TY - JOUR
KW - behavioral health
KW - e-Health
KW - telehealth
KW - Telemedicine
AU - M. Waugh
AU - J. Calderone
AU - Brown Levey
AU - C. Lyon
AU - M. Thomas
AU - F. DeGruy
AU - J. H. Shore
A1 - 
AB - BACKGROUND: Integrated care is characterized by evolving heterogeneity in models. Using telepsychiatry to enhance these models can increase access, quality, and efficiencies in care. INTRODUCTION: The purpose of this report is to describe the process and outcomes of adapting telepsychiatry into an existing integrated care service. MATERIALS AND METHODS: Telepsychiatry was implemented into an existing integrated care model in a high-volume, urban, primary care clinic in Colorado serving patients with complex physical and behavioral needs. Consultative, direct care, educational/training encounters, provider-to-provider communication, process changes, and patient-level descriptive measures were tracked as part of ongoing quality improvement. RESULTS: Telepsychiatry was adapted into the existing behavioral health services using an iterative team meeting process within a stepped care model. Over 35% of the requests for psychiatry services were medication related-and medication changes (type/dose) were the most frequent referral outcome of psychiatric consultation. Forty percent of patients in the service had multiple behavioral health diagnoses, in addition to physical health diagnoses. DISCUSSION: Telehealth will become an increasingly necessary component in building hybrid/blended integrated care teams. Examples of flexible model implementation will support clinics in tailoring effective applications for their unique patient panels. CONCLUSIONS: An adapted integrated care model leveraging telepsychiatry is successfully serving the complex deep end of a primary care patient population in Colorado. Lessons learned in implementing this model include the importance of team attitudes.
BT - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
C5 - HIT & Telehealth
CY - United States
DO - 10.1089/tmj.2018.0132
JF - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
N2 - BACKGROUND: Integrated care is characterized by evolving heterogeneity in models. Using telepsychiatry to enhance these models can increase access, quality, and efficiencies in care. INTRODUCTION: The purpose of this report is to describe the process and outcomes of adapting telepsychiatry into an existing integrated care service. MATERIALS AND METHODS: Telepsychiatry was implemented into an existing integrated care model in a high-volume, urban, primary care clinic in Colorado serving patients with complex physical and behavioral needs. Consultative, direct care, educational/training encounters, provider-to-provider communication, process changes, and patient-level descriptive measures were tracked as part of ongoing quality improvement. RESULTS: Telepsychiatry was adapted into the existing behavioral health services using an iterative team meeting process within a stepped care model. Over 35% of the requests for psychiatry services were medication related-and medication changes (type/dose) were the most frequent referral outcome of psychiatric consultation. Forty percent of patients in the service had multiple behavioral health diagnoses, in addition to physical health diagnoses. DISCUSSION: Telehealth will become an increasingly necessary component in building hybrid/blended integrated care teams. Examples of flexible model implementation will support clinics in tailoring effective applications for their unique patient panels. CONCLUSIONS: An adapted integrated care model leveraging telepsychiatry is successfully serving the complex deep end of a primary care patient population in Colorado. Lessons learned in implementing this model include the importance of team attitudes.
PP - United States
PY - 2018
SN - 1556-3669; 1530-5627
T1 - Using Telepsychiatry to Enrich Existing Integrated Primary Care
T2 - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
TI - Using Telepsychiatry to Enrich Existing Integrated Primary Care
U1 - HIT & Telehealth
U2 - 30394851
U3 - 10.1089/tmj.2018.0132
VO - 1556-3669; 1530-5627
Y1 - 2018
ER -