OnePerspective: VA shows how technology can improve mental health care

Editor’s note: This inaugurates our new series of ‘OnePerspective’ articles. These are written by industry contributors on issues of importance to our Readers and are archived under ‘Perspectives’. For more information on contributing an article to our OnePerspective program, email Editor Donna.

[grow_thumb image=”” thumb_width=”150″ /]By: Gigi Sorenson

The shortage of mental health professionals in the U.S. is becoming more acute for two reasons: 1) more health professionals are encouraging their patients to seek treatment, and 2) more people now have health insurance due to the Affordable Care Act.  A December 2016 assessment showed that over 106 million Americans live in areas where there are not enough mental health providers to meet the need. Because of this provider shortage, as well as the stigma attached to behavioral health treatment, roughly half of mental illness cases go undiagnosed or unaddressed.

However, telehealth could fill much of this gap, and the beginnings of this trend are already evident. A growing number of psychiatrists and psychologists are using video and audio teleconferencing to treat patients remotely. Patients have access to this “telemental health” either in clinics and medical centers or, in some cases, through their Internet-connected personal devices. Studies of telemental health have found that it is effective for diagnosis and assessment in many care settings, that it improves access and outcomes, that it represents a portable, low-cost option, and that it is well-accepted by patients.

VA Program Sets the Pace

The Department of Veterans Affairs (VA) began to deploy telemental health in the early 2000s, and the VA now has the largest and most sophisticated such program in the U.S. In 2016, about 700,000 of American’s 22 million veterans used VA telehealth services. In 2013, 80,000 veterans used telemental health services, and over 650,000 veterans took advantage of those services in the previous decade.

The VA system has trained more than 4,000 mental health providers in evidence-based psychotherapies for post-traumatic stress disorder (PTSD) and other mental health conditions.  It has expanded the use of telemedicine at its 150 medical centers and its 800 outpatient clinics.  It is relying increasingly on telemental health to serve its beneficiaries, partly because nearly half of the veterans of Iraq and Afghanistan live in rural areas. Mental health professionals are often unavailable in these regions, and it can be difficult for these veterans to travel to metropolitan areas where VA clinics and medical centers are located.

Telemental health can address these issues.


State of telehealth in Australia – a GP’s view

As we have noted in the past, Australia has provided incentives for GPs to implement videoconference telehealth [grow_thumb image=”” thumb_width=”150″ /]consultations in remote rural areas. Simple though it may be from a conceptual point of view, providing the ability for people in isolated communities to have access to specialists can make an enormous difference to the healthcare they receive.

Dr Ewen McPhee, a GP from rural Queensland, writing in the Australian Family Physician’s December issue (“Telehealth: the general practice perspective”) briefly looks at the state of videoconference telehealth in Australia 3 years after the current incentives were implemented. “Three years later, the implementation of telehealth videoconferencing has been inconsistent and patchy, yet to be normalised as part of primary care practice” says McPhee.

Living in cities like London or New York it can sometimes be hard to imagine (more…)

Australia’s telehealth incentive programme nears end

A multi-million dollar financial incentive programme to encourage Australian clinicians to start telehealth [grow_thumb image=”” thumb_width=”150″ /]schemes is due to end in June. Launched as a four-year programme in July 2011, the Telehealth On-Board Incentive Programme was funded from a wider AU$620 million telehealth initiative, but the end of the programme was brought forward to June 2014.

The Medicare rebates and financial incentives for specialist video consultations were introduced to address some of the barriers to accessing medical services, particularly specialist services, for Australians in remote, regional and outer metropolitan areas. The Telehealth On-Board incentive was one of five financial incentives in the wider initiative and encouraged and supported the initial and ongoing provision of telehealth services to eligible patients by practitioners. (more…)

Videolink telehealth continues expanding in Yorkshire (UK)

The video-link/ videoconferencing system used by Airedale NHS Foundation Trust in Yorkshire, [grow_thumb image=”” thumb_width=”150″ /]England, to provide remote medical assistance is being rolled out to additoinal care home sites. The service is staffed by a specialist nurse at Airedale General Hospital who uses the system, known as the Telehealth Hub, to assess patients and support staff at the homes.

According to the Keighley News the service was installed in a Bradford nursing home with the first use on New Year’s Eve. Staff at Ashville Care Home are quoted as saying that the service allows their residents to receive medical care without having to call a GP out or take them into hospital. A hospital visit would mean having to get extra cover as a member of staff needs to go as well.

Meanwhile the Telegraph & Argus reports (more…)

Telehealth counselling program expands in Texas

Following on from our article on the school telehealth scheme in Michigan  (Smaller scale telehealth and telecare sucesses, [grow_thumb image=”” thumb_width=”150″ /]TTA Jan 4), we report now how a remote counselling clinic started by Texas A&M to provide psychological counselling to rural population has expanded. The Telehealth Counselling Clinic in Centerville, Leon County, was started from a grant in 2007 to the Center of Community Health Development (Texas A&M) and Leon County, and provides counselling using Texas A&M faculty and graduate students in the counselling psychology program, supervised by licensed psychologists.

The service has now been expanded to Madison and Washington counties based on the success seen in Leon County. Two more sites are planned for opening  in 2014. (more…)

Saypage Telehealth introduced at West Suffolk Hospital (UK)

When this editor worked for the NHS in West Suffolk – long, long ago – my colleagues and I always denied the saying that West Suffolk was ‘the graveyard of ambition’, and we pointed to numerous innovations that we introduced without fanfare into our various fields. So it is pleasing to see that the tradition appears to be continuing. The following press release describes the introduction of a hospital-to-home internet-based video link system to reduce the need for some orthopaedic patients to attend hospital to receive post-operative follow-up consultations. Significantly, it appears to be a development championed by an enthusiastic hospital consultant. We have seen over and over again that technological solutions to care pathway problems work best when they are adopted from the ground up. West Suffolk NHS Foundation Trust Launches Virtual Orthopaedics Outpatients Clinic Built On Saypage Telemedicine Platform. (Saypage press release) [Will the people who use the system be counted towards the 3millionlives (3ML) target? Oh! Silly me! No one is counting anything, and it’s an aspiration, not a target!]

Related links: What is Saypage Telehealth? and Saypage User Guide.

Northamptonshire NHS contracts for video consultation service (UK)

The Saypage Telehealth Platform looks like an interesting addition to the number of companies providing video conferencing services to health services in the UK but the company’s announcement would get a warmer welcome from us if were not for its classic hype-it-up press release. Just because one NHS Trust has contracted for the service does not justify the implied claim that the whole NHS is rolling it out. NHS Launches Online Video Consultations Service Using Saypage Telehealth Platform. The lesson for all suppliers is to keep it real if you do not want to undermine readers’ respect.