Clinician Corner: Meet Dr. Mark Miceli, MD

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Dr. Mark Miceli.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: Before I joined Iris, I was working at an inpatient hospital in New Jersey as the medical director of my unit and the interim chairperson of the division of psychiatry. I was doing a lot, and it was really hectic. I wasn’t happy at the job.

I was working with another clinician who told me I should look into Iris, and I ended up applying. I went through the interview process, and it went from there.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I work for a health system in Minnesota. I’m credentialed at 10 or 12 different hospitals and partial hospital units across that health system and I fill in when they need people. That includes when people are on maternity leave, when organizations are in-between hiring a new psychiatrist, or if someone is taking an extended leave.

Q: What do you love about being a telepsychiatry provider?

A: In my previous job, I was in a little office with no windows and a cold air vent blowing on me – it wasn’t comfortable by any stretch of the imagination. With Iris, I love that I’m in my own environment. I love that I can work with people in different geographical areas. My patients are all in Minnesota, so I get to know the culture that exists there. There’s also a separation where I’m not going to run into patients at the grocery store.

Another thing I love is the flexibility to work from different places. At the height of the COVID-19 pandemic, my family and I were able to rent a beach house in Cape Cod. The beach house had Wi-Fi so that I could work there and my son could enjoy the outdoors and fresh air.

With inpatient, we usually see people early in the day, and then we do documentation. Once I see my patients, I can move my computer anywhere where there’s Wi-Fi. I can take a break to get my son and eat good, hot food at home instead of spending money at a restaurant. I also love that I don’t have to commute 45-minutes or an hour every day. There are a million great things.

Q: How do you foster connection with patients virtually?

A: In my home office, I have things behind me like a guitar or a yoga mat – having these things related to my interests in the background gives my patients and I something to talk about. Another thing I always do is look into the camera, smile, and try to make eye contact. I try to send them really good, positive energy over the internet.

One helpful thing is having the on-site staff really trust and work with me. They’re a major factor for inpatient care, and their extra help makes a significant difference. They help reassure the patient and let them know what I’m doing and that I care about them. One of the most satisfying parts of the job is the people I work with. The teamwork is fantastic.

I work at four or five places steadily where I rotate through, and I look forward to seeing the people, and they look forward to seeing me. It’s a nice thing, and it doesn’t get old after six years of being in the same place. It stays refreshing and diminishes the grind. When you work in an inpatient unit, you’re going to the same place every day and seeing the same people. The specific job I have with Iris is amazing.

Q: As a healthcare professional, how do you manage work-life balance?

A: I don’t have a commute, so I can drop off my son in the morning, go for a walk in Central Park, do my yoga exercises, then work. I can take time to relax, have lunch, then go back to work. I can still get my son in the afternoon. I don’t know if there’s any secret to it. We can travel and have a life outside of being stuck in an apartment.

I have much more time in my life now that I’m a telepsychiatrist. It’s liberating. You’re not trapped in a certain place for that many hours.

Q: What are your biggest learnings from your time at Iris?

A: I learned a lot of new technology that I wasn’t really aware of – like Epic. Getting to know Epic was a great skill to learn, and I love that platform. It’s one thing that I didn’t use before. It’s amazing, and I’m so happy that all my jobs are using it now. It’s powerful, and you can easily learn about the patients.

Q: What is the most rewarding part of your job?

A: Working for Iris has been the most rewarding out of all the jobs I’ve worked since my residency. The people I work with are super positive. I always feel supported and proud to work for Iris.

I also love working in Minnesota. I love the culture and the people. I like making connections with the support staff and the patients there. It’s been gratifying. I live in New York City, and I work on the East Coast, so it’s just a different approach to life. I have more connection with my son, and I’m able to be a big part of his life even though I’m working full time. If I were commuting an hour back and forth every day, that would be two fewer hours to be a part of my son’s life.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: It brings psychiatry to places where it’s not easily accessible for people. Especially where I’m working in some of the smaller towns in Minnesota, it’s hard for people to get quality psychiatry. I know that primary care is doing a lot of medication management. However, that’s not their specialty, it’s one more thing to learn, and they may not be comfortable with it.

I think we can bring more quality, specialty care to people who don’t have access. Even though COVID-19 made it unsafe for people to go out, they can still get their medications refilled, have a connection, have someone check in on them, support them, and help treat their conditions.

Even in Minnesota, they were canceling outpatient programs in the bad snow and cold, but we could still see people in their homes. This type of access varies by state, and some states don’t allow the patient to be at their home. However, Minnesota is really progressive. In the partial hospitals where I’m working, people talk from their own homes instead of having to come into a clinic.

Q: What do you love about working with Iris?

A: Iris makes you feel like you’re part of the team, and they really validate you. I’ve worked so many places where you’re just there, and they expect you to be there and do your job, but you don’t get any appreciation.

After four years, Iris gave me a plaque, and I was employee of the month. Ted Bryant, the Senior Manager of Clinical Operations, is amazing. He’s always positive and is always saying, “You’re a great doctor!” It makes a difference to feel like you’re not just a cog in the machine, but you’re a person. I don’t know what it would be like to work for another telehealth company, but I can’t imagine anything better than working for Iris.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Dr. Mark Miceli. If you’d like to learn more about working for Iris Telehealth, contact us today.

How to Jumpstart Your Child Psychiatry Career

Over the past few years, child and adolescent psychiatrists have experienced a surge in demand due to the pandemic’s impact on children’s mental health. While many parts of the country have suffered from a shortage of child and adolescent providers for many years, the disruptions of COVID-19 have led to an unprecedented mental health crisis. Only last year, the surgeon general declared a national emergency for child and adolescent mental health.

Given this landscape, there are ample opportunities for child psychiatrists to provide help to patients across the U.S. With so many career and development opportunities, it’s critical for you to choose the position that is the best fit for you and your goals.

However, finding a fulfilling, flexible, and impactful job as a child psychiatrist can be difficult. That’s why, we’re here to help you get off to the right start and set yourself up for success (while preventing burnout). Read on to learn how you can find the best culture, setting, and organizational fit for you.

Finding the right care setting for you

There are some environments and work settings that will always have a high demand, like outpatient mental health centers, for example. Many providers go into outpatient care because of their interest in child development. With outpatient work, you can often see a child until they’re an adult and cultivate a long-term relationship with them.

Knowing what type of child and adolescent patient population you want to work with can help you narrow in on what care setting will work best for you.. However, this insight might develop over time. As you go through your career, clarity about whether you want to provide care for a specialty population, a specific age group, or specific diagnoses will become clearer. You might even have a good idea of your preference as early as your residency or medical school rotations. While you’re still early in your child psychiatry career, it’s okay to not have it all figured out yet.

Finding a good organizational fit

Securing a good organizational fit with a telepsychiatry vendor should be one of your biggest priorities as a child psychiatrist. By finding the right fit, you’ll be well positioned to deliver high-quality services to your patients while achieving long-term job satisfaction. However, finding the right position is more than just getting a spot on someone’s team.

When it comes to finding the right position for you at a healthcare organization or telepsychiatry company, asking detailed questions about the systems already in place for their clinicians is key to understanding the type of support and resources you’ll have available.

Here are four questions to ask your next employer to determine whether they’re a good fit for you:

  1. What support structures are available? Knowing what support structures are available to you is crucial to understanding how a given organization treats their providers. Support at a company or organization can look like having someone available to answer your questions, providing equipment for your practice, or even offering PTO and other benefits to their providers (we provide all of that and more for our Iris clinicians).
  2. What is the organization’s turnover rate? A high turnover rate can be a red flag indicating the organization is not meeting their providers’ needs – or, for a telepsychiatry company, making suitable matches for their providers. A low retention rate can raise questions about the workplace culture and values.
  3. Who is responsible for licensing, credentialing, and malpractice insurance? These administrative tasks can seem daunting to do alone. Working with an organization that handles or supports these tasks can make your work life a little easier, giving you time back to be the best child psychiatrist you can be. At Iris Telehealth, we tackle all the licensing, credentialing, and burdensome administrative work so our providers can focus on what they love most – providing exceptional care to their patients.
  4. How does placement work? Here at Iris, we provide matches based on experience, schedule preferences, prescribing philosophies, personality match, and much more.

How telepsychiatry can set you up for success

Telepsychiatry can help close the mental health care gap in rural areas for adults and children alike. For some youth experiencing mental health conditions or increased stress, it can be difficult to access appropriate, effective mental health care.

However, especially early in your career, it is important to learn how to use telepsychiatry effectively – whether or not you’re interested in a position as a full-time telepsychiatrist.

If you are using telepsychiatry with your patients, these tips can help you effectively provide care to your patients:

  1. Establish parameters with parents. When working with children and adolescents, it is vital for child psychiatrists to ask parents to agree to confidentiality rules before treating their young patients. Confidentiality is key to providing effective treatment as it can help build a relationship between you and the patient. The same expectation for confidentiality for in-person visits should be adhered to during virtual appointments.
  2. Check in with the child and parents. It is not safe to assume that adolescents are immediately comfortable with telepsychiatry, even if they are accustomed to technology through video games or social media usage. By checking in with them to see how they’re feeling about this modality, you can alter the method of care as needed and build a strong relationship with your patients.
  3. Adjust your camera setup. It can be helpful to zoom in and out with your equipment to observe kids play. By having the same vantage point as if you were in the office, you can provide better care.

Resources and training opportunities

Continuing medical education (CME) is important to facilitate life-long learning as a provider. By developing your skills and expanding your knowledge as a child psychiatrist, you can improve patient satisfaction and outcomes.

Here are some resources that can help you as you continue your journey as a child psychiatrist:

  1. American Academy of Child and Adolescent Psychiatry (AACAP) Telepsychiatry Toolkit: This toolkit covers a broad range of topics related to the implementation of mental health services for children and adolescents. Some areas include legal and safety issues, setting up your practice, telepsychiatry with children and adolescents, and working with special populations.
  2. AACAP’s Online CME Courses: The AACAP offers multiple self-study courses that can help your individual educational needs through videos and lectures. They also provide a test to gauge your learning.
  3. Medscape’s CME Learning Center: Medscape offers a comprehensive list of resources for child and adolescent psychiatrists. Various topics include telehealth, clinician burnout, management, and providing care to specific populations.

How Iris Telehealth can help

At Iris Telehealth, we take provider placement very seriously. Our matching process is set up to make sure you get placed at the best healthcare organization for your long-term goals, patient preference, and schedule. Your dream job could be here at Iris Telehealth.

We provide equipment, 24/7 tech support, CME credit, and malpractice insurance for our clinicians to support and help them thrive. In addition, we connect our clinicians with providers who can offer long-term career advice. Contact us today to see if our telepsychiatry services are right for you.

Clinician Corner: Meet Dr. Jessica Jeffrey, DO

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This month, we’re sitting down to talk with Dr. Jessica Jeffrey.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: I was working for a community mental health clinic, and when the pandemic hit, we quickly moved to telehealth. It was the first time using telehealth for just about all of us, but I found there was a lot I liked about it. Personally, the schedule worked well for my family. It also worked well for many of my patients, whether they were in rural or urban communities.

For patients in urban areas, telehealth made getting care easier because of the challenges brought on by the COVID-19 pandemic. Telehealth also worked well for patients with conditions that make it difficult to leave their homes and for moms with young children. It was much easier for these patients to see me from their kitchen table and not have to pack up maybe two or three children and bring them to the visit.

So, when I had the opportunity to look for a different type of clinic, I looked for telehealth. I applied to Iris because I happen to know Dr. Milam from my training days. I figured if Dr. Milam was associated with the enterprise, I should probably apply, and I did.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I am part of a new initiative with a large enterprise partner in Pennsylvania who serves a wide range of patients in rural communities and some urban areas. They wanted Iris’s help managing the large influx of referrals coming into their clinic. Currently, I’m doing telehealth from home, and I’m working with adults. In the future, I’m probably going to start doing some on-call pediatric work on the weekends.

Before starting the clinic, we spent a lot of time coordinating with the partner and discussing potential issues – whether those issues were related to IT or crisis support. We also spent time working on the scheduling and getting to know the support staff. We talked with the LCSWs from Iris about how we would work as a team and how to triage and manage workflow.

Now that it has started, I mostly spend my time seeing new patients, and we have weekly meetings with the care team to assess what’s working, what’s not working, and how we can make this better.

Q: What do you love about being a telepsychiatry provider?

A: Well, number one, I love being a psychiatrist. I think it’s the most interesting medical specialty there is. There is a fair amount of medicine even within a psychiatry practice, which surprises some people. However, a lot of patients have multiple medical problems and because of the nature of their psychiatric illness, sometimes their physical health is neglected. So, our patients are often fairly sick and there is a lot of coordination with the other specialties, which I enjoy.

Being a psychiatrist is so interesting because you get to know the people and follow them. And outpatient care is like a new chapter in the book in learning about them. I’m very fortunate to be in this specialty.

I like the flexibility of being in telepsychiatry. It’s a little easier for me with my schedule. It’s also easier for the patients, especially for those who are going to have more trouble with transportation, whether it’s the expense of the ride, or not having a car. It’s not for everybody, but we’re doing a good job of making sure that people who are eligible for this kind of service can utilize it.

Q: How do you foster connection with patients virtually?

A: When I first have a visit with a patient, the first few things I tell them are, “Here’s what we’re going to do. If you have any problems with the connection, I’m going to call you right away. Don’t despair if there are problems with the communication or telehealth equipment.” Then, we launch into it. If you’re looking at the camera and talking to someone like they’re a human being, pretty soon it feels like a normal conversation.

I do have the advantage of practicing telehealth in what’s already a FaceTime, Zoom sort of environment. Many of my patients are already pretty familiar with having video chats with their friends and families. So, it’s not much of a leap to talk to the doctor.

Q: As a healthcare professional, how do you manage work-life balance?

A: At the end of the day, I try very hard to stop being Dr. Jeffrey and start being Jessica. I try very hard to keep those boundaries between work. We all have those moments where we’re thinking about a particular patient who was having a hard time when we’re brushing our teeth. But, when I’m off, I’m with my family and doing things I enjoy doing – and when I’m back at work, I’m in that mode, and that’s what I do. In psychiatry it’s important to have those distinct boundaries because there is so much of a human element to what we do. So, you have to be able to leave it in the office.

Q: What are your biggest learnings from your time at Iris?

A: Iris has been a lot of fun so far. The people I’m working with have a good sense of humor. They’ve been refreshingly vocal about maintaining boundaries and work-life balance right out of the gate. When you hear that coming from the administrative side, it’s very appealing for physicians because they don’t feel they’re the only ones advocating for work-life balance. So, I felt really good about that.

Iris has really impressed me in how they think about helping any particular partner. There’s an enormous amount of work that goes into the logistics of putting a new physician in a clinic, and supporting that clinic once it’s up and running. I came to understand that it’s more than just putting someone in the seat and filling a position, it’s the ongoing support with that clinic.

Working for Iris and with this partner is exciting because they’re working with you all along the way, to serve the clinic. This approach is probably quite unique amongst telehealth companies.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: It’s access. Many of the patients we serve, particularly in community mental health and larger university settings, are communities with the most access issues. Telepsychiatry is one of the ways we can bring access to these people — whether it’s meeting people where they are or increasing provider availability. By increasing provider availability, organizations can bring in physicians who may not necessarily be in that area. The expense and time commitment to recruit and bring a physician to a new location is enormous – so if organizations can recruit someone who may not be in that area but is willing to sit down and learn the locality remotely, then you’re improving access to patients.

At Iris, we believe our providers should be respected, valued, and applauded for the work they do, and we couldn’t be more proud to say, “thank you” to our very own Dr. Jeffrey. If you’d like to learn more about working for Iris Telehealth, contact us today.

5 Common Questions about Telepsychiatry in the ED

Access to prompt, high-quality care is of the utmost importance for psychiatric patients seeking treatment in the emergency department (ED). However, with a nationwide psychiatrist shortage, patients are left waiting for care in EDs across the country. Fortunately, telepsychiatry can help.

Telepsychiatry is a seamless solution that helps health systems provide timely care to psychiatric patients while increasing throughput for EDs. Read on to learn the five common questions healthcare organizations consider when investing in this solution.

How does the telepsychiatry process work in the ED?

Initiating a telepsychiatry consult is similar to calling any other consult in the ED. Here’s how it works:

Step one: A clinician evaluates the patient and determines whether or not they need a psychiatric consultation.

Step two: If they do, the clinician enters the essential information into a paging system, and an assistant in the ED takes a telehealth cart into the patient’s room.

Step three: From this point, the consult is nearly identical to a standard face-to-face consult. After the evaluation, the telepsychiatrist promptly calls a designated individual (such as a social worker) to discuss the basics of the patient’s presentation.

Step four: Next, the telepsychiatrist connects to the telehealth cart and speaks with the patient in real-time. The psychiatrist develops a treatment plan that typically includes a disposition and communicates this plan with the attending ED doctor.

Step five: Finally, the psychiatrist writes a note directly into an organization’s EMR, and the consultation is complete.

With five simple steps, telepsychiatry can facilitate a seamless process for providers, patients, and the organization at large.

Can telepsychiatry integrate within any health system?

High-quality telepsychiatry solutions can be seamlessly implemented into an organization’s existing equipment, including their EMR, prescribing system, and protocols for managing operations. At Iris Telehealth, we’ve found this is a crucial step to help minimize disruption. We act as a technology-agnostic addition to an organization’s team by becoming familiar with and integrating into their existing systems and workflows, and we ensure all staff are trained on best practices for using technology and are comfortable with it.

What type of equipment do health systems need for telepsychiatry?

The equipment required for telepsychiatry is relatively simple. The nature of psychiatry (which requires a person to person connection, but no mandatory physical assessment) makes it a well-suited field for telehealth as there’s not much equipment needed beyond a computer. If an organization already has existing equipment – ranging anywhere from telehealth carts to laptops and tablets available for use – chances are a telepsychiatry solution like Iris can implement with your current systems without any additional work and without your care team having to learn how to use new tools.

How long do we have to wait for the doctor?

In most cases, the wait is less than 30-minutes from the initiation of a consultation to the psychiatrist being at the patient’s bedside. Timing is essential in all areas of medicine, but it is critical within emergency medicine. For high-quality patient care, things must run efficiently to allow the timely delivery of services to your patients.

A good telepsychiatry partner should have systems in place to initiate a telepsychiatry consultation as quickly as possible. With an active and dynamic call pool of dedicated psychiatrists or other appropriate behavioral health providers (including LCSWs and PMHNPs), organizations can ensure a system that consistently puts a provider at the patient’s bedside in under 30-minutes.

What makes for a successful ED telepsychiatry program?

Cultural fit can make a significant difference in the success of your telepsychiatry program. That’s why it’s essential to partner with a telepsychiatry vendor who aligns with your vision and values. This compatibility is vital at every level, from the leadership team to clinicians. In fact, at Iris, we’ve discovered that provider match is essential to the success of a telepsychiatry program. Our process connects healthcare organizations with providers, thoughtfully, based on experience and need. This process allows us to ensure an organization’s population get’s the specialty care they need, and providers can work within their specializations – allowing everyone to get the most value.

Telepsychiatry groups are only as good as their providers. We work with the best psychiatrists, PMHNPs, and LCSWs in the field who learn the needs and goals of an organization’s ED. Over time, we’ve found that our providers can build authentic relationships with an organization’s staff and truly become integrated members of their treatment team.

Get started with telepsychiatry today

At Iris, we ensure your ED is set up for success and help facilitate an implementation process that’s smooth and straightforward. Once complete, your patients will have 24/7 access to a behavioral health provider and spend less time in the ED waiting for care. Telepsychiatry is a powerful platform that delivers quick access to the high-quality care patients need when they need it – whether at home, in an outpatient clinic, or a hospital.

If you would like to learn more about how you can optimize your behavioral health strategy in the ED, contact us today.

Addressing Mental Health Stigma in Rural Communities

Mental health stigma is a serious problem that can cause people to opt-out of treatment for their behavioral health conditions. In fact, a study by the Cohen Veterans Network found that nearly one-third of Americans have worried about others judging them for seeking mental health services. While one-fifth of individuals say they’ve lied to avoid telling people they were seeking mental health care.

Stigma can prove even more challenging for those living in rural communities with limited access to mental health resources. This population deals with unique barriers regarding anonymity in their communities, health literacy, pervasive provider shortages, transportation challenges, and more.

However, despite these barriers, telepsychiatry provides an opportunity for rural communities to receive the same level of treatment as metropolitan areas, helping them overcome stigma and get the care they need.

Keep reading to learn more about rural health stigma, how to address stigma in these communities, and successful community approaches.

How mental health stigma manifests in rural America

Stigma can take shape in many different ways. Whether it’s fear of public stigma or self-inflicted judgment, getting care in rural America isn’t easy. Let’s look at three unique barriers that this population may encounter when seeking care.

  • Lack of anonymity: Small towns don’t have the same level of privacy that cities provide. For example, someone is more likely to blend in when walking into a mental health clinic in a metropolitan area. However, it’s more likely that someone could be seen by a neighbor when walking in to get treatment in a small town, or they may even know the person checking them in for their appointment. This lack of anonymity can compromise a person’s feeling of safety and keep them from seeking care.
  • Family concerns: Another level of concern associated with stigma is family. People in rural communities may not want their family history or things that have happened in their families to be disclosed to anyone else. There’s a common colloquialism in some rural communities about not “airing your dirty laundry in public.” This mentality can keep someone from opening up to a mental health professional and receiving the care they need.
  • Religious barriers: Seeking care for mental health can be viewed as a spiritual weakness or a moral failing in many communities. In fact, a study by the Mental Health & Prevention journal uncovered several common themes related to stigma among rural, low-income healthcare consumers. Some of the top themes were, “faking and pretending,” “get over it,” and “God is all you need.” Additionally, some individuals may view taking psychiatric medications as oppositional to their religion.

While this population may be up against negative sentiments in their communities, there’s also potential to change the dialogue around mental health. And understanding what this community encounters is essential to determining the best way to help them get care and break the stigma.

Three solutions to help break stigma around mental health treatment

Tackling stigma in these communities can happen in several different ways, from education and telepsychiatry to sharing experiences and social media. Let’s take a closer look at these three unique approaches.

  1. Education: Good education is an essential component to breaking stigma. For example, educating people that the brain is an organ, just like the lungs or the heart, can help them better understand mental health. This education can happen within families, schools, workplaces, and religious organizations. Additionally, healthcare organizations that partner with telepsychiatry vendors like Iris Telehealth can also take an active approach to education that reduces stigma.In their StigmaFree campaign, the National Alliance of Mental Illness (NAMI) encourages people to use respectful language that doesn’t define someone by their illness, challenge misconceptions, and avoid labels. For example, instead of saying, “they’re bipolar,” try saying, “they’re living with bipolar disorder.”
  2. Increasing access: Access is a significant barrier for people living in rural areas. However, telepsychiatry serves as a creative avenue for support in these communities. This virtual approach allows people to connect to a high-quality, specialty mental health provider from the privacy of their home. Telepsychiatry can enable this population to get help and maintain their anonymity at a community level.The American Psychiatric Association (APA) calls telepsychiatry’s reach into rural and remote areas one of the best successes of telemedicine. The APA also cites that satisfaction has been superior for patients, families, and providers.
  3. Spreading awareness: According to the APA, about three in four young teens experiencing depression look online to find personal stories from others who have previously suffered from the condition. This data underscores the importance of spreading awareness through sharing stories.Social media can be a powerful platform for those in rural communities. Social media can connect people with support from others who might be dealing with similar conditions. This connection can help people feel less alone, and when people speak up about their mental health, it can be an excellent avenue for reducing stigma.

Taking these steps can help create powerful change for those experiencing the effects of stigma in their daily lives.

Successful approaches to combating stigma in the community

Creating opportunities for behavioral health care in the community is a game-changer for this population.

  • Effective programming: Programs that assist with opioid use disorder have been effective in helping reduce stigma. By providing safe injection sites, and implementing harm reduction or replacement therapy, more lives are saved. While these programs are often misunderstood, the more people are educated on the serious outcomes of utilizing substances and how intervention can save lives, the more they understand.
  • Organizational solutions: Turning to emergency departments often feels like the best option for individuals living without adequate mental health resources. However, emergency care is costly. That said, hospitals that create opportunities for 24/7 behavioral care access can help better serve their communities with high-quality, on-demand services. Along with this organizational approach, communities can receive grants for crisis centers and other solutions that can help address mental health concerns outside of the emergency room. Instead of waiting for something to become a problem, putting preventive measures in place can be a more effective strategy.
  • Telepsychiatry: Finding providers can be a daunting task for organizations in rural communities. For Aroostook Mental Health Services, Inc. (AMHC) in rural northern Maine, recruiting and retaining high-quality behavioral healthcare providers was challenging. Specifically, AMHC needed psychiatrists specializing in children and adolescents and a psychiatrist for consultation help. That’s where Iris Telehealth came in to connect AMHC with high-quality, trained providers. Not only do their patients get the specialty care they need, but their physicians get the consultative support they need before prescribing or diagnosing certain conditions.

Where Iris Telehealth fits in

At Iris, we partner with communities in need of mental health resources. By providing rural populations access to specialty behavioral health providers from around the country, we can help support their needs. Contact us today if you would like to learn more about how telepsychiatry can support your community.

How Telepsychiatry Helps Impact Social Determinants of Health

Social determinants of health (SDOH) are defined by the conditions of an environment where people are born, live, and work. Depending on an individual’s circumstances, these conditions can create and exacerbate mental illness and make it difficult to access mental health care.

Despite these challenges, healthcare organizations have the power to make meaningful change by bridging the gap between underserved populations and high-quality mental health care. By investing in solutions like telepsychiatry, healthcare organizations can positively impact their communities’ mental health.

Read on to learn more about why social determinants of health and mental health matter to healthcare organizations, how healthcare organizations can address them, and additional resources to help reach those who need care the most in your community.

Why SDOHs matter to healthcare organizations

Healthcare organizations are catching on to the importance of addressing social determinants of mental health. In a survey of 300 hospitals and health systems, the Deloitte Center for Health Solutions found that 80% of hospital respondents said their leadership team is committed to establishing and addressing social needs in clinical care. Providers see the value, too. The Commonwealth Fund reports that 80% of physicians consider addressing a patients’ social needs as critical as addressing their medical needs.

And, the potential financial impact of not addressing SDOH is substantial. An article by Modern Healthcare highlights a Chicago-based health system that discovered 26% of its medical inpatients had a co-occurring behavioral health issue that cost approximately $26 million annually in excess healthcare costs and increased the average length of stay by 1.07 days.

Taking an integrated approach that encompasses mental and physical healthcare needs is essential to helping underserved patients and maintaining organizational costs.

Identifying who needs help in your community

For those experiencing SDOH, lack of access to routine mental and physical healthcare can impact their quality of life. And the effects are widespread. In fact, in a study by Anthem, 60% of Americans believe their community faces at least some health issues related to SDOH. 23% say access to good doctors and hospitals is a major problem for those in rural parts of the country.

Anthem also found that Americans of color are disproportionately affected by the consequences of SDOH, citing mental health, safe communities, and access to affordable and nutritional foods were components significantly impacting their health.

Along with these challenges, there are specific factors that stand between individuals experiencing SDOH and a more sustainable quality of life:

Whether your organization aims to help a specific population or contribute to solving a unique issue in your community, you should consider a few things before getting started.

How healthcare organizations can address SDOH

With a pandemic and a growing provider shortage at play, helping patients get appropriate and affordable mental health care has never been more important or challenging.

So what can hospitals and health systems do to help relieve the burden on overworked providers while facilitating high-quality care for their patients? It starts by ensuring your teams are set up to address these challenges.

Consider the following:

  • What type of geographic access does your population have?
  • What resources are available?
  • Are people motivated to utilize these resources?
  • Do they have a support system?

When addressing SDOH in the community, chances are you might face some challenges related to stigma, transportation, and socioeconomic status. While these might be difficult to address, there are four solutions to these challenges that can help your organization realize optimal outcomes:

  • Stigma: For those facing stigma in their communities, providing a telepsychiatry option can be helpful. That way, they can receive effective treatment from the comfort of their homes, or through their primary care provider’s office, without the worry of being exposed for seeking help.
  • Culturally competent care: Using telepsychiatry can help organizations access providers who speak a specific language or have experience with a particular culture. This connection is highly beneficial to individuals who may not have someone locally who speaks the same language or can understand the unique aspects of their culture.
  • Technology and digital literacy: By partnering with organizations that seamlessly integrate into your organization, patients in your community can access providers from across the country at their local clinic, regardless of what personal access they may have at home.
  • Transportation: If patients have trouble getting to their appointment because of transportation challenges, telehealth can help them get the care they need from home. Along with a virtual approach, your organization can consider offering free transportation, or partnering with a ride-share company, to help individuals make it to their appointment.

Additional Resources

If you’re looking for additional resources to reach your community, check out some of the options below:

American Psychiatric Association: The American Psychiatric Association has collected a series of factsheets that provide an inside look into current mental health disparities experienced by diverse populations. This is a meaningful resource that your organization can reference when determining how and who to help.

Iris Telehealth: Iris Telehealth provides high-quality behavioral health services for patients across the country. Wherever the need, Iris meets people where they are, helping to break stigmas and defy geographic and economic barriers.

AHA Resources: The AHA provides recommendations on improving health equity or check out what they suggest your organization can do to ensure access to care. Whatever the need, AHA has a bounty of resources for reference.

RHIhub SDOH in Rural Communities Toolkit: RHIhub has compiled a toolkit of resources, including content around care coordination, community health workers, health promotion, telehealth, rural transportation, and more.

Where Iris Telehealth fits in

Iris Telehealth works with healthcare organizations across the country to bring high-quality, specialty psychiatry services to people who need them most. If you’re a healthcare organization looking to increase access in your community, Iris Telehealth can work with you to seamlessly integrate behavioral health services. Contact us today.

Clinician Corner: Meet Dr. Isabel Norian, MD

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day. This week we’re sitting down to talk with Dr. Isabel Norian.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: At the time, I was working in outpatient psychiatry at a community mental health center. It was a very fulfilling job, but I had a growing family with four kids, a husband, and pets. I was dissatisfied with the back and forth between the clinic and the really late nights. There were times I felt my work-life balance was out of kilter. That’s when I decided I wanted to look into telepsychiatry.

I started researching different telepsychiatry companies and was quickly impressed with Iris. I had other leads, but I found Iris to be the most responsive, welcoming, and clear in its mission. As soon as I had my first meet and greet, I felt like I belonged. I wouldn’t dream of working with any other company than Iris.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I work at a community mental health center with patients affected by intellectual and developmental disabilities and patients on the autism spectrum. My typical day includes protected time for administrative work, seeing patients, and collaboration with the clinical staff. I often see them for consultations, and they call me if they have a question or a complex issue.

I’m also a big fan of our protected time for staff meetings. While the meetings don’t happen often, they’re a huge part of my job satisfaction. We talk about cases, bounce things off each other, and connect. It’s really therapeutic. Even though I’m not on-site, it gives me a real sense of community and that I’m a part of the clinical team. Our clinic works really well with Iris, so that’s a great feeling. I really lucked out in a lot of ways.

Q: What do you love about being a telepsychiatry provider?

A: Everything. I feel like I got my personal and family life back. My family and I love that I’m not commuting. Without all the transitions, I can end work one moment and be out the door to pick up my kids the next. Transitions can be quicker, and for a working mom, that’s priceless.

By working in my home, I can look at the screen and be present for the moments when my patients need me. I’m able to tune out the rest of the world, and that’s serene. It’s almost meditative at times, and it really helps me focus.

I also feel less tethered to a system I am frustrated with, which is my experience in previous jobs. Now, I’m partnered with a company that I chose and who chose me. I pursued them voluntarily and intentionally because they presented synchronous values.

Then, I was matched with a clinic that I feel very fulfilled by and that is very receptive to my needs and aspirations. It is a great balance. I feel more in control than I have in any other work situation. I think that’s empowering.

Q: How do you foster connection with patients virtually?

A: Creating connections has come naturally. I act as if I’m in the room with the patient, which informs how I ask questions, make eye contact, present myself physically, and relate to them through the screen. My job is to make patients feel comfortable and with a little bit of practice, you quickly forget the screen is there.

However, when my patients seem unsure, I try to provide education and reassurance. I also remind families that they have options. Where I work, we have one or two on-site providers at any given time. I let patients know that if telepsychiatry isn’t something they’re ready for or if it isn’t something that’s a good fit, there are other ways they can be seen.

I’ve found that if I’m providing education, reassurance, and reminding people of their options, it’s enough to dissolve the uncertainty. When people feel they have choices, they typically navigate towards something that works.

Sometimes I’ll check in at the end and ask, “How is this for you?” I’ll ask them, “What might I do differently?” “I welcome you to always tell me what I can do differently to help make this work better.”

Q: As a healthcare professional, how do you manage work-life balance?

A: Boundaries are important when you work from home. I’ve learned that I have to close the door, even when I’m home alone, to provide a sense that I’m at the office. When the workday is done, I close the door and say, “Now the office is closed.” I even have a little sign on my door that says, “out of office” and “in a meeting.”

It’s also important to take advantage of the flexibility that telehealth provides. I would recommend using that flexibility to build in movement breaks throughout the day and stretch. Along with this, I’d say do something different or something that you enjoy. For me, it’s dance. When I’m not dancing, I’m not taking care of myself.

I’ve also found it’s helpful to spend time with my family without devices. Since devices have become such a significant part of my work, I’ve found that it’s imperative not to be staring at a screen when I’m not working.

Q: What are your biggest learnings from your time at Iris?

A: I’ve learned that it’s not only okay but also good and healthy to delegate. There’s an impulse to fix things when working in broken systems, and I’m a fixer. When systems weren’t working, I tried to fix things independently. Whether it was the computer, EHR, staff support, or the lack of resources for people with mental illness — I would work harder, not smarter, to compensate for breaks in the system. That’s why I was relieved when I found Iris. Iris is so well-resourced and well-prepared to address all the hiccups and challenges that come with the daily work in mental health.

I have many experts to lean on, whether it’s IT, HR, or my clinic liaison. This support gives me the freedom to focus on patient care. I have the structure to succeed, and I’m learning to let experienced, talented, dedicated people help me be more effective.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: I think access to care is one of the biggest mental health crises that exists. It’s not that there aren’t talented providers or a lack of students ready to become psychiatrists — it’s that there’s a disconnect between resources and people who need those resources.

Telepsychiatry provides access to care that is unparalleled. As a telepsychiatrist, you get to see people from their home, group home, or foster care system. So for me, telepsychiatry is the connection, and it is the future of mental healthcare.

At Iris, our providers help create a better world through healthy minds. Thank you, Dr. Norian for helping us further our mission through your incredible work. If you’d like to learn more about working for Iris Telehealth, contact us today.

6 Qualities to Look for in a Telepsychiatry Provider

If you’re looking to hire a telepsychiatry provider but don’t know where to begin, we’ve got you covered. At Iris Telehealth, we’ve learned how to identify the qualities that make (and don’t make) a great telepsychiatry provider.

Whether you’re optimizing your behavioral health program or bringing in someone to help with the growing demand for high-quality mental healthcare, there are key considerations and questions you should be asking.

Before you post the job description

Getting started requires a deep understanding of your existing clinical workflows and how a telepsychiatry provider will integrate into your clinical team. By identifying potential roadblocks, you’ll be better prepared for future issues that, inevitably, will arise.

Key questions to consider before starting the hiring process:

Location

  • Will your telepsychiatry provider be completely remote, or will they occasionally come on-site? Location is a key consideration as it can affect workflows, clinical organization, and recruiting efforts.

Integration

  • How will your existing clinic workflows develop to include a telepsychiatry provider?
  • How will the patient’s experience change?
  • How will your current staff’s roles and responsibilities change?

Communication

  • How will you ensure open communication between your telepsychiatry team and your existing care team?
  • Will your telepsychiatry provider join regular care team meetings?
  • Will you set up a daily/weekly huddle with your on-site team and your telepsychiatry provider?

Training

  • Will you provide training for everyone to learn telepsychiatry workflow?
  • Who will develop and deliver this training?

Taking the time to consider these questions will help you find the right provider for your organization.

What makes a great telepsychiatry provider?

It’s important to note that not every excellent doctor is a fantastic telepsychiatry provider. We’ve learned it takes a strong and unique skillset to make a superb telepsychiatry provider.

Here are six key components that make up a great telepsychiatry provider:

They believe in patient-centered care. This belief can be said for any provider, right? Regardless of medical specialty or whether they’re on-site or remote, it is imperative. This approach to care is one of the most critical factors to ensure patient satisfaction and high-quality care. That’s why it’s essential to take the time to identify providers who put their patients first – but you don’t have to do it alone. At Iris, we provide a thoughtful job matching process that ensures every organization is matched with a high-quality provider who shares their values.

A team mindset is central to their work. It’s easy for remote employees to feel like they are a “team of one,” so it’s vital to foster a sense of inclusion between remote providers and on-site teams. Providers with a team-focused mindset tend to integrate well into existing clinical care teams and feel like they are genuinely a part of the team, no matter the physical distance. We all know it takes a village to care for our communities, and the better we work together, the better the outcome for our patients.

They’re self-motivated. It’s much easier to be held accountable when you’re surrounded by colleagues than it is when you’re potentially 3,000 miles away from them. Telepsychiatry doctors need to be self-motivated go-getters who can hold themselves accountable in their work. When it comes to having remote employees, there’s a level of trust that needs to be reached. That’s why at Iris we ensure organizations are set up to succeed, matching them with thoroughly vetted providers who become an indispensable part of the team.

They’re tech-savvy or willing to learn how to be tech-savvy. Telepsychiatry providers do best when they have an intermediate level of comfort with technology (and we’re lucky enough to have an IT team available to our providers 24/7). You want the technology to fade into the background during the patient’s experience.

They have a willingness to ask for help. Our providers are incredibly knowledgeable, but they also know when to ask for help. We’ve found that this is an important quality as you scale your team and continue to improve your program. Providers who don’t know how or when to ask for help may find themselves overburdened or stuck with an issue for days, especially since they can’t just walk down the hall for support. Instead, those willing to ask for help will increase productivity, improve quality of care, and foster a sense of camaraderie with on-site teams.

Independence is a part of their success. Your telepsychiatry providers will be interacting with patients all day, but they need to be independent workers. They’ll likely be in a home office, and independence is essential for anyone working from home. Their independence will help them remain motivated, but it is also just a good quality for anyone who will be alone for much of their job.

If you find a provider who encapsulates these characteristics, you and your organization will surely be set up for success.

How we know what works

Iris Telehealth is a telepsychiatry organization made up of only the highest quality behavioral health providers. We partner with health systems and clinics nationwide to bring mental healthcare to the communities that need it most.

We employ more than 200 psychiatrists and psychiatric nurse practitioners who are truly integrated as part of our team. We have a comprehensive and rigorous vetting process, and our tried and true method has given us the opportunity to work with the best in the business. Our partners and their patients also report a 97% average patient satisfaction rate with our services. With over 1.5 million patient encounters, we’ve found that our patients can seamlessly build relationships with their providers, even in a virtual environment.

If you need help finding the perfect match for your organization, contact us today.

3 Questions to Ask Yourself Before Implementing Telepsychiatry

There’s a lot to consider when implementing telepsychiatry into your health system, but first, let’s explore what telepsychiatry really is.

Telepsychiatry delivers psychiatric assessment and care via telecommunications technology, typically video conferencing. This solution equips health systems across the nation with the tools to provide high-quality, accessible, and affordable mental healthcare to their patients. This approach has never been more critical as the demand for mental healthcare in the United States grows.

Telepsychiatry is transforming the way care is delivered. This solution allows hospitals and clinics in rural and underserved areas to recruit excellent providers and improve patient care while reducing and maintaining costs. So, where do healthcare organizations begin? It starts by asking three simple questions.

1. Why telepsychiatry?

Before you begin, determine why you need a telepsychiatry solution. Are you looking to add, maintain or grow psychiatric services? This answer will help you navigate to the right solution. A few things to consider:

  • Do you have psychiatrists but need a few more people to help with the patient load?
  • Is your health clinic located in a remote area where it’s hard to recruit or retain doctors?

Knowing whether your organization will use telepsychiatry to supplement in-person care or as the main vehicle to care is critical to determining your plan moving forward.

Next, determine which method will work best for your setting.

1. Are you planning to supplement current on-site psychiatric providers with a telepsychiatry provider? If so, you’ll need to determine how their workflows will mirror each other. You will also need to develop best practices for your care team’s communication.

2. Are you planning to exclusively use telepsychiatry in your organization? If so, then your on-site staff will need to be prepared to make small changes to the current workflow in order to integrate the remote provider and ensure your program is successful.

We have seen both approaches work successfully in various settings. Knowing which one you plan to use ahead of time is crucial.

2. What technology will you use to deliver telepsychiatry?

Take an assessment of any existing hardware and software that you can use for your telepsychiatry program. Regardless of your starting point, it doesn’t need to be complicated or require a significant up-front investment. Often, people already have equipment that can be repurposed for telepsychiatry, which often reduces the early fees of getting started. As far as software goes, telepsychiatrists will typically document into your existing EMR and use simple video conferencing platforms, like Skype for Business.

Even if you don’t have much equipment – or any equipment at all – startup fees are typically minimal. All you really need is a laptop with a high-quality camera and microphone, but knowing what you already have, and what you need, helps get the ball rolling.

3. How will you build your telepsychiatry program?

Once you’ve determined the “why” behind investing in telepsychiatry and have taken a scan of existing equipment that will help get you started, it’s time to figure out how you will build out your telepsychiatry program.

Key considerations

  • Will you keep your telepsychiatry program in-house?
  • Will you work with a telepsychiatry provider vendor?
  • Will you partner with a telepsychiatry provider services organization?
  • Do you have the know-how, equipment, and people to start a telepsychiatry department on your own?
  • Would you like the support, expertise, and assistance of an experienced telepsychiatry provider partner?

Many groups have the resources and infrastructure to start in-house telepsychiatry on their own. For other organizations, that’s simply not a desire, or even a reality. Picking a partner you can trust is essential. After all, they will be working with your patients and your staff. You want a partner that is a leading industry expert with the experience to be a true consultant, working alongside you every step of the way to develop and deliver a custom telepsychiatry solution.

Iris Telehealth has helped countless healthcare organizations across the country deliver high-quality, specialty care to their patients. If you’d like to learn more about how Iris can help implement a telepsychiatry solution at your organization, you can talk to an expert today.

Clinician Corner: Meet Dr. Marialba Romero Medina, MD

Iris clinicians are at the heart of what makes our organization such a special place to work. That’s why we’re turning the spotlight on the amazing work they’re doing every day — starting with our very own Dr. Marialba Romero Medina.

Q: How did you find Iris and decide you wanted to be an Iris provider?

A: I found Iris at a time in my life where I needed a change. I wanted to expand my horizons in terms of what I was doing and what I could do considering the circumstances. I’m Latina, and I’m based in Puerto Rico. As the world knows, we went through a natural disaster a couple of years ago, Hurricane Maria. After that time, a lot of services changed here, and a lot of things that doctors could or could not do sort of modified. To put it simply, there were a lot of clinic closures.

I had to adapt to the times. As clinics were closing, I started to consider what I could do to continue working and hopefully continue living close to my family. Telehealth was the option. I did an overall search of companies and found Iris. My friend had already interviewed with the company and was in the process of onboarding. So, I interviewed with Iris, and it seemed like a good opportunity. I took a leap of faith, and here I am three years later.

Q: What does a typical day as an Iris Telehealth provider look like for you?

A: I do outpatient child and adolescent psychiatry at a community mental health clinic in Monroe, Michigan, with a population very much far removed from my own experience in terms of Puerto Rico. Even though I trained in Philadelphia, it’s still a sort of cultural adjustment.

A typical day is fairly standard and generally includes following up on patients and doing initial patient appointments. In times of COVID-19 and other things specifically going on in Michigan, there are many difficult circumstances that people have been going through. These challenges can complicate their daily lives and affect their kids.

I provide people with whatever resources we have, but I don’t do it alone, and I’m happy to have a great team. It’s refreshing because we have nurses, which is not something that I used to have in outpatient treatment. And, we have therapists and case managers, so it’s a team effort. I’m one tiny piece in a gigantic clinic offering a bunch of services.

Q: What do you love about being a telepsychiatry provider?

A: On the professional side, I love the idea that we can reach more people. And, more recently, things are moving more towards collaborative care. There’s an opportunity for physicians to work together remotely, and telepsychiatry opens up the scope of what we can do with very limited hours.

Personally, it’s been nice. Despite the significant loss and pain brought on by the pandemic, it has allowed me to be home. It’s a change in pace and expectation. Instead of driving an hour and a half to work, I can get up early to exercise, play with my dog, or if it’s sunny, I can look at the sun and prepare myself for the day. Considering the nature of the job and the stories we hear every day, being able to take care of yourself is a plus. Telehealth has allowed me to take better care of myself.

Additionally, if I have a no-show, I can go outside and take a walk or throw a ball with my dog, or even do some laundry. All around, I think it’s an improvement in quality of life.

Q: How do you foster connection with patients virtually?

A: I keep my video background very interesting, and even though it’s a view into my private life (or my human cave) it shows a little bit of who I am. I think this comforts patients by giving them something to look at, and it shows them that their doctor is also a human being with interests, likes, and random Christmas lights in the background. This atmosphere helps kids engage, ask questions, and opens up the conversation. It helps them feel more at ease, versus my experience at previous clinics where it’s hard to provide a personal touch or give a glimpse of who you are as an individual.

I try to be as genuine as possible with the way I talk and dress — I’m very colorful, and I have found that this helps.

Q: As a healthcare professional, how do you manage work-life balance?

A: Working from home can be isolating, which many people have experienced in the last two years. For me, I’ve been fortunate that I’ve made connections with people I studied with in medical school. We communicate, almost obsessively, daily. Connection is a good thing that technology has provided. But, maintaining those connections takes work. You have to make an effort to connect with someone, send them a text, or give them a call.

I’ve also been very lucky that the chart system we use at work is very responsive, and everyone uses the same one. If there’s a question about a patient, we can all talk to each other. I adore my nurses. We understand one another and can acknowledge that some days are harder than others.

Q: What’s the most rewarding part of your job?

A: I always hope I won’t have a patient long-term and that they can be discharged and go on. Sadly, especially in community settings, things are a little more complicated. Individuals can stay in a community mental health center for many years, so it’s nice to see them grow. It’s nice to see the change in their faces and how they see and interpret things compared to when they were younger. And, hopefully, they change for the better. It’s nice to see them realize that you can overcome even when things seem insurmountable.

Q: What are your biggest learnings from your time at Iris?

A: I’ve learned that there are positive and nice working environments. It has been healing to be with a company that is so supportive and so kind. Because not every work environment is that way. I think that Dr. Shaheen managed to grow a company that values genuine kindness, connection, and being nice to each other — even when things are overwhelming. We’re all overwhelmed at times, but I’ve always been treated in the most kind and respectful way. Every time I reach out, somebody answers and is paying attention. They’re making sure we’re okay.

Q: Why do you think telepsychiatry is important to the future of mental healthcare?

A: I think as the world continues to accept the reality that we’re all connected in one way, shape, or form, they’ll realize that we can’t do this on our own. The importance of being able to see and talk to each other even when we’re not in the same space or in the same area is vital. Whether it’s psychiatry or another type of healthcare, the idea that we can see and talk to each other, regardless of where we are, will be important.

Additionally, when it comes to healthcare, there are only so many doctors, and having somebody who can provide services in different areas is going to be positive. When it comes to what we need as individuals, many people need to be close to their families or to an area where they feel comfortable and where they enjoy living. And, that’s not always where a patient is going to be. Having the ability to meet with a patient where they’re comfortable and where the provider is comfortable, too — is a plus. There’s also no commute, and if they have to commute, it’s to a clinic in their area. It’s a win-win. Read this post to learn more.

If you’d like to learn more about working for Iris Telehealth, contact us today.