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TELEPSYCHIATRY

TELEPSYCHIATRY. MARYLAND RURAL DEVELOPMENT GRANT Delta States September 2009. Brian Grady University of Maryland Holly Ireland Mid-Shore Mental Health Jean Honey Project Coordinator. BACKGROUND. One Year Grant with 2 one-year potential continuations MSMHS Lead Agency Partners

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TELEPSYCHIATRY

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  1. TELEPSYCHIATRY MARYLAND RURAL DEVELOPMENT GRANT Delta States September 2009 Brian Grady University of Maryland Holly Ireland Mid-Shore Mental Health Jean Honey Project Coordinator

  2. BACKGROUND • One Year Grant with 2 one-year potential continuations • MSMHS Lead Agency Partners • Maryland Department of Health and Mental Hygiene (DHMH) • University of Maryland School of Medicine Department of Psychiatry • Garrett County Core Service Agency • St Mary’s County Department of Human Services

  3. Mental Health Professional Shortage Area Designations By Rural/ Non Rural Classification at 11/2008 Single (Entire) County Comprehensive Health Center Facility

  4. Counties Seven Rural Counties: St. Mary’s, Garrett, Caroline, Dorchester, Kent, Queen Anne’s and Talbot Mental Health Care Professional Shortage Area

  5. Sites • Caroline: Caroline County Mental Health Clinic • Dorchester: Wellness Center Mace’s Lane Middle School • Garrett: Garrett County Health Department • Kent: A.F. Whitsitt Center • St. Mary’s: Pathways, Inc • Talbot: Maple Shade Youth and Family Services • Priority Populations: Child/ Adolescent, Geriatric, Co-Occurring Substance Abuse, Deaf/ Hard of Hearing

  6. Operational Framework • Time Line – Announced May 2008 • October 27 – November 5th: Installation of Equipment • Procedures/Schedules/Outreach • Targets • Through April 09: 117 clients/333 encounters • Through 3 year project: 585 clients/ 1,665 encounters • 85% Satisfaction • 95% Completion

  7. University TMH Philosophy • Quality Mental Healthcare • Improve Access • Cost Effectiveness • Utilization of Limited Resources

  8. BENEFITS Consumers: Overall Increases Choice, independence and quality of life • Reduces Appointment Wait Times • Early intervention and treatment • Access to Specialist Providers • Continuity Between Appointments • Reduced ER visits and Inpatient Length Providers: Increases clinical capacity • Connected to Academic Centers, Meetings, Training, Group Therapy

  9. Textbook Implementation Strategy* • Alliance • Assessment • Approach • Access • Accountability • Apprehension • Anticipation *Grady BJ. Chapter 41: TelePsychiatry, Textbook Of Consultation-Liaison Psychiatry, Edited by Wise, MG, Rundell, JR, APP, 2002.

  10. Alliance • Consultant/Consultee • “Ivory Tower” • Communication • Consultee/Patient • Attitude toward MH • Consultant/Patient • Administrative and Support Staff

  11. Assessment • Needs/Resources of Originating Site • Equipment, Capacity, Staff, Budget • Capabilities/Resources of Distant Site • Equipment, Capacity, Staff, Budget • Personal Investment • Distant Site • Originating Site

  12. Approach • Clinician Driven • Consultee Orientation • Appropriate Patient Selection/ Evaluation/Treatment

  13. Access • Patient • Specialty Care • Originating Site • Located within the clinic • Distant Site • Located within the clinic

  14. Accountability • Standard Operating Procedure/Protocols • Records • Cost

  15. Apprehension • Risk/Benefit Ratio • Cost/Benefit Ratio • Patient Information • Security • Privacy • Confidentiality

  16. Hub Patient Safety Equipment Failure Staffing Problems Satellite Patient Safety Equipment Failure Staffing Problems The Seventh "A" Anticipate

  17. Success Depends On Interest Alliance Simplicity Appropriate Use of Resources 18

  18. How Are We Doong? • Alliance • Consultant/Consultee • Consultee/Patient • Consultant/Patient • Administrative and Support Staff • Assessment • Originating Site • Distant Site • Personal Investment • Approach • Clinician Driven • Consultee Orientation • Appropriate Patient Selection/ Evaluation/Treatment

  19. How Are We Doing? • Access • Patient • Accountability • SOP/Protocols • Records • Cost • Apprehension • Risk/Benefit Ratio • Cost/Benefit Ratio • Patient Information • Anticipation

  20. Telepsychiatry Development Grant Program Choices: 21 • Factors Uncontrollable • Grant Rural Eligibility Requirements • State Mental Health Services Organization • Factors Limited Control • Patient eligibility/participation • Provider participation • Site participation • Steering Committee Participation • Sustainability/Economics • Clinical Practice Model

  21. Telepsychiatry Development Grant Program Choices: 22 • Factors Controllable • Lead Agency • Staffing • Project Management • Grant Reporting • Tech Support • Data Analysis

  22. THANK YOU QUESTIONS?

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