Telehealth Behavioral Health Consultation Services: Implementation Strategies and Challenges Jean Cobb, Ph.D. Behavioral Health Consultant, Cherokee Health Systems J. David Bull, Psy.D. Behavioral Health Consultant, Cherokee Health Systems Collaborative Family Healthcare Association 16 th Annual Conference October 16-18, 2014 Washington, DC U.S.A. Session # B1b Friday, October 17, 2014
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Telehealth Behavioral Health Consultation Services: Implementation Strategies and Challenges Jean Cobb, Ph.D. Behavioral Health Consultant, Cherokee Health.
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Telehealth Behavioral Health Consultation Services: Implementation Strategies and Challenges
Jean Cobb, Ph.D.
Behavioral Health Consultant, Cherokee Health Systems
J. David Bull, Psy.D.
Behavioral Health Consultant, Cherokee Health Systems
Collaborative Family Healthcare Association 16th Annual ConferenceOctober 16-18, 2014 Washington, DC U.S.A.
Session # B1bFriday, October 17, 2014
Faculty Disclosure
We have not had any relevant financial relationships during the past 12 months.
Learning Objectives
At the conclusion of this session, the participant will be able to:
• Gain an increased awareness of how telehealth behavioral health consultation services can achieve the Triple Aim by helping to reduce costs, improve patient experience and population health, and reduce barriers to access care
• Gain understanding of an effective clinical model that implements telehealth behavioral health consultation services in integrated primary care settings
• Discuss challenges and recommendations for successful implementation of telehealth behavioral health consultation services
• Describe equipment and technology capabilities necessary for successful implementation of telehealth behavioral health consultation services
Implementation: Billing & Coding• Add modifier GT “via interactive audio and video
telecommunications systems”• Originating Site = location of patient• Distant Site = practitioner who furnishes and receives
payment for covered telehealth services • Per Centers for Medicare & Medicaid Services - can
include MD, NP, PA, Nurse Midwife, Clinical Nurse Specialists, Clinical Psychologist, Clinical Social Worker, Registered Dietitian or Nutrition Professional
• Must have strong & efficient communication between BHC and on-site staff
• Important to train staff in advance and have plan in place (guided by on-site and community resources)
• May need staff to assist by:• Informing other patients that BHC is running late• Changing patient rooms if needed• Help patient access telephone and other crisis resources as needed• Monitor patient for physical safety during crisis assessment &
• It helps to have remote access to an on-site printer, but if not available have commonly used handouts on-site (or alternative plan to send by fax or email)
• Recommend scheduled BHC follow-up appointments be limited to one “originating site” on a given day
• Use clinical judgment for patients who are more appropriate for face-to-face encounters, strategically schedule them on days you are physically present
• Coach support staff on how to appropriately introduce telehealth (don’t “make a fuss” over it)
• Polycom high definition video codec* • High Definition LED/LCD TV - 720p or higher, using HDMI or Component
connections• Bandwidth capable of supporting 615kb** of video/audio traffic per telehealth
session• End to End Quality of Service (QoS) across the LAN/WAN*** to prioritize audio
and video traffic* Cisco and LifeSize also make video codecs, but require more bandwidth to initiate a "high definition" call**This is what is recommended for a high definition connection using Polycom video codec***The Wide Area Network Provider (such as AT&T, Windstream, Verizon) should also create QoS policies within the WAN
• 8 key issues: Competence, Standards of Care, Informed Consent, Confidentiality, Security and Transmission of Data, Disposal of Data and Information and Technologies, Testing and Assessment, Interjurisdictional Practice