The Challenge

Geographic barriers, cultural concerns

Building a strong care team to support community mental health is a top priority for Forest County Potawatomi. By turning to telepsychiatry, the community has overcome geographic and cultural barriers to make that vision a reality.

Located in Crandon, Wisconsin, Forest County Potawatomi provides healthcare, education and other services to families living on the reservation. Most staff live more than an hour’s drive away, making it difficult to recruit quality behavioral health professionals on-site. As a result, residents often had to travel up to three hours away to receive care, preventing many from receiving the treatment they needed.

The tribal community also needed mental health clinicians who would be sensitive to the residents’ challenges, from ongoing substance abuse issues to years of intergenerational trauma. After trying unsuccessfully for six months to hire an in-person clinician, Forest County Potawatomi recognized that telepsychiatry could connect the community to a broad range of clinically and culturally appropriate professionals.

The Solution

Establishing an effective team

Forest County Potawatomi partnered with Array Behavioral Care to expand access to behavioral health. As a leading provider of integrated telepsychiatry services, Array provides the high-quality clinicians, tools and support to improve mental health access for all, regardless of where they live.

From the start, the two organizations have shared a commitment to delivering services personalized for the tribal community’s residents. Array matched Forest County Potawatomi with a skilled telepsychiatrist and advanced practice nurse, and both Array staff and the clinicians visited the community in person to build rapport with the on-site staff. To help address substance abuse issues in the community, Array's clinicians and medical director collaborated with local care teams to prescribe controlled substances only when necessary.

That collaboration extends to all aspects of the program, with Array's clinicians charting directly into Forest County Potawatomi’s EHR and meeting with on-site staff to discuss specific patients and treatments. Patients see the same clinician weekly, helping to build trust and make treatment more effective. Potawatomi’s advanced practice nurse has even provided care on-site as the two organizations continue to strengthen their working relationship. Forest County Potawatomi also collects patient feedback directly through Array's AtHome videoconferencing platform, to monitor and continually improve its services.

 

“Hiring and retaining quality clinicians on-site was a tremendous challenge for us. Thanks to Array, we now have a team of professionals who are highly competent, culturally sensitive, and take the time to understand the needs of our community and our residents.”

Julie Beeney, Interim Director Health Division and Clinical Services Administrator, Forest County Potawatomi

The Results

A happier, healthier community

Through its partnership with Array, Forest County Potawatomi now has a strong integrated care team to meet its population’s significant mental health needs. Key benefits include:

  • A true clinical collaboration. Array's clinicians have become a seamless extension of Forest County Potawatomi's primary care team. The professional team works together closely to make day-to-day decisions, and Array's psychiatrist consults with Potawatomi's medical director to promote a collaborative approach to each patient's care.
  • The flexibility to grow. As patient needs change, Forest County Potawatomi can easily adjust its telepsychiatry services to match. While the community launched its telepsychiatry program with an advanced practice nurse and a psychiatrist, it soon added a licensed clinical social worker (LCSW) to meet additional demand. The reception was so positive, the LCSW’s services have expanded from 24 to 40 hours a week.
  • Convenient, effective care. With skilled, caring clinicians available instantly on-screen, the community is finally getting the mental health support it needs. Patients no longer have to travel for hours to see a psychiatrist or therapist, and program feedback has been overwhelmingly positive.

Care Goes Virtual

 

Telepsychiatry is becoming more widely adopted and used across the country in hospital emergency departments, psychiatric crisis centers, inpatient units, correctional facilities and other organizations that require as-needed psychiatric assessments and care. On-demand telepsychiatry services are generally one-time encounters focused on determining the appropriate disposition and plan for an individual in psychiatric crisis.

Under this service model, trained and experienced telepsychiatry clinicians collaborate with onsite resources to augment and enhance the existing system of care, so that individuals can move on to appropriate next levels of care quickly.

Complete the form to download this white paper.

Solutions That Save

 

Hospital emergency departments (EDs) across the country are experiencing a surge in the number of patients presenting with mental health issues. This trend is due to a combination of factors, including lack of community mental health services, cost and coverage barriers, insufficient outpatient resources and inpatient treatment options and a nationwide shortage and uneven geographic distribution of psychiatrists.

Given this, patients seeking behavioral health treatment face long wait times and may have to travel significant distances for an appointment. They may also have trouble finding psychiatry practices accepting new patients or that take their insurance since many have converted to cash-only private practices. Therefore, with nowhere else to turn, these patients are increasingly relying on EDs for behavioral health care.

Complete the form to download this white paper.

It has been a year like no other and that’s particularly true for the telemental health and telepsychiatry industries.

Unfortunately, mental health need has spiked during COVID-19, which has brought on the removal, at least temporarily, of nearly every barrier that previously limited telehealth.

While telehealth advocates have preached that telehealth is health, in 2020, we saw that come to fruition, particularly within the behavioral health space. You’d be hard pressed to find a behavioral health clinician today who has not held a remote session. So, what does this mean for the future?

As we look into the year to come, here are six trends we predict to see in 2021.

  • Care for clinicians - Our health care workers, including mental health care clinicians are the heroes of the year, shouldering the burden, stress and pain of so many. This sacrifice comes at a cost. The burnout and fatigue clinicians are feeling are real and measurable. Employers are pouring resources into mental health support programs for their teams. In 2021, we predict these types of programs to finally become a permanent priority.  
  • Crisis Intervention Teams expanding their reach by leveraging telehealth - As many communities have look closely at their police programs and funding in 2020, we anticipate a rise in crisis interventions teams or mobile crisis units that can bring trained mental health experts into the community to better respond to individuals in crisis. CITs, paramedic teams or even law enforcement can have more robust in-the-field support by leveraging remote behavioral health clinicians who can help assess risks and direct individuals to the appropriate level of care and support.  
  • Collaborative Care The connection between physical and mental health is indisputable, and payers across the country are doubling down on programs that help bring mental health care clinicians into individual’s primary care treatment teams. This is most efficiently done via telehealth. We anticipate major growth in this segment in 2021.  
  • Treatment teams in crisis settings - As the strain on mental health care clinicians worsens, it is vital to make the highest and best use of all mental health resources. Accordingly, we are beginning to see modifications to crisis telepsychiatry programs that layer in different levels of remote behavioral health clinicians to help with screening, triage and care. This trend, paired with a newfound desire for behavioral health clinicians to work remotely (at least for part of their week), means we expect to see more and more remote telepsychiatry teams serving all settings of care.  
  • Focus on disparities - 2020 put an important and needed lens atop healthcare disparities. We are seeing new telehealth organizations pop up that specialize in telemental health for populations with social, economic and/or environmental disadvantages and more focus placed on these efforts from existing telemental health players. One size does not fit all when it comes to mental health care, and determining the most effective ways to reach and appropriately address the needs of underserved populations must be a priority for all in 2021 and beyond. 
  • Telehealth regulations WILL change permanently 2020 was a regulatory sandbox for telehealth. Regulators moved incredibly quickly to greenlight any and every regulation that increased access to care via telehealth – however most of this year's changes were/are temporary and dependent on the public health emergency. As the CMS administrator, Seema Verma delivered what some consider the telehealth quote of the year: “The genie's out of the bottle on this one I think it's fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there's absolutely no going back." 

We are ready for permanent action. The telepsychiatry industry predicts and respectfully calls for regulators to make it happen. Here’s the short list:  

  • Reimbursement - by CMS and by every private payer for all aspects of mental health care regardless of the modality, including audio-only encounters. It must happen and it must expand.  
  • Simplified Licensure - In late November, a group of Congressmen introduced a bill (HR 8723) that would prevent states from receiving some forms of HHS funding unless they’ve joined the interstate medical licensure compact which makes it easier for physicians to use telehealth to treat patients across state lines. This bill showcases a sentiment we expect to follow us well into 2021. Unnecessary hoops to jump through in order to serve patients must go. 
  • Appropriate Controlled Substance Prescribing via Telehealth We must enact permanent policies to ensure access to behavioral health services via telehealth in order to address the opioid epidemic and other widespread behavioral health conditions. We call for the DEA to make a permanent and long-promised option for controlled substance prescribing via telemedicine under the Ryan Haight Act.

About the Author: Olivia Boyce, MPH is the chair of the American Telemedicine Association’s Telemental Health Special Interest Group and a Vice President at Array, the leading national telepsychiatry organization and a long time telehealth advocate.

About Array

Array Behavioral Care (formerly InSight + Regroup) is the leading and largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities and communities. As an industry pioneer and established thought leader, Array has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations. To learn more, visit www.arraybc.com.

Healthcare systems and individual hospitals can evaluate their very own metrics against industry data to evaluate cost and revenue implications of an investment in on-demand telepsychiatry.

(October 22, 2020) – Array has launched a customized capability using a value calculator to help hospitals and healthcare systems evaluate costs associated with their current process for managing behavioral health patient demand against savings and revenue opportunities.

The unique tool responds to a long-standing need for hospital administration to quantify the expected return on investment of behavioral health coverage via on-demand telepsychiatry. This new capability comes at a critical time as the industry faces unexpected operational and financial challenges. Many facilities are seeing a rise in demand for mental health services, while a simultaneous drop in ED visits in the wake of COVID-19 is presenting financial strain.

For hospitals and healthcare systems considering on-demand telepsychiatry to meet growing patient need for mental health services, implementing a financially sustainable and scalable program is essential:

  • 25% of all emergency department visits are due to behavioral health issues
  • 3X longer emergency department boarding times for mental health admissions vs. non-mental health admissions

On-demand telepsychiatry can have a positive financial ripple effect that extends well beyond emergency departments, including reduced reliance on scarce inpatient psychiatric resources, reduced inpatient psychiatric admissions, improved emergency department throughput and increased capacity for med-surg admissions. It allows healthcare systems to allocate resources to populations with heightened need and acuity to reduce strain on clinicians and improve operational metrics.

Array's value calculator uses proprietary logic based on more than two decades of experience implementing programs and delivering telepsychiatry services within hospitals and health systems. Customizable to organizations of all sizes, the tool uses validated data, clinical research and demonstrated outcomes to help organizations determine the financial impact of on-demand telepsychiatry applied to their specific use case. It takes into account actual direct and indirect costs using current behavioral health demand within the facility in order to quantify specific areas of cost savings and highlight untapped revenue opportunities.

Using key data on current behavioral resources and gaps, such as patient length of stay, bed capacity and existing clinical coverage, hospitals and health systems can:

  • Isolate specific metrics that impact overall cost of care to understand where and how telepsychiatry can drive savings
  • Compare actual data against industry benchmarks to evaluate the broader impact of telepsychiatry on operational, financial and clinical outcomes
  • Validate where and how on-demand telepsychiatry is appropriate in a variety of applications across the health system
  • Provide a clear, customized picture of potential ROI to aid in decision-making and the development of a justifiable business case

“We understand the key role on-demand telepsychiatry can play in helping hospitals deliver financially sustainable care, but it has typically been challenging for leadership to quantify its impact at a detailed level,” says David Cohn, Chief Growth Officer at Array. “Now, this capability allows us to collaborate with healthcare organizations and give them a fresh, detailed view of their current cost exposure and expected operational outcomes and financial returns from on-demand telepsychiatry programming.”

Request a Customized ROI Assessment Now

About Array

Array Behavioral Care (formerly InSight + Regroup) is the leading and largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities and communities. As an industry pioneer and established thought leader, Array has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations. To learn more, visit www.arraybc.com.

Array Behavioral Care's CEO, Geoffrey Boyce, joins the Partnership to Advance Virtual Care to share lessons learned from the pandemic and how changes to legislative and regulatory environments could support patients and providers moving forward. 

You’ve experienced the telehealth surge firsthand at the height of the public health emergency. Now, hear from Array and other leading providers on how we deployed telehealth solutions and supported patients during COVID-19, and how the healthcare industry can work together to maintain the positive momentum we’ve witnessed with telehealth implementation.


About Array

Array Behavioral Care (formerly InSight + Regroup) is the leading and largest telepsychiatry service provider in the country with a mission to transform access to quality, timely behavioral health care. Array offers telepsychiatry solutions and services across the continuum of care from hospital to home with its OnDemand Care, Scheduled Care and AtHome Care divisions. For more than 20 years, Array has partnered with hundreds of hospitals and health systems, community healthcare organizations and payers of all sizes to expand access to care and improve outcomes for underserved individuals, facilities and communities. As an industry pioneer and established thought leader, Array has helped shape the field, define the standard of care and advocate for improved telepsychiatry-friendly regulations.  To learn more, visit www.arraybc.com. 

Now is the time for telebehavioral health. We’ve seen a remarkable evolution for a rapidly changing telehealth industry, and the virtualization of behavioral health interactions is exploding as the need for mental health services rises and is predicted to continue. 

Array (formerly InSight + Regroup), the industry’s most experienced telepsychiatry service organization, will share fundamental best practices for implementing hospital-based telepsychiatry and discuss Illinois’ regulatory landscape. 

The webinar will cover a variety of topics, including:  

  • Hospital and health system applications of telepsychiatry 
  • How telepsychiatry has helped in response to COVID-19 
  • Illinois regulatory changes (reimbursement, HIPAA compliance, prescribing and licensure) 
  • Operational and financial outcomes derived from on-demand telepsychiatry (ROI) 
  • Lessons learned and how they will shape the future of telehealth care delivery 

Join Scott Baker, MBA, Vice President & Senior Group Lead of Partnerships as the discusses how telepsychiatry gives hospitals the ability to achieve quick, safe throughput to ensure proper use of ED and inpatient unit resources while driving a return on the investment of telepsychiatry. 

For questions, contact webinar@arraybc.com

Please complete the form to view the webinar recording and download the slides. 

Virtually Caring for Behavioral Health

Telebehavioral health has been accepted as a proven medium for increasing access to psychiatric, mental and behavioral healthcare by connecting individuals to providers through video calls. Today, in-home, mobile, outpatient and primary care models of telebehavioral health allow for community-based care that addresses behavioral health issues before they reach critical levels. On-demand models of care offer timely services to individuals in the emergency department (ED), psychiatric crisis centers or in the community through mobile crisis teams. There are more patients, employers, health systems and payers employing telehealth, as well as more providers becoming involved in telehealth work in a range of fields, like psychiatry.

The first thing to ask yourself may be, “What are my organization’s overall strategic priorities?” Example questions may include:
• What is my vision for the next [x] number of years?
• How do I evaluate progress toward that goal?
• How does telehealth already fit in or how could it?
• Who is responsible for tracking the telehealth industry within my organization?
• How do I share and apply that information across my organization?

Complete the form to download this whitepaper.

Treating the Whole Patient

Quality behavioral health care remains frustratingly out of reach across America. With few psychiatrists available in many parts of the country, this lack of coverage comes during a time when many of these services are needed now more than ever. Against this backdrop, the need for innovation in practicing quality mental health care is resoundingly clear

To treat the whole patient, we must first understand the key factors behind the mental health care shortage

  • A shrinking pool of providers
  • Uneven distribution of clinicians
  • Growing needs for mental health services
  • Patient barriers to care

Complete the form to download the white paper.

More clinicians are choosing to work in telehealth than ever before. As the industry matures and more competitors enter the market, clinicians have more options in where they chose to work.  What makes them choose one provider organization over another?  

Telepsychiatry is changing the way mental health services are being delivered. Telepsychiatry not only transforms access to care for patients, but it also offers clinicians unparalleled job flexibility and opportunities for growth.   

The clinician network at Array continues to grow rapidly as we regularly add new psychiatrists and other behavioral health professionals to our team. In the past 6 months, more than 200 clinicians and 18 supporting administrative members have joined our teamIn addition to these new hires, we have numerous existing clinicians who have been with our organization for many years.  

These new and seasoned clinicians alike share what initially attracted them to Array and why they chose to stay: 

Work-Life Balance 

Array prioritizes the well-being of clinicians and administrative team – the mental health of our patients starts with us. Aside from the flexibility that comes with working from home and choosing your own schedule, we’ve established a wellness committee and clinician engagement team who continuously promote healthy work-life practices and on-going education. 

Longtime Array clinician, Julie Lu, a psychiatric NP who has worked with us for several years explains why she enjoys working in telepsychiatry. 

“What I like most about practicing telepsychiatry is that it feels like I’ve found more time in the day; I no longer have to fight traffic during a long commute. That time is now better used talking to patients and my clinic staff. The technology has allowed me to reach across the distance and make connections with patients who might otherwise still be on a wait-list to be seen by a psychiatric provider.”  

Focus on Clinical Care 

Array has an unmatched internal technical and administrative infrastructure backing its clinicians. We offer around-the-clock clinical, operational and technical support designed to help clinicians with their delivery of care every step of the way. Clinicians enjoy support from a large responsive team so they can focus on what they do best – providing patient care.  

Array offers reliable support via admin staff, care navigation team and user-friendly systems. Thank you, Array for allowing me to put 100% of my energy into providing therapy.” - Kelly Wood, LCSW 

Being Part of a Team 

Collaboration is a cornerstone of our organization. Through collaboration, Array clinicians develop strong professional relationships with their partner site as well as with their telepsychiatry peers and administrative support staff. Clinicians are not providing care “on an island” by themselves; our clinicians can find reassurance in having systems in place that makes it easy to communicate with colleagues and collaborate with necessary personnel in order to deliver the highest-level care  

When community health clinics across the country had to close or temporarily suspend services during the coronavirus crisis, one of our partners, the Fauquier Free Clinic in rural Virginia, in collaboration with our clinician, Dr. Azpiri, was able to quickly convert from facility-based to home-based virtual care so their patients could continue to receive much-needed mental health services. 

“I am so grateful that patients have been so receptive to this new approach. They have been so welcoming and inviting and flexible, which is a big reason we’ve been able to pivot so quickly and successfully to in-home virtual care. Delivering care directly to patients in their homes gives me a glimpse inside their private worlds, without being overly intrusive. I can assess environmental cues such as the orderliness and cleanliness of their surroundings, appearance, food needs, etc. This allows me to really see how they are doing physically, emotionally and mentally and determine if additional support is needed.” – Alicia Azpiri, MD 

Expanding Organization 

Following the recent merger between InSight Telepsychiatry and Regroup Telehealth in December 2019, even more clinicians have inquired about clinical opportunities with our newly combined organization. The merger created a larger, more comprehensive nationwide team that allows us to grow more quickly and strategically. With a bigger footprint and opportunities in various settings across the continuum of care, we are able to offer clinicians different options for where and how they practice. Clinicians also benefit from, our collective partnerships, expertise, leadership and resources; together we are truly transforming access to care. 

Clinician Choice in Care Setting 

Array is the only telebehavioral health care organization that offers clinicians the flexibility to select among multiple models, serve multiple organizations and work with multiple patient populations. Clinicians have the opportunity to choose from a myriad of settings such as emergency departments, hospital medical/surgical floors, inpatient units, mobile crisis programs, crisis centers, residential programs, primary care clinics, community health centers,  tribal programs, correctional facilities or direct-to-consumer. Given the multitude of options available, we work with each clinician from the start to figure out the best care setting for them. We discuss their individual needs and preferences as well as the needs of the organization to ensure long-term success. We have found that uniquely matching our clinicians and partners and maintaining a strong line of communication has enhanced clinician satisfaction. 

“I have been a psychiatrist with Array for 2 years. It has been a phenomenal work experience. I enjoy rotating my days between an outpatient clinic, a correctional facility and a commercial insurance/home setting. It keeps my clinical work interesting and my skills sharp.” - Betsy O’Brien, MD  

Work for an Established Reputable Organization 

Array is the pioneering leader in telepsychiatry. For the past two decades, our mission has remained the same – to transform access to quality behavioral health care. Clinicians appreciate the stability and reassurance of working for an established and rapidly growing organization that has the technical, clinical and operational support to make them successful. Clinicians can engage with telepsychiatry peers, learn from behavioral health thought leaders and clinical experts.  

The collaboration between professionals, flexible hours, and ability to work with a company whose values and standards are in alignment with mine are some of the reasons why I continue to choose Array as an employer. I enjoy working in telehealth; it's a rewarding and humbling experience to be invited into a patient’s home once a week for online therapy and have the opportunity to observe and help them when their most vulnerable.” – Robert Cleveland, LCSW 

Array uses the Net Promoter Score (NPS) metric that assesses clinicians’ experience with our organization by asking them how likely they are to recommend us to a friend or colleague. The final aggregate NPS score can range from as low as –100 to as high as 100. With the most recent clinician NPS scores for the two organizations averaging 55, it’s clear that clinicians like working at Array.  We are committed to fostering the best clinician experience possible to ensure they can deliver the best in class care. 

What do you look for in a telebehavioral health employer? We’d love to hear from you. Visit this link to either share your ideas or to discuss the various telepsychiatry opportunities available at Array. 

If you are in crisis, call the National Suicide Prevention Lifeline, a free, 24-hour hotline at 1.800.273.8255. If your issue is an emergency, call 911 or go to your nearest emergency room.