OSF HealthCare Combines Direct-to-Patient and eConsult Telepsychiatry to Improve Rural Care Access

The Challenge

Growing demand magnifies care shortages

Many Americans in rural areas struggle to access high-quality mental health services due to a chronic shortage of providers, costs and time associated with care, and persistent stigmas surrounding seeing a behavioral health specialist. As the growing opioid crisis and other factors create a higher demand for care, this lack of access becomes even more urgent. That was the case at OSF HealthCare’s Saint Elizabeth Medical Center in rural Ottawa, Illinois, which faced an influx of patients with untreated mental health and substance use disorders.

Due to the compounding issues of provider shortages and rising demand, patients were at risk of subsequent psychiatric hospitalizations while OSF faced potential decompensation. Wait times for in-person psychiatric care and for services at the CHOICES outpatient department had ballooned to six months. In addition, some patients were reluctant to visit a psychiatrist because of stigmas surrounding mental illness, costs associated with treatment, and time required to travel to appointments away from their primary care facility, all impeding the ability to receive the care they needed.

Recognizing its challenges and facing the reality of long patient wait times, OSF aimed to erase barriers to care at Saint Elizabeth Medical Center through an innovative approach to these issues.

The Solution

The right level of care, every time

In 2017, OSF launched a telepsychiatry program featuring direct-to-patient care as well as eConsult services. To bring its telehealth and eConsult programs to life, OSF turned to Array Behavioral Care, a leading provider of integrated telepsychiatry services. Array's eConsults empower primary care providers to treat some issues themselves, ensuring mental health clinicians are available to treat more severe conditions.

“Array has been a tremendous partner to our organization as we roll out an array of telepsychiatry options, including innovative consultative and patient treatment approaches,” says Luke Raymond, manager of behavioral health at OSF HealthCare. “Array demonstrates a commitment to customer service, high-quality psychiatric care and effective communication.”

Before referring a patient for direct psychiatric care, OSF’s primary care providers leverage eConsults to contact a Array clinician and determine if a referral is clinically appropriate. Based on the telepsychiatrist’s responses, a primary care provider may prescribe medications directly to the patient or refer them for additional services as needed. Providers also use eConsults to help patients access treatment more quickly when appointment wait times are significant.

eConsults are helping to decrease psychiatric wait times by enhancing the capacity of primary care physicians to provide mental health services. In addition, eConsults can increase the likelihood of patients seeing a mental health clinician, since they can more easily navigate the social stigma of seeking treatment and are often more comfortable talking to their primary care providers. For patients who still need to see a behavioral health specialist, Array clinicians provide telepsychiatry services through the secure ArrayConnect™ platform.

The Results

Shorter waits, high satisfaction, expansion-ready

Through its partnership with Array, OSF is significantly expanding access to care while ensuring each patient receives the right level of services. The telehealth and eConsult programs have helped OSF:

Reduce patient wait times dramatically. By adding Array telehealth clinicians for direct-to-patient care and reducing unnecessary referrals through eConsults, OSF has slashed patient wait times from six months for in-person consultations to six weeks for telepsychiatry sessions, a 75 percent reduction in wait In total, Array has completed more than 1,000 direct patient sessions and provides about 25 eConsults monthly.

Deliver patient and provider satisfaction. More than 98 percent of telepsych patients give the experience high marks. Among OSF providers surveyed about the eConsult program, 88 percent are satisfied with the content and 91 percent are satisfied with Array's response times.

Drive continuous improvement. The HIPAA-compliant ArrayConnect platform, designed specifically for telepsychiatry, securely and effectively connects patients with Array clinicians while offering session data and reporting tools so OSF can monitor program success. Array's deep pool of clinicians also gives OSF the flexibility to grow, with the two organizations  already discussing expanding the program to new sites.