As Delaware works to set up a system of care for its overdose patients, one option on the table is expanded use of telehealth to connect patients to the addiction treatment and mental health services they need.
Telebehavioral health would allow mental health professionals to visit with overdose patients in an emergency room from a remote location.
Officials are considering this specifically for downstate emergency departments to resolve transportation challenges facing Sussex County. Hospitals there have already utilized telehealth for Parkinson’s patients unable to travel to a doctor’s office.
Telehealth psychiatrist Adrienne Yourek, MD agrees using telehealth in emergency departments would help to connect patients to mental health professionals immediately at critical moments, but adds other pieces are needed for telehealth to be truly effective.
“So intervening immediately upon the point of crisis is wonderful as long as the patient then has immediate links to other services that are going to help them start working on their recovery,” said Yourek.
Yourek says the willingness of overdose patients to engage with mental health professionals is another challenge. During a talk over the weekend before the Psychiatric Society of Delaware, she said mental health patients can sometimes be uncomfortable with the use of technology and even display paranoia when talking to a face on a screen.
In addition to HIPAA privacy, federal law also requires the consent of a patient with substance abuse disorder before sharing the patient’s data.
Traci Bolander, PsyD is CEO of Mid Atlantic Behavioral Health.
She also says using telehealth as a resource to combat the opioid crisis would be beneficial, but points out there is a workforce shortage in the mental health industry. She says it’s important to have professionals working at the top of their license.
“It may not necessarily need to be a psychiatrist or a psychologist that is intervening in that moment,” said Bolander. “It might be a peer support specialist or a community mental health worker that is specially trained to be that liaison for the patient.”
Bolander adds telehealth could be an effective means of cost savings as the state looks to bolster its emergency departments. She says one on-call telehealth professional could treat multiple patients in an evening across the state from a remote location reducing the need for additional staffing.
Morris James Attorney and health care law expert Andrew Wilson notes telehealth technology is also much less expensive to set up than it used to be.
“Those gigantic karts that cost $20,000—thankfully we came over that technology hump very quickly,” said Wilson.
He also describes telehealth as a coming renaissance.
“I think it’s only going to be to the benefit of Delaware patients who are going to be able to be in that continuity of care, where they can get those services with the faces and people they know when they need it,” he said.
Though the state is looking into telebehavioral health for Sussex County emergency departments, officials with the state’s behavioral health consortium say optimum patient engagement is with in-person interviews.
