Tele-Behavioral Health at Kaiser Permanente Andrew Bertagnolli, PhD April 28, 2014
Key Legal & Compliance Issues Professional licensure Clinician must be licensed to practice in the state the patient resides Medicare Coverage Reimbursement is currently limited to designated rural locations only Prescribing State laws vary, but there should be an established provider-patient relationship to prescribe medication based on a video visit 2
Example Use Cases for Legal Review Interregional Telehealth Services Leveraging clinicians from other regions to provide services for local members Nonphysician Telehealth Services Need to review any state specific legislation Prescribing State laws vary, but there should be an established provider-patient relationship to prescribe medication based on a video visit 3
Other Regulatory Considerations Scope of Practice Medical Record Documentation Patient Consent Website Requirements Privacy & Security Credentialing & Privileging Patients in a Health Facility Health Plan Coverage and Cost Share Determinations Health Plan Access Standards 4
KP Georgia Tele-Behavioral Health Proof of Concept Overview Went live on December 8, 2011 between the Southwood and Henry Towne Center MOBs Tele-Behavioral Health visits were booked for Medication Management visits only POC Providers - Charles Heath, MD and Wendy Hill-Park, PhD Established patients only A new visit type was created for booking - TELEPSYCH 30 minute appointment slots No member cost share was collected during POC 5
6 POC Workflow
BH Proof of Concept Dr. Charles Heath 7
POC Overview Con t. Patient Feedback Real-time feedback gathered from patients Very positive patient feedback; comments includes: smooth process, very cool will definitely schedule another Tele-Behavioral Health visit All patients seen for Tele-Behavioral Health visits have booked follow-up visits as a Tele-Behavioral Health appointment Provider Feedback Minimal impact to existing KPHC workflows AVS Printing may be an issue (selecting correct printer) Tele-Behavioral Health unit easy to interpret/navigate Would like to offer service to patients from Newnan, Fayetteville and Douglasville 8
POC Patient Satisfaction Survey Patients are surveyed by the providers at the conclusion of their Telemedicine visit Survey questions: On a scale of 1-5 (1= least satisfied and 5= most satisfied), how satisfied are you with the following: Ease of checking in for Telemedicine appointment - 5 Comfort level of equipment - 5 Comfort level in communicating with doctor - 5 Overall Telemedicine visit 4** Survey comments: My visit was very cool and easy The telehealth room was cold in appearance with no décor or reading materials. ** I felt like I was in my doctor s office and was very comfortable during the visit I will definitely schedule my next visit as a telehealth visit That was easy! **Visit materials were added in the Telehealth room as well as additional items to add decor 9
16 BH Telehealth Visit Data con t. 14 12 10 8 6 4 2 0 Canceled No Show Completed 10
BH Telehealth Current State 1.5 years later BH Telehealth visits are being expanded at the SW MOB Four additional providers are conducting telehealth visits Dr. Watford, Dr. Thompson, Dr. Stewart, Dr. Dickson No additional facilities at this time but expansion underway A new laptop has been delivered (at SW) to support the additional physicians during the Telehealth visits Dr. Heath s office (SW) has been built in KPHC as a resource room for scheduling Telehealth visits Telepsych machine is slated to be relocated to a common room giving more providers access during their work week. 1:1 training approach for clinicians (facilitated by Dr. Heath) 11
Expansion Plans CMC We have identified two additional facilities We will install in two other BH Modules BHCL Dedicated MD that practices across all offices Home visits with Vydeo Facility discharge barriers 12
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