ developmental disabilities residing in remote areas throughout Ohio To increase psychiatric services to children with DD throughout the entire state

Goals of this Project (con t.) 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.

Psychiatric Services Directed By: Dr. Julie Gentile, MD Wright State University Consumer Advocacy Model Dr. Gentile continues her work to develop a community of psychiatrists with a focus on serving those with MI/DD and has successfully recruited WSU graduating physicians to join her team at CAM

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. Gentile/Fraker

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) Gentile/Fraker

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, Email, MD-MD, MD-patient, etc) Gentile/Fraker

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 Gentile/Fraker

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 Gentile/Fraker

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 (except referrals for children/adolescents) Those ineligible for initial project may be considered once initial target group is saturated, or in future expansions Child Psychiatry services just expanded to include all counties due to the overwhelming need across the state

Top 13 Counties by Size: Not Included in the Project at this Time* Cuyahoga Lorain Franklin Mahoning Hamilton Lake Summit Warren Montgomery Trumbull Lucas Stark Butler *Child/adolescent referrals accepted

Project Map

Ohio s Telepsychiatry Project Required Criteria for Individuals Referred: Child or adult with co-occurring mental illness/ developmental disabilities Medicaid Enrolled Self/Parent/Guardian consents and agrees to participate fully

Project Data as of 10/31/12 Project expects to serve up to 120 individuals by June 2013 64 adults and 11 children currently referred Out of those, 39 adults and 2 children actively receiving services 27 counties participating/referring at this time Began accepting referrals for those under 18 years in August 2012

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

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.

Send Referral Packets To: Nicole Duff, PCC LSW LCDC III Outpatient Services Coordinator Wright State University Nicole.Duff@wright.edu

DODD Contact: Pam Berry, Senior Policy Advisor Ohio Department of Developmental Disabilities Pam.Berry@dodd.ohio.gov (614) 301-2992