A Guide To Building A Sustainable. Scheduling To Staffing & Training

Transcription

1 A Guide To Building A Sustainable Telehealth Program: From Billing & Scheduling To Staffing & Training T h e O P E N M I N D S Te c h n o l o g y & I n f o r m a t i c s I n s t i t u t e October 23, :45am 1:00pm D a v i d Y o u n g, M B A, S e n i o r A s s o c i a t e, O P E N M I N D S 15 Lincoln Square, Gettysburg, Pennsylvania info@openminds.com

2 Agenda I. Building A Telehealth Program That Aligns With Your Organization s Strategy II. Telehealth Case Study: Jeffrey Steigman, Psy.D., Chief Administrative Officer, Family Service League III. Telehealth Case Study: Krista Lewis, MHR, LPC, Chief Program Officer, Medical & Crisis Services, Family & Children's Services, Inc. IV. Questions & Discussion 2018 OPEN MINDS 2

3 Building A Telehealth Program That Aligns With Your Organization s Strategy 2018 OPEN MINDS 3

4 Why Add A Telehealth (Virtual Health) Delivery Program? Current need? Goals compelled or chosen? Staff shortages? Reaction to access problems? Developing a longer term solution (strategy) for delivering care? Integration with other service lines 2018 OPEN MINDS 4

5 Developing A Strategic Goal & Plan For Telehealth Emphasis on strategic planning A telehealth plan stems from the organization strategic plan o Cannot overemphasize planning both strategic and tactical planning Does not mean analysis paralysis Clarity Organizational commitment Champion Leadership o Yeah, sure that s a good idea is not enough of a commitment Distractions in priorities 2018 OPEN MINDS 5

6 Where Does Telehealth Belong? Department Not IT Clinical Operations Join Effort IT Finance Need a champion with sufficient organizational power Telehealth is the vehicle for care delivery, not a service line 2018 OPEN MINDS 6

7 Buy Vs. Build: The Challenges Of Pilot Programs Although seemingly logical for first entrees into new systems it can be detrimental To commitment To organizational strategic plan To execution To people involved A crisis/distraction anywhere in the organization can cause pilots to drift A word to vendors on pilots They seem to be a way in the door Its time to check your customer s commitment 2018 OPEN MINDS 7

8 Build: Pro V. Con Pros Control of project o Can be illusionary Pace of implementation o Develop a check list Ownership of project Vendor participation o Technology (software/hardware) Platform? Cons Capital Expenses o Hardware/Software o Platform? Human resource allocation o Who leads, who works, who is accountable No one to blame 2018 OPEN MINDS 8

9 Build Checklist Personal Leadership Project management Clinical resources Technology o Software/Hardware Buy vs. Build Financial Capital Billing for services o Medicare/medicaid/Commercial o Quirks in the law (SSA) Physical space requirements Service line integration 2018 OPEN MINDS 9

10 Buy: Pro V. Con Pros Professional experience o Assumed but check No or limited capital expense Package deals o Models Clinical only (locum tenens with hotel rooms) Technology only Complete telehealth operations Someone to blame Cons Control issues Mixed messages Commitment from internal resources HR changes o Clinicians change unexpectedly o Account management Cancellation issues Vendor viability 2018 OPEN MINDS 10

11 Buy Checklist: Vendor Selection Qualifications Time of firms existence Experience of leadership Performance guarantees o SLA Pricing model o At risk o Per hour o Subscription Includes checklist items from build 2018 OPEN MINDS 11

12 Budgetary Costs Revenue/Reimbursement Measuring Success What are the metrics for success? What are the metrics for corrective action? Suggested Metrics Strategic Plan Fidelity Access Improved New Consumer Time To See Clinician Appointment Wait times Treatment Outcomes Consumer/Client Satisfaction Halo effect Outcomes 2018 OPEN MINDS 2018 OPEN MINDS 12

13 Thoughts On The Future Telehealth is now part of virtual health The ability to provide health services and receive information from patients over distance, in real time and asynchronously, using multi-model forms of delivery and monitoring. Consolidating that into a single source of truth data center in real time to be used in real time to improve health status, anticipate (predict) needs, reduce patient inconvenience (assisting in engagement) and manage costs. A telehealth program can be the first piece in a modular design to create a virtual health program (hint: Primary Care) OPEN MINDS 2018 OPEN MINDS 13

14 Jeffrey Steigman, Psy.D., Chief Administrative Officer, Family Service League 2018 OPEN MINDS 14

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16 MISSION STATEMENT Family Service League helps individuals, children, and families to mobilize their strengths and improve the quality of their lives at home, in the workplace, and in the community.

17 FAMILY SERVICE LEAGUE Serves over 53,000 Long Islanders every year.

18 FSL FAMILY CENTERS Bay Shore Iovino South Shore Family Center Huntington Olsten Family Center Huntington Station Manorfield Family Center Mastic Beach William Floyd Family Center Patchogue Medford Family Center Riverhead - Riverhead Family Center

19 NEW SERVICES IN 2019 It s an exciting time with a whole array of new crisis services coming to Suffolk: 24/7 Crisis Stabilization Program (DASH) 24/7 Mobile Response Teams 24/7 Hotline

20 WHAT DROVE DECISION TO EMBRACE TELEPSYCHIATRY We have always been an agency that embraces innovation, technology and new models-e.g. integrated care (DSRIP), Transition of Care Models Gaps in prescriber capacity, particularly out East (Nor and South Forks) where difficulty to recruit, cost of living high Have relatively large prescriber/medical staff-over 30 prescribers. Belief that we could better utilize/tap into this great resource

21 WHAT DROVE DECISION TO EMBRACE TELEPSYCHIATRY In time, with new programs/expansion realized needed to enlist/partner with telepsychiatry vendor- Genoa Healthcare I, and Directors of our Behavioral Health programs, have been involved for some time in the intersection of operations and technology. Was not IT staff that drove this Building evidence about effectiveness and satisfaction on both provider and client side

22 TIMELINES-COSTS Timeline for Implementation-on average about 2 months. This includes application to licensing agency to add this optional service; ordering and installing equipment, site visit by local licensing staff and training on work flow and other issues We have worked to keep costs low without sacrificing quality-equipment expense is about 2k per set-up All 10 of our clinics are approved and set-up for telepsychiatry. Looking to use for MAT

23 CHALLENGES Having to go through repetitive process with licensing agencies Having to focus on FFS and Managed Medicaid clients-not all payers approve outright Change management process particularly with those prescribers who don t consider themselves tech savvy-erx Investment in training, set-up (in EMR, eprescribing application) and ongoing communication with remote prescriber Finding best ways to communicate with remote prescriber/problem solve any workflow issues-labs Ensuring uniform process is in place and staff stick to the fidelity of such-important for remote prescriber

24 HOW DO WE MEASURE SUCCESS At this time, success is primarily gauged by being able to fill gaps in our system effectively-that those who require access to a psychiatric evaluation/medication management will be availed of such services when needed Anecdotal accounts from clients and staff regarding the effectiveness of telepsychiatry Quality of the services offered via documentation and clinical outcomes achieved We will be gathering more objective evidence/feedback

25 Krista Lewis, MHR, LPC, Chief Program Officer, Medical & Crisis Services, Family & Children's Services, Inc OPEN MINDS 25

26 Why Telehealth? Family & Children s Services Tulsa, Oklahoma Krista Lewis Chief Program Officer Adult Mental Health and Crisis Services klewis@fcsok.org

27 Why Telehealth? ENTER

28 Overview Our Reasons WHY Components to Consider HOW Measurements OUTCOMES

29 Lisa s Story

30 Why Telehealth?

31 Components To Consider 1 TECHNOLOGY 2 LEADERSHIP & CULTURE

32 Dr. Adam Ruggle in the telehealth suite at Family & Children s Services

33 Dr. Adam Ruggle in the telehealth suite at Family & Children s Services

34 Patient Response Will they respond well? Can we increase engagement? Can it enhance continuity of care?

35 Financial Sustainability

36 Consumer Satisfaction Outcomes 100% Productivity

37 Why Telehealth? Family & Children s Services Tulsa, Oklahoma Krista Lewis Chief Program Officer Adult Mental Health and Crisis Services klewis@fcsok.org

38 Questions & Discussion 2018 OPEN MINDS 38

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