ATA16: Telehealth helps Inova improve care access for stroke, behavioral health patients

Telehealth has been a boon for Inova Health System, particularly in the areas of neurosurgery and behavioral health, according to representatives from the Falls Church, Virginia-based provider who spoke Monday at the American Telemedicine Association's annual conference in Minneapolis.

According to Steven Dean (pictured), the health system's director of telemedicine, Inova has seen downstream income of more than six figures from telehealth consults for neurosurgery, although he did not provide a dollar amount. The health system uses a traditional hub-and-spoke model, he said, in which nurse practitioners at community clinics consult with a subspecialist neurosurgeon at more well-equipped Inova hospital sites. Patients receiving such care represent "an outlying" population that "otherwise would not have driven into" Inova's urban facilities, Dean said.

Meanwhile, telehealth also has helped Inova's psych liaison service, which provides round-the-clock crisis help to emergency departments, cut patient response times from two to three hours down to roughly 30 minutes, according to Abbey May, director of Inova's Psychiatric Assessment Center. Since 2014, all nine Inova EDs have supported telehealth. Prior to 2012, however, the liaison service consisted of staffers physically driving from one ED to another for consults, with individual staffers responsible for two to three facilities.

"Realistically getting between the hospital systems was really difficult," May said.

Overall, May said, telehealth has helped Inova to streamline its psych liaison efforts by centralizing and using less staff; about six less FTEs are needed under the new system, she said.

In addition, the health system last year rolled out a pilot connecting eight of its primary care clinics via telemedicine to its community mental health walk-in clinics. The telemedicine system, which is integrated with Inova's electronic health record, enables primary care doctors to connect directly with or make referrals to behavioral health providers.

"There's still this stigma with behavioral health," May said. "Not wanting to go see a psychiatrist, to drive to a psychiatric walk-in clinic. Here you are at your primary care doc, and they can dial into telemedicine, you can see a psychiatrist over telepsych, get an assessment, get started on medication, and it was the engagement to get them hooked in.

"It was just what we needed to get [hesitant patients] started, to get them engaged, and to follow up with care after that."

May said that Inova's plan is to connect its 33 primary-care clinics to behavioral health via telehealth over the next year.