Patients suffering with any of these conditions in a rural facility may have to wait for a local specialist to finish with their scheduled patients or for a licensed therapist to drive in from out of town – which may take more than 8 hours. As a patient in crisis waits for a specialist, scarce resources in these facility (including the room and the time of a patient care tech with special training sitting with them) are unavailable for other patients.
Patients in rural areas don’t always have access to outpatient care and so often put off seeking treatment until they are in crisis. They have a different mindset. One of the goals of Intermountain’s Crisis Care TeleHealth program is to help people feel they have resources, even if it is just the emergency department. They don’t always have access to health centers that support behavioral health concerns. They do know they can always get help at the hospital’s emergency department.
Using TeleHealth, Intermountain now connects behavioral health workers at LDS Hospital in Salt Lake City to remote facilities, reducing wait times and getting patients the help they need sooner. The median time from when a behavioral health worker at LDS Hospital is paged to when the evaluation starts is 20 minutes, vastly cutting down the time a patient in crisis is waiting.
Using TeleHealth, we are able to provide better care in a timelier manner, like at Garfield Memorial Hospital where we’ve used this technology in their emergency department since November 2015. In addition to reducing stress on patients and their families, the extra support also reduces strain on beside staff, builds teamwork across the system, and helps boost morale. The program provides better fidelity to clinical practices, exposes clinicians to Care Process Model’s more regularly, and allows them to collaborate with colleagues.
Our philosophy is about becoming part of the on-site team, not making them part of our team. We are part of the emergency department team and part of the community. TeleHealth helps patients and their families get the evaluations they need and information on additional care, including getting scheduled for follow-up visit with a local social worker or therapist. It helps them be able to move past the moment and have hope for the future.
At first, behavioral health resources may seem to only benefit a small number of people. However improving mental health in the community at large is one way Intermountain is addressing population health. In addition to consulting with on-site care givers and evaluating patients in crisis, our behavioral health specialists are helping rural facilities find more resources. The program is also working with local schools to connect patients with local therapists and primary care physicians.
The Crisis Care TeleHealth program is live in 11 Intermountain facilities, and our team is working to expand the reach of this service to additional Intermountain facilities as well as non-Intermountain sites, like Kane County Hospital in Kanab, Utah.
About the author: Adam Hornung, Director of Behavioral Health for the Central Region, has led the efforts to establish and implement the Crisis Care TeleHealth program. Hornung joined Intermountain late in the spring of 2015 from the Banner Health System in Arizona. Facing a shortage of crisis care professionals at emergency departments, Hornung has helped this service approved and properly staffed with a dedicated 24/7 team, including hiring a new manager for the crisis care workers.