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After a year of talking to patients on Zoom, the phone, and sometimes FaceTime, some mental health providers in central Ohio are confident that telemedicine will continue after the pandemic ends.
Kristen Carpenter, director of outpatient services at Ohio State Harding Hospital, said the hospital had been running some telehealth services prior to the pandemic, but they were mainly used to connect various emergency rooms and provide emergency psychiatric care. But with COVID-19, the hospital shifted from "almost 100% personal care to almost 100% telemedicine care," she said almost immediately.
Now that about 90% of Harding's outpatient care is still delivered through telemedicine, Carpenter foresees a future where patients can choose how to receive their care.
"Our patients have experienced almost no interruption in their care," she said. "We have been able to provide care that we never thought we could reach through telemedicine."
Harding currently offers individual counseling and psychiatry services in person and via telemedicine. The partial hospitalization and the intensive outpatient program – a structured three- to four-week treatment program in which patients usually have to complete all-day group sessions in the hospital – are now taking place via Zoom.
John Dawson, interim president and CEO of Community for New Direction, also sees telemedicine in the future of the nonprofit group – despite not offering telehealth services before the pandemic.
"We have a higher issuance rate … There are so many barriers for patients with mental health and substance use disorders coming to appointments that telehealth has helped tremendously in this area," he said.
A new study found that during the first few months of the pandemic, patients were more likely to use telemedicine services for behavioral health treatments than for physical illness. This is based on a recently published by RAND Corp. published January study. The study shows that 53.6% of patients with a behavioral health status sought treatment via telemedicine from mid-March to early May 2020. In comparison, 43.2% of patients with chronic physical illness used telemedicine to receive care over the same period.
Delivering services over the phone or videoconferencing has removed many barriers, including unreliable access to transportation and labor disputes, Carpenter said. At Harding, for example, there are fewer emergency cancellations and lower no-show rates due to telemedicine appointments, she said.
However, as with other things remotely controlled, there are some downsides.
Linda Jakes, executive director of Concord Counseling Services in Westerville, said the nonprofit group has found it a little more difficult to remotely treat especially young children and older adults. Both groups are usually more difficult to engage, and older adults sometimes have greater problems with navigation than other patients.
"It could be difficult if you're just having a phone call to someone to really see the body language involved," Jakes said. "There are many things we use our eyes for."
There are other challenges as well, said Dawson of Community for New Direction.
Reliable internet and access to a private room for appointments are privileges some people just don't have, he said.
To improve the accessibility of telemedicine, his agency is working to provide funding for data cards and telephones for patients in need.
Aside from accessibility, some patients need to be seen in person, Dawson said. This includes, for example, people with severe opiate use disorder or personality disorder who require more detailed assessment. All patients, he added, come to the office for documentation for ingestion and follow-up drug testing, if this is part of their treatment plan.
Concord Counseling has established security protocols such as staggered appointment times and changing days on which employees enter. Otherwise, individual clinicians can decide when to bring patients to the office, said Mike Preston, director of clinical operations. He said most providers have face-to-face appointments with patients for whom "telemedicine just doesn't work for them."
Carpenter said most virtual appointments are exhausted for vendors sitting in front of computer screens for hours without a break. And although psychiatric treatment lends itself to telemedicine, the social interaction that personal care provides is lost with virtual appointments.
"Over the year we put a lot of focus on how entering the office can actually be some kind of behavioral health intervention to pull them back out into the world," she said.
Jakes said telemedicine was invaluable and she couldn't imagine offering only personal care again. But she said many clinicians are looking forward to certain milestones that they did not appreciate before the pandemic.
"I spoke to one of our therapists the other day and she says, 'Oh my god, it will be so exciting to come back' because she has part of her case burden that she's never met before, she just has Telemedicine done, "said Jakes. "She says, 'If I passed them on the street, I wouldn't even know who they are.'"
Social factors did not affect the acceptance of telemedicine by families in the early pandemic
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According to providers, telehealth has a permanent place in psychiatric treatment after the pandemic (2021, May 3).
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