Wayne Sparks, MD, performing a telepsych test at Carolina’s HealthCare System’s Behavioral Health Center -
CMC Randolph.

Hospitals and health systems around the country are adopting technology as a way to change the future model of delivery of care. Leveraging a virtual care platform, telemedicine is an effective and practical way for physicians to provide access to highly specialized care across a large geography.

Carolinas HealthCare System is establishing virtual care services as a consistent delivery model, integrated across the System to improve patient quality, safety and access.  As long as it makes sense from a quality standpoint, the System will make every effort to have technology available for its patients and providers.

Wayne Sparks, MD, the assistant medical director for psychiatric emergency services and telepsychiatry at Carolinas HealthCare System's Behavioral Health Center - CMC Randolph, was one of the first adopters of telemedicine at the System using telepsychiatry to reach patients who needed a behavioral health specialist but had limited access to one.

“We actually started taking advantage of telepsych technology about 16 years ago,” Dr. Sparks said. “Our first telepsych location was Cannon Memorial Hospital in Linville, N.C. At that time, it was primarily used to offer some help to a Carolinas HealthCare System behavioral health unit and their psychiatrist, who was the only physician managing that unit. It was very low volume at first, but we saw a growing need for it, so we kept going.”

Recognizing the advantages of providing access to a psychiatrist via telepsychiatry services, Carolinas HealthCare System University and Carolinas HealthCare System Pineville were the next hospitals in the System to take advantage of the service.  Since then, volume of telepsychiatry appointments continued to grow, and as 2013 draws to a close, services will have expanded into 11 Carolinas HealthCare System Emergency Departments in five counties.  

“We are now seeing up to 250 patients a month through telepsych,” Dr. Sparks confirmed. Over the next few years the service is projected to grow to more than 1,000 patients per month.  “The growth plan is very exciting to me,” said Dr. Sparks. “If we can continue to offer telepsych appointments in all Emergency Departments and have the service available 24 hours a day, seven days a week, that would be a huge win for our patients.”

Offering psychiatry services using the telemedicine platform offers several benefits and measurable outcomes, including:

  • Access to treatment
  • Timeliness of treatment
  • Decrease in Emergency Department wait times
  • Decreases in the costs to deliver emergency care
  • Appropriate care plan - specialist can determine if a patient needs more serious treatment at a psychiatric hospital or is safe to go home

“Any visit to any Emergency Department is expensive; with telemedicine, the savings are significant when we can move a patient out of there. In turn, with the money saved, we can add resources to help with the growing number of patients we see every day,” Dr. Sparks said.

While there may be some doubt as to how user-friendly a medical visit through a computer screen instead of a face-to-face visit can be, Dr. Sparks says people have been very accepting of the technology.

“It’s an adjustment that we all have to go through, but a big reason why people are so accepting of this is that the technology is much improved. The video quality is almost like real life,” Dr. Sparks said. “Even acute patients will still participate with us in a virtual evaluation.  It’s amazing how people have adapted to this.”

The leaders of the behavioral health service line believe the possibilities for helping patients access behavioral healthcare are endless when virtual care is added as an option. “The hope is to be able to provide consultation services to understaffed inpatient units in remote areas right from an office in Charlotte,” said Martha Whitecotton, MSN, FACHE, senior vice president of behavioral health services. “They can provide support to the primary care physician who treats behavioral health issues on a daily basis but currently has no one to consult with about difficult cases, and they can ensure that every day where a patient has to wait in a medical Emergency Department for psychiatric inpatient care, is a day spent improving because there is a psychiatrist to suggest medications and check in with them as often as is necessary." 

The use of telemedicine across the nation is on the rise, as measured by the statistics below:

  • Over 40,000 health-related mobile phone applications are now available for consumers and health practitioners.
  • 70 percent of patients reported being comfortable replacing select in-person visits with texts, email or video.
  • Approximately 17 percent of all emergency medicine visits will occur virtually by 2023.
  • In 2012, the U.S. Department of Veterans Affairs supported the care of 148,335 patients via real-time telemedicine, over 44 clinical specialties.  Teledermatology increased by 127 percent, covering 27,000 patients.
  • 20 states have pro-telehealth coverage legislation and another 13 have pending legislation.
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