03/01/22 03/01/22 Last Update: 10/18/2012 Last Update: 10/18/2012 1 TeleHealth & Broadband Conference TeleHealth & Broadband Conference October 19, 2012 October 19, 2012 Prattville, Alabama Prattville, Alabama A Story of Clinical A Story of Clinical Success: Success: the DMH Telepsychiatry the DMH Telepsychiatry Consultation Program Consultation Program
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05/01/2305/01/23 Last Update: 10/18/2012Last Update: 10/18/2012 11
A Story of Clinical Success:A Story of Clinical Success:the DMH Telepsychiatry the DMH Telepsychiatry
Consultation ProgramConsultation Program
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OverviewOverview the Problems – the Problems – Timeliness and Hospital Timeliness and Hospital
Emergency Department (ED) Behavioral Health Emergency Department (ED) Behavioral Health (BH) Costs(BH) Costs
the Partnershipsthe Partnerships The Duke Endowment, SC Department of The Duke Endowment, SC Department of
Health and Human Services, SC Department Health and Human Services, SC Department of Mental Health, and the SC Hospital of Mental Health, and the SC Hospital AssociationAssociation
the Proposal – the Proposal – an initial Three-year Grantan initial Three-year Grant the Purpose – the Purpose – Achieving Tomorrow, TodayAchieving Tomorrow, Today
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Primary GoalsPrimary Goals Timely Psychiatric Assessment and Timely Psychiatric Assessment and
Rapid Initiation of TreatmentRapid Initiation of Treatment Increased Quality of CareIncreased Quality of Care Reduced Lengths of Stay (LOS)Reduced Lengths of Stay (LOS) Comprehensive Discharge PlanningComprehensive Discharge Planning Savings to the Hospital and Savings to the Hospital and
CommunityCommunity
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Partnership Partnership DiagramDiagram
BaptistEasley
Conway
McLeodSeacoast
Chester
McLeodDillon
RoperBerkeley
Carolinas CarolinasMarion
GrandStrand
Clarendon
Fairfield
George-town
HamptonWacca-maw tRMC McLeod
LorisSprings
SC DHHS
Laurens
WallaceThomson
UpstateCarolina
Upstate
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Remote Site LocationsRemote Site Locations
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Consultation ProcessConsultation Process Patient Presents in EDPatient Presents in ED ED Physician Requests ConsultED Physician Requests Consult Psychiatrist Reviews CIS/SCHIExPsychiatrist Reviews CIS/SCHIEx Patient ConsultedPatient Consulted Encounter EndsEncounter Ends Psychiatrist Electronically Signs ConsultPsychiatrist Electronically Signs Consult Recommendations Sent to EDRecommendations Sent to ED Hospital Dispositions the PatientHospital Dispositions the Patient
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Clinical OperationsClinical Operations
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DiagnosesDiagnoses
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Dashboard - TimeDashboard - Time Current program impact results in a Current program impact results in a
44% discharge rate for same day of 44% discharge rate for same day of consult for those seenconsult for those seen
Even with a 40% increase in BH Even with a 40% increase in BH patients presenting in ED’s, patients presenting in ED’s, “Snapshot Average Wait Times” “Snapshot Average Wait Times” (09/2009 v. 09/2012) have not (09/2009 v. 09/2012) have not significantly increased (~2%)significantly increased (~2%)
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Turn-AroundTurn-Around 6.25 hours from initial ED request for 6.25 hours from initial ED request for
Telepsychiatry to patient discharge Telepsychiatry to patient discharge (10/2012)(10/2012)
11.9 consults every 18 hour day 11.9 consults every 18 hour day (09/2012)(09/2012)
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Data ResourcesData Resources CIS – DMH patients (past/present) *CIS – DMH patients (past/present) * EMR – DMH Intranet-based medical EMR – DMH Intranet-based medical
assessment formassessment form SCHIEx – ORS repository for multi-SCHIEx – ORS repository for multi-