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Open Minds & Genoa Healthcare: A Successful & Sustainable Telepsychiatry Program Takes The Right Partner

Open Minds November 1, 2018

Over the past couple of years, regulations around telehealth have decreased as payers become more comfortable with the model and relax restrictions (see Telehealth Gains Popularity, Telehealth Budgets Don’t). At the same time, the psychiatrist workforce is shrinking, increasing problems with access to psychiatric services (see Workforce Shortages As a Strategy IssueWhat Health Plans Are Looking For? Hint: It’s Not A Bigger Provider Network). This has created a unique set of circumstances for the rise of telepsychiatry. But for many provider organizations, figuring out the logistics of implementing a telehealth program can be daunting.

To learn more about the process of setting up a successful telehealth program, I talked to Dr. Mehdi Qalbani, M.D., psychiatrist, Integrated Behavioral Health in New Orleans; and Samir Malik, executive vice president/general manager of telepsychiatry at Genoa Healthcare.

In his practice, Dr. Qalbani has extensive experience providing telepsychiatry through direct-to-consumer care for individuals with commercial insurance, as part of an ACT (assertive community treatment) team for consumers with serious and persistent mental illness. Dr. Qalbani explained why he has partnered with Genoa Healthcare:

Genoa has chosen to focus on people who don’t otherwise have access to care, and that’s why I’ve chosen to work with them. They have also spent the time focusing on the process to find the right provider for the right clinic. They’ve also implemented a support structure to help the clinic and provider both provide best care to the patient.

Mr. Malik is the co-founder of Genoa Healthcare’s telepsychiatry program, which provides over 100,000 telepsychiatry visits in 35 states each year. Genoa Healthcare is also a leading provider of integrated pharmacies in community mental health centers and of medication management solutions.

The key component to setting up a successful telepsychiatry program, Dr. Qalbani & Mr. Malik agreed, is choosing the right partner to support your organization. The three characteristics to look for in a partner, they said, is an organization that provides a robust technology and information system, integrates a responsive support system, and offers solutions that go beyond the computer screen.

First, a good telehealth program requires a robust technology and information system, which can be fairly straightforward when working with a partner like Genoa Healthcare who provides the infrastructure and technology setup. The technology necessities includes a strong internet, a secure connection, and the right equipment. In addition, the right hardware such as a large TV screen, good microphones, and the right computer camera can help minimize distance and boundaries created by the screen. Dr. Qalbani explained that it is important to have a partner that can walk your organization through the set-up process, and that will also be responsive to technology issues that may arise over the course of the program.

Second, it is essential to choose a partner that provides support in maintaining the relationship between the clinical professional providing telepsychiatry and the clinic. Mr. Malik noted that the single most important factor he has identified in finding a good partner is one who will match your organization with the right clinical professional and remain an ongoing partner throughout the evolution of the telepsychiatry program.

Probably the biggest determinant of a telehealth success is the quality of the match between the clinical professional and the clinic, Mr. Malik said. If the doctor and clinic have good partnership and repertoire, things get resolved more easily. There are specific things that are going to be important to each stakeholder, such as the pre-clinical workflow, the treatment philosophy, how communication takes place, the data that should be captured during an appointment, etc. At Genoa, to make the best match possible, we interview the clinical professional and clinic in advance of matching them. Then we do a video interview/meeting with everyone involved. It’s a multi-nodal vetting process.

Dr. Qalbani noted that once the match is made and the implementation period complete, organizations should acknowledge the work isn’t yet finished. He explained:

Once the match is made, Genoa has a very good continued support program. It’s different from any other place I’ve worked with. Usually I agree to work at a place and have to figure it out but with Genoa they have a team to help you, provide information, and ask questions – there’s that additional support to both clinic and clinical professional.

After the honeymoon period ends, it’s almost certain that challenges and problems will arise that need to be addressed. Genoa’s ongoing account management team keeps the relationship going and proactively address problems. For example, if there are prescribing changes or unfilled schedules, Genoa will huddle with all parties involved and head off problems, providing support.

Finally, Mr. Malik and Dr. Qalbani shared that partners who provide more than telepsychiatry services can deliver a deeper understanding of the community mental health space and Medicaid population, ultimately better aligning incentives & outcomes. Mr. Malik explained, “Genoa has more than 435 pharmacies across the country in community mental health centers (CMHCs). We are already at the forefront of trying to improve patient adherence. When we overlap we can invest in care coordination between the prescriber and the pharmacist.”

Telepsychiatry’s presence and impact on community health is continuously increasing as it presents a sustainable solution to provider organizations and clinical professionals for increasing efficiencies, improving access, and allowing for specialization of service provision. With the right partner, an organization’s telepsychiatry program can ultimately reach its full potential in increasing access and improving outcomes to underserved populations – the core reason for setting up a telepsychiatry program in the first place.