North Carolina’s Telepsychiatry Initiative

The Office of Rural Health and Community Care  within the North Carolina Department of Health and Human Services (DHHS) is expanding their Statewide Telephsychiatry Program (NC-STeP) administered by the East Carolina University Center for Telepsychiatry and e-Behavioral Health (CTeB). The goal is to improve access to telepsychiatry in hospital emergency rooms.

The state legislature appropriated $2 million for 2013-2014 and $2 million for 2014-2015 for the program. In addition, Duke Endowment, a private foundation based in Charlotte, awarded a grant for 1.5 million to be disbursed in two installments. Funding for $800,000 would be disbursed in 2014 and $700,000 in 2015 to build on the initial success of the telepsychiatry program. The funding will help to improve care for patients, and achieve cost savings

Previously, out of the state’s 108 hospitals, 49 were already providing psychiatry in emergency rooms. In 2013, 18 hospitals were added to the network and by the end of March 2014, 23 more hospitals were providing telepsychiatry services in their emergency rooms. Other hospitals are negotiating contracts and by July 2015, it is expected that the remaining 36 hospitals will be serviced by the program.

To further the goals of NC-STeP, the recent report “Telepsychiatry in North Carolina: Mental Health Care Comes to You” produced by the North Carolina Center for Public Policy Research makes several recommendations such as:

  • Raise awareness about telepsychiatry in rural and underserved communities
  • Provide information on expected costs, funding sources, legal restrictions, and reimbursement rates for telepsychiatry services
  • Consider whether private insurers should be required to fully reimburse healthcare providers for telepsychiatry services
  • Provide financial and technical assistance to rural healthcare providers who want to incorporate telephsychiatry into their practices
  • Increase funding to the state’s medical schools, nursing programs, schools of social work and psychology programs as needed to incorporate telemedicine and telepsychiatry as part of the curriculum
  • Enable DHHS to partner with medical schools in North Carolina to incorporate telepsychiatry into the residency programs
  • Enable DHHS to adopt practice guidelines for video-based online mental health services as promulgated by ATA in May 2013
  • Have DHHS develop criteria and outcome measures to evaluate the successes and failures of the state’s telepsychiatry program

 

The Center for Telepsychiatry is already required to submit a report to the DHHS Office of Rural Health and Community Care on the number of consultant and referring sites participating, number of psychiatric assessments conducted, length of stay of patients receiving telepsychiatry services in the emergency room, and the number of involuntary commitments as a result of telepsychiatry assessments. Additionally, all clinical providers are required to participate in a peer review process.

According to the report, ECU’s Center for Telepsychiatry would also be required to track and report on the satisfaction of emergency room staff, the psychiatrists attending the patients, the response of the patients, and the number of patients who return to the emergency room within 30 days.

To view the report, “Telepsychiatry in North Carolina: Mental Health Care Comes to You” go to www.nccppr.org/drupal/sites/default/files/file_attachments/accomplishments/telepsychiatry.pdf

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