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.

What Your Healthcare Organization Can do to Make Patients More Comfortable with Telepsych

Since the onset of the COVID-19 pandemic, telehealth has become a mainstay for patients across the country. The American Telemedicine Association (ATA) reports the following data:

  • 28 studies found that more than 80% of patients indicated satisfaction with telehealth
  • 75% of people expect virtual care to become a standard part of their care
  • 85.52% report that telemedicine has made getting the care they need easier

With its growing popularity, it’s clear telehealth is a long-term solution and not just a temporary fix during the pandemic. As of 2017, the American Hospital Association cited 65% of hospitals had incorporated a telehealth solution. In 2021, about one-sixth of hospitals reported using telepsychiatry with a wide variation across states.

Still, healthcare organizations have a lot to consider when implementing virtual specialty solutions like telepsychiatry, and patient comfort should be a top priority. Keep reading to learn more about common telehealth misconceptions, why virtual works so well for psychiatry, and how to set patients and providers up for success in a virtual environment.

Common telehealth misconceptions

Despite the benefits and popularity of virtual care, misconceptions about the patient experience persist, and the telepsychiatry space is no different.

Here are four of the top misconceptions we encounter on a daily basis:

  1. Patients don’t want to use telehealth: This is perhaps one of the biggest myths busted by the pandemic. Across the board, patients want to conveniently and quickly see a provider across any specialty in the most convenient way possible — and for many, that means telepsychiatry. Additionally, while some organizations might be concerned about their patients thinking telehealth is low quality, there is no current data to support this notion. As the ATA study reports, patient satisfaction is high, and patients expect telehealth to continue being a possibility for their care well into the future.
  2. Elderly patients have trouble accessing technology: According to the American Association of Retired Persons (AARP), technology usage among older adults skyrocketed during the pandemic. The AARP reports that 44% of older adults view tech more positively as a way to stay connected than they did before COVID-19. Additionally, the American Psychiatric Association (APA) reports that since the late 1990s, telepsychiatry has been an effective treatment for anxiety, dementia, and cognitive impairment within this population.
  3. Populations with specialty concerns can’t get care: Many providers or organizations may think certain patients with specific concerns, like those experiencing paranoia, wouldn’t be interested in telepsychiatry. However, psychiatrists have seen that the ability to receive care from the comfort of their own homes has a more influential benefit for this population. Additionally, for deaf or hard-of-hearing patients, sharing the call with a sign-language interpreter has proven helpful and easy to manage virtually.
  4. Reaching rural communities will be difficult: While there may be concerns about getting this population on board with telepsychiatry, patients have seen real benefits over the past few years. In rural or small-town communities where access to care is limited, stigma around getting mental health treatment still exists, and not having to go to a psychiatrist’s office is a bonus for many people who may be wary of community backlash. Additionally, according to the Pew Research Center, 93% of American adults use the internet, diluting concerns that populations in rural America can’t access virtual care. Additionally, the ability to get care from home, so they don’t have to drive long distances, is a huge plus for this population.

Why virtual works for psychiatry

The virtual environment of telepsychiatry allows providers to meet patients where they are. This virtual platform is compatible with the nature of a psychiatrist’s work, and dates back as far as the 1950’s.

Additionally, for individuals with anxiety who aren’t comfortable leaving their houses, telepsychiatry is an excellent fit. The same goes for lower income populations, or patients experiencing homelessness. For these patients, getting transportation can stand as a barrier, and it can also be more difficult for them to want to go into a busy medical office.

The vast majority of work that goes into psychiatry is talking and listening, and telepsychiatry is the perfect fit for this line of work. Educating patients, providers, and organizational leadership about the benefits of telepsychiatry can help solidify this modality as a long-term solution for your organization.

Increasing patient comfortability at healthcare organizations

While most patients will be comfortable utilizing virtual care platforms, some may be hesitant. In this case, communication is vital. Ask your patients where else they’ve used this modality in their lives. If they’ve been able to communicate and connect with their loved ones, chances are, they’ll like telepsychiatry as well.

You can also ask them what they want directly. For example, do they want to come into the clinic? Or, do they want to connect from home? Maybe there will be some patients who are interested in a hybrid option. The data you collect can help guide your organization’s decision when considering investing in a telepsychiatry solution.

Tips for providers using telepsych

While telepsychiatry is beneficial to patients, it also benefits providers. In the ATA report cited above, 94% of mental health professionals say they would like to continue offering telehealth services. That said, making sure your providers have the information they need will set them up for success as they embark on their virtual practice.

At Iris Telehealth, we ensure our providers have all the resources, tools, and support they need to do what they do best — take care of patients. We’re psychiatrist-owned and operated, and we know what providers need, like less paperwork, a supportive work/life balance, and even 24/7 tech support.

Here are five tips our providers have found useful:

  1. Ensure a nice office set-up with a neutral background that’s not too distracting or too plain, like a blank white wall
  2. To prevent headaches, encourage providers to be aware of any glare on their glasses or their computer screen
  3. Investing in a noise-canceling microphone can help providers keep communication clear and cut back on distractions
  4. To help ensure patient privacy, ask your providers to invest in a headset to ensure they’re the only ones who can hear what the patient is saying
  5. Ensuring your provider’s cameras are set to a good gaze angle can help promote connection. When a provider’s camera is pointed down and they’re looking up (or if the camera is on a different monitor than the screen they’re looking at), it can look like they’re staring off into a different direction — providers should seek to position their cameras in a way that makes it appear as though they’re looking directly at their patient

By incorporating these tips, your providers will be set up for successful patient sessions that will make patients more comfortable with any virtual communications.

Get started on your behavioral health strategy

Here at Iris, we make sure your organization has everything it needs for a successful behavioral health program.

Contact us today to see if our telepsychiatry services would be a good match for your organization. Or, if you have more questions, check out our FAQ page.

How Nurse Practitioner Authority Varies By State

Nurse practitioner practice authority varies by state. This variation defines whether or not nurse practitioners (NPs) can utilize the full extent of their education. For NPs, they follow guidelines around how they can see patients, whether or not they need a collaborative physician, and what controlled substances they can prescribe with or without the need for co-signatures. Whether your organization needs help addressing the provider shortage or decreasing wait times, an NP can help.

According to the AANP, nurse practitioners’ practice authority varies depending on what state they choose to practice in. The three types of state practice environments are:

  • Full practice (independent)
  • Reduced practice (partially independent)
  • Restricted practice (non-independent)

In restricted practice states like Texas, NPs must work under another health provider’s supervision to practice. Reduced practice states like New York allow NPs to be in a collaborative agreement with another health provider to facilitate patient care. They also have one or more limits on NP practice. Full practice states like Arizona allow NPs to practice independently, evaluate, and provide care to patients without a collaborating physician or agreement.

As of right now, there are 29 NP full practice authority states, 16 reduced practice states, and 11 restricted practice states.

Finding the right fit

While NPs are essential to addressing the provider shortage and improving patient experience, they’re also indispensable when it comes to mental health treatment. The type of NP working in the mental health field is called a psychiatric mental health nurse practitioner or a PMHNP. These providers work in correctional settings, residential treatment centers, inpatient hospitals, health systems, and private practices. However, the majority of PMHNPs are practicing in underserved and rural areas.

PMHNPs can be a major benefit to your organization, especially if your organization serves patients from vulnerable populations, like Community Mental Health Centers (CMHCs), Certified Community Behavioral Health Clinic (CCBHCs) and Federally Qualified Health Centers (FQHCs). PMHNPs are skilled at caring for patients, and their quality level is similar or equal to a psychiatrists. Not only can they provide a similar quality of care as a psychiatrist, but they are also skilled at facilitating holistic care, which overall contributes to the level of quality care and treatment they can provide.

PMHNPs receive specific training in various types of treatment they provide like:

  • Extensive training in psychotherapy and behavioral health conditions
  • Crisis intervention and directing patient care planning
  • Collaborative care
  • Effective communication with patient families

If your organization is looking to provide these skills and treatments, PMHNPs might be a valuable asset for your organization.

Challenges and opportunities you might face

Across the country, healthcare organizations are facing a provider shortage. According to USAFacts, as of March 2021, 37% of the U.S. population lived in 5,833 mental health professional shortage areas. Providing cost-effective but high-quality care can be difficult in these regions, but in full authority NP states, the providers can serve as a primary care provider.

In restricted and reduced practice states, PMHNPs cannot practice without a collaborating physician. During the provider shortage, it is especially challenging to find a collaborating physician. These agreements have to be renewed annually, and they have to meet with the physician they are collaborating with on a monthly basis. This specific agreement can cause issues for rural areas where there may not be a physician locally available, or there may be a shortage of physicians who would be able to work collaboratively with a nurse practitioner. In some extenuating circumstances, if the collaborating physician becomes ill or retires, patients cannot be seen, and you might have to cancel the appointment.

By utilizing telepsychiatry, you can find the best-qualified PMHNP for your organization’s needs, especially during a provider shortage when you cannot find a PMHNP locally. Telehealth can extend healthcare delivery to underserved populations and rural areas. With the help of a PMHNP, it can be easier to meet that need by partnering with telehealth organizations like Iris Telehealth. Telepsychiatry solutions can help healthcare organizations overcome access issues and help alleviate the pressure of finding a qualified provider locally. For example, a PMHNP living in Texas can meet the licensure requirements in Utah, making it possible to extend healthcare delivery through telepsychiatry.

Telepsychiatry that meets you where you are

Regardless of where nurse practitioners practice, they can utilize telehealth to connect their patients with specialty care while working in their scope of practice. Telepsychiatry can open up your search by hiring a PMHNP from across the country instead of searching locally, especially since there is a high saturation of providers on the East Coast and a higher need on the West Coast.

If you decide to hire a PMHNP for your organization, you can ease some of the administrative burdens, like licensing, credentialing, and obtaining a collaborative agreement.

How Iris Telehealth can help

Iris Telehealth serves as a resource for providers who need support and can help your organization source and vet potential PMNHPs. If you’re looking to develop a formal telepsychiatry program to provide high-quality care for your patients, Iris can help you through the process.

If you would like to learn more about how telepsychiatry can help supplement your behavioral health team, contact us today.

The Long-Term Effects of COVID-19 on Mental Health

The COVID-19 pandemic has left a seismic impact on the hearts and minds of people across the world — whether through job loss, the grief of losing a loved one, difficulty paying bills, or trouble finding quality healthcare.

In tandem with these experiences, the state of mental health has plummeted. According to data published by The Lancet, 76 million people have reported pandemic-related anxiety, a number that increased by 26 percent between 2019 and 2020.

As the pandemic continues, we’re pausing to look back at the unique experiences of different populations across the country, the long-term effects on mental health, and how to help decrease the impact of COVID-19.

Long-term effects on families, rural Americans, and underserved populations

The COVID-19 pandemic has affected everyone differently and has been particularly challenging for families, Americans in rural parts of the country, and underserved populations.

Families and children

For families, the pandemic transformed daily life. Social determinants of health have been exacerbated, and paying bills has gotten harder. In fact, The Commonwealth Fund reported that 7.7 million workers lost their employer-sponsored health insurance (ESI) jobs due to the pandemic-induced recession. This loss also affected 6.9 million dependents across the country.

Additionally, nearly 93% of school-aged children were engaged in distance learning, creating changes and new dynamics in the home. Today, as kids transition from a more controlled, virtual environment to one that’s in-person with more people, noise, and different expectations, it may trigger separation anxiety or underlying fears that could potentially impact their development.

The compounding stress has been so significant that the American Academy of Pediatrics, alongside the Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association, recently declared a national state of emergency in children’s mental health.

Rural America

During the pandemic, 30% of rural Americans reported suffering from anxiety or depression. While finding care can prove challenging, many rural Americans turned to telehealth. In fact, 43% say they have used telehealth for mental health and/or substance use treatment services once a month or more over the past year.

Telepsychiatry works to reach people to get them the right care when and where they need it. For healthcare organizations located in rural areas looking to impact their communities and improve their services in the wake of COVID-19, telepsychiatry can make a real difference in the short and long term.

Underserved Populations

The impact COVID-19 had on underserved populations was especially hard. A survey by The Commonwealth Fund found that Latino and Black people, women, and people with low income are most at risk of mental health concerns because of the pandemic.

The COVID-19 pandemic has underscored the need for health equity. By making mental healthcare more accessible and equipping communities with the right mental health resources, these populations will have the care they need throughout and after the pandemic.

Provider shortages and increased need

Healthcare organizations were hit hard throughout the pandemic, further exacerbating the pre-existing psychiatrist shortage and causing people to delay mental and medical care. At the height of the pandemic, 1 in 5 adults in the U.S. reported they could not get care or delayed care for serious problems, and 57% reported negative consequences. Additionally, a report by the Kaiser Family Foundation (KFF) found that the pandemic and the economic recession created new barriers for those experiencing mental health conditions. In a July 2020 poll, KFF reported specific negative impacts on adults:

  • 36% had difficulty sleeping
  • 32% had difficulty eating
  • 12% experienced an increase in alcohol consumption or substance use
  • 12% experienced worsening chronic conditions due to worry and stress

While there’s mounting pressure on healthcare organizations, there are steps they can take to help relieve shortages and empower patients and providers.

Solutions for healthcare organizations

This lack of access to care for both mental and physical health throughout the pandemic decreased overall wellness. So, what can healthcare organizations and providers do to help set their patients up for success? There are three solutions every organization should consider.

1. Incorporate an integrated care program

Conditions like generalized anxiety disorder, social anxiety, agoraphobia, and more have been exacerbated. When mental health goes untreated, certain medical conditions can worsen over time. The Centers for Disease Control and Prevention (CDC) calls mental and physical health equal components of overall health.

That’s where integrated care programs come in. These programs can play a significant role in helping hospitals, health systems, Federally Qualified Health Centers, and Community Health Centers recover from the pandemic. This convergence of medical and behavioral health facilitates true collaboration between providers, offers patients the best possible care, and mitigates downstream medical costs.

2. Invest in telepsychiatry

As the demand for care increases due to unmet needs, staffing up healthcare organizations with telepsychiatry solutions can help hospitals keep up with demand, support providers, and provide high-quality care to patients. This solution is beneficial for patients in need of specialty care who may not have time to sit on a waiting list or in an emergency room.

By incorporating this solution, hospitals will have a specialist on call 24/7 in the emergency department to consult with inpatient services or support outpatient services to drive better outcomes. Telepsychiatry makes it possible for people to get the care they need when they need it.

3. Ask questions

When providers take the time to ask people how they are and how COVID has affected their lives, it can open up critical communication channels that can ultimately help your organization better serve your patients. For example, if a patient is experiencing food insecurity, providers can point them toward a food bank. Or, if they need to get tested for COVID but don’t know where to go, your organization can help them find a testing location. Asking the right questions can reveal core issues, reduce stress, and encourage connection.

Healing long-term effects through self-care and awareness

Stress can take a toll on us all. For providers who are already dealing with high rates of burnout, it’s imperative to set aside time for self-care. Incorporating lifestyle medicine principles into your life can help heal long-term physical and mental effects. The pillars of this solution include staying hydrated, eating nutritious foods, exercising, getting adequate sleep, limiting substance use, and emphasizing social connectedness.

Taking care of your mental health and turning your awareness towards self-care can make a big difference in helping heal the long-term effects of the COVID-19 pandemic.

Where Iris Telehealth fits in

If you’re looking to incorporate telepsychiatry into your organization but don’t know where to start, Iris Telehealth is here to help. Together, we can help your organization combat the long-term effects of the COVID-19 pandemic. Contact us today!