HCA Healthcare rolls out in-EHR referrals to Talkiatry's telepsychiatrists

Primary and urgent care providers within HCA Healthcare’s network now have the option to refer their patients to Talkiatry’s full-time psychiatrists from within their electronic health record thanks to a new integration and partnership between the telepsychiatry provider and major for-profit health system, Fierce Healthcare has learned.

The integration is live across the “vast majority” of HCA’s technology systems with the organizations collaborating on a “division-by-division” rollout plan to educate the chain’s providers on the new capabilities, Talkiatry CEO and co-founder Robert Krayn told Fierce Healthcare.

Once selected in the EHR by a clinician, Talkiatry reaches out to the patient to schedule a virtual visit with one of its 300-plus board-certified psychiatrists, usually within five days. The platform handles intake and insurance verification, generally giving patients a choice between four psychiatrists that are matched based on these factors.

Importantly, Krayn said, the platform also works to coordinate care alongside the referring provider. With the patient’s consent, Talkiatry updates the provider with information on any diagnoses and medications, or even if the patient ever made it to the appointment.

“What’s game-changing about that is when you get [the referral] electronically … it allows you to close the loop much better,” Krayn said. “Sending a referral via paper, even if Talkiatry got the referral, there’s no real mechanism to let that referring provider know what’s going on. So they’re like, ‘I sent him a referral — no clue if they actually made the appointment, no clue what they were diagnosed with.’ That could change what they’re doing with that patient or how they’re treating that patient.”

Krayn said that his company will continue to work with HCA to continue onboarding and educating its providers as new clinicians join or locations are added.

The CEO didn’t share any estimates of how many patients Talkiatry expects to see as a result of the integration, but noted that HCA is among the country’s largest health systems with 186 hospitals and about 2,400 ambulatory care sites. As such, the for-profit system likely has “an incredible number of patients who need access to behavioral health and, specifically, psychiatric care.”

He expects there will continue to be situations when providers prefer to keep patients in-network with HCA providers and behavioral health resources.

“Talkiatry has absolutely no problem with that,” he said. “I’m sure a lot of providers, if they have a co-located behavioral health clinic or something along those lines, there’s probably even more care coordination that can be done internally.

“Second, there are some things Talkiatry doesn’t treat that are better treated in person, right? So that’s part of the education component. A great example is schizophrenia. The correct treatment protocol for that is an injectable medication. Well, Talkiatry is virtual so we don’t inject medication, and that’s a great example of, hey, Talkiatry’s not the right place to send that patient.”

Still, Krayn said that Talkiatry is a strong partner for large providers like HCA due to its unique ability to handle such a large-scale partnership while maintaining care quality.

The company recently published data in the peer-reviewed Journal of Medical Internet Research showing clinically significant improvements in depression and anxiety symptoms among patients. Nearly all of the company’s prescribing staff are physicians, Krayn said, and its medical affiliate was also accredited last year as a provider of continuing medical education.

“That’s something very rare in outpatient medicine, period, and almost unheard of in digital health,” he said. “While [we are] combining technology and a new way of doing things nationally to increase access and quality, we also have a more traditional approach, if you will, in terms of how we staff physicians and how we enable them to deliver care. And so that allows us to do these interesting, really broad, big partnerships with people like HCA Healthcare that I think others just aren’t able to do.”

The integration with HCA is the first large health system partnership Talkiatry has announced publicly, though Krayn said that it has partnerships and is live with “a large number” of national, regional or state-specific health systems that it hopes to announce down the line.

Talkiatry is in-network with over 60 health plans across 44 states and has seen patients in 48 states since launching in April 2020. It notched its 1 millionth visit last month, with Krayn noting that “the vast majority of that was done in the last 12 months.”

Talkiatry also has partnerships with other digital health providers like NOCD and Charlie Health. These collaborations, respectively, help the company provide integrated behavioral health care for patients with obsessive-compulsive disorder in need of medication management, and for teen and young adult patients requiring intensive outpatient treatment.