With relatively inexpensive equipment that uses secure Internet connections, Mason District, a public hospital, has contracted with Springfield’s Southern Illinois University School of Medicine and Lincoln Prairie Behavioral Health Center to provide live video interactions between psychiatrists and patients.
Sarah Culbertson Memorial Hospital in Rushville also is providing psychiatric services to patients through SIU, and the medical school is looking to expand its telemedicine services to more hospitals as a way of dealing with the chronic shortage of psychiatrists in rural Illinois.
“It is the wave of the future,” said Dr. Jeffrey Bennett, director of SIU’s psychiatry residency program.
Harry Wolin, Mason District’s chief executive officer, said: “This is a great program all the way around. The fact that there are not literally face-to-face conversations doesn’t seem to affect it so much.”
More affordable, easier
Mason District, a 20-bed hospital, is one of a growing number of hospitals nationwide to make medical expertise available close to home via telemedicine.
Long-distance medical advice on short notice has been available since the invention of the telephone, and telemedicine has been around for about 40 years in the United States.
But technological innovations, especially through the Internet, have made telemedicine more affordable and easier to use, said Bennett, who works with residents to provide care for telemedicine patients twice a month at Mason District and once a month at Sarah Culbertson.
“It’s almost like sitting with someone in the room,” Bennett said.
The two hospitals contract with the SIU doctors and then bill patients and insurance plans. Mason District also contracts with Lincoln Prairie for weekly telemedicine services with pediatric psychiatrist Dr. Juan Medina.
“If we want to make services more readily available, it will likely be in endeavors like this,” Lincoln Prairie CEO Mark Littrell said. “We really need to look outside of the box of traditional service delivery.”
If prescriptions or other orders from doctors in Springfield need to be issued for patients after telemedicine visits, Bennett and Medina make recommendations to patients’ primary care doctors.
Meets outpatient needs
Patients overall have been happy with the services, according to Wolin and Sarah Culbertson CEO Lynn Stambaugh.
Wolin said published studies indicate tele-psychiatric treatment is almost as effective as face-to-face outpatient treatment for depression and other mental illnesses.
For Mason District, the new program is connected with a reduction in patients who seek mental-health treatment from primary care doctors and other health-care providers employed by the hospital, he said.
That’s a sign patients are having many of their outpatient needs met through telemedicine, Wolin said. Mental-health problems can be time-consuming and frustrating for primary care providers, most of whom don’t have extensive training in psychiatry, he added.
SIU’s mental-health experts also use telemedicine equipment to provide training to primary care doctors at Mason District, Culbertson Memorial and other rural hospitals so those doctors are better equipped to deal with their patients’ non-emergency mental-health needs.
Ideal training tool
Bennett, who sits with residents in Springfield as they talk with patients in Havana and Rushville, said the experience is ideal training for young doctors going through SIU’s four-year psychiatry residency because many of them will have the option of practicing telemedicine after completing the residency.
And for patients in Havana, the specialty care is much more accessible than an hourlong drive to Springfield or Peoria, where they may or may not be able to get timely, affordable appointments with psychiatrists. That’s especially true for patients on Medicaid, Wolin said.
Tele-psychiatry is a money-losing service for the Havana and Rushville hospitals, but they plan to continue it.
“We feel like it’s a service that should be available,” Stambaugh said. “The patients like it. There are some patients who wouldn’t have gotten care before this.”
At Mason District, for example, 45 adult patients and 40 adolescents and children received tele-psychiatric visits with doctors over the past year. More than 95 percent of those patients were covered by Medicaid.
The hospital was paid about $5,000 for their care, which cost cost the hospital about $26,000 to provide — $16,000 for services from SIU and Lincoln Prairie and $10,000 in other direct costs for hospital staffing and equipment.
The loss doesn’t take into account potential savings connected with doctor visits and emergency room visits that may be avoided, but Wolin still would like to see better reimbursement from the state for mental-health services.
“It’s been a wonderful program,” he said. “The challenge is to look at funding for Medicaid and other programs to cover the costs of telemedicine.”
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Autor(en)/Author(s): Dean Olsen
Quelle/Source: The State Journal-Register, 19.07.2010
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