Technology Enables Medical Care for Patients With Immediate Needs


 

When you imagine the most common barriers to medical care, what comes to mind? The financial burdens or lack of transportation? Rural areas with a scarcity of specialists, critical access hospital closings, or the doctor and nursing shortage currently facing the nation?  All of these obstacles are formidable, but access to care can be denied in more subtle ways. The stigma surrounding certain medical conditions often prevents patients and their caregivers from seeking treatment and can have resounding impacts.

Consider the following story:

Sarah* attended a prestigious university, and with prestige often comes pressure. She reported feeling depressed in high school, but the symptoms didn’t start to physically manifest until her freshman year of college, when she began to experience weight loss and academic difficulties. There was a health clinic on campus, but no psychiatric services were available. While she was on break, her parents took her to their family doctor who instantly knew she needed a psychiatric evaluation. Sarah’s parents scoffed at the idea that she was experiencing depression. They both had high-pressure careers, understood the squeeze, and felt confident that Sarah would adjust with time.

The summer of Sarah’s junior year, her symptoms became impossible for her family to ignore any longer. Her parents took her to a psychiatric practice, where Sarah was evaluated by a seasoned psychiatrist, who immediately recognized just how urgently she needed help. It became clear the barrier to Sarah’s care was not financial; it was the stigma her parents associated with branding their daughter with a mental health condition. The psychiatrist suggested Sarah take some time off from school to focus on her care, but her parents were adamant she not fall behind. The office offered remote sessions via telepsychiatry, an excellent solution that would allow Sarah to receive the continued care she so desperately needed while at college, but her parents declined. They were adamant that their daughter was not depressed, just overwhelmed.

A few days before she was supposed to return to school, Sarah’s mother found her in her bedroom closet. She had hanged herself.

Increasing Access to Mental Healthcare

Sarah was unable to seek care on her own, due to her school’s lack of access to psychiatric care.  Inaccessibility to mental healthcare is a common problem across the United States, not just at universities. Many hospitals—especially those in rural areas—don’t have a dedicated psychiatrist or nurse practitioner on staff and must rely on other facilities. Even in large, metropolitan hospitals staffed with qualified specialists, those professionals are typically overextended, leaving patients waiting for the care they so desperately need.

Hospital leadership is turning to telehealth to provide the access their patients need. They recognize the tremendous benefits telehealth brings to their patients and how it successfully closes the gaps.

 

Adding Telehealth to Your Own Facility

Many healthcare facilities challenged by a lack of professional resources—such as psychiatrists, hospitalists, cardiologists, and pediatric specialists—are discovering how telehealth can help them provide these services without adding permanent staff. Access to care, particularly highly specialized care, is critical for so many regions across the US. In many cases, a healthcare facility can leverage their existing technology and audio/visual equipment in the deployment, especially if they partner with a vendor who utilizes a system promoting interoperability.

Before committing to a telehealth vendor, it’s important to make sure they have the necessary experience to set up a program that will be sustainable. Ask questions about the security of their system, advanced encryption, and HIPAA and HITECH Act compliance. You will also want to determine if they can provide the proper technology support and clinical expertise to support a custom telehealth solution.

The right telehealth provider will ensure you are armed with all the tools to make your staff and your providers comfortable with the process, because acceptance by key stakeholders is crucial to the success of the rollout. It’s also important to choose a telehealth partner who will work on recruiting the specialties you need, matching outstanding candidates with your facility’s culture, workflows, staff makeup, and patient profile. This is often the most crucial component to success. These on-call specialists must have more-than-proven clinical skills; they need a strong “tele” presence, giving the patient the feel that the healthcare professional is in the room offering full caring, trustworthy medical advice.

Using Telehealth to Overcome Stigma

Sarah’s story is tragic and demonstrates just how imperative it is to continue the work of reducing the stigma associated with mental health conditions. It is important to recognize not only the ways in which telepsychiatry is saving lives, but also its potential to encourage patients and their caregivers to seek care when they need it the most, for conditions that they otherwise wouldn’t due to fear of judgement. Often, when patients need care for stigmatized conditions, they are more likely to seek treatment where they have options and flexibility. It’s imperative that facilities and providers adopt this model and continue to promote accessibility for all. In addition, we need to continue the conversation about mental health, a pervasive problem that affects every generation, regardless of socioeconomic status or education.

*Name has been changed to protect patient privacy.