Like physicians across the country, those at Virginia Commonwealth University (VCU) Health were thrust into the world of telehealth thanks to the COVID-19 pandemic. In just four days, the health system turned their almost exclusively in-person psychiatry care and outpatient programs into care delivered primarily via video.
A little more than a year into the change, VCU Health’s telepsychiatry program was maintaining continuity of care for patients, enabling “humanizing” patient-physician interactions during the pandemic and fostering a drop in no-show rates, according to a case study (PDF) the AMA and Manatt Health released.
The “Return on Health” (PDF) research measured the value of virtual care programs using the AMA Return on Health Framework to evaluate how technology affects:
- Financial and operational outcomes.
- Clinical outcomes, quality and safety.
- Access to care.
- Patient, family, caregiver and physician experiences.
- Health equity.
Now two years after those case studies, VCU Health psychiatry chair Robert Findling, MD, detailed how the telepsychiatry program has evolved and the challenges and benefits of delivering care this way.
“In many ways, acculturating to this was not an option, but once it happened, people learned what they liked and didn’t like, got better at things they weren’t as comfortable with, and then it became part of our armamentarium so that when greater flexibility occurred, people were comfortable offering people options,” Dr. Findling said in an episode of the “AMA STEPS Forward® Podcast.”
Supporting telehealth is an essential component of the AMA Recovery Plan for America’s Physicians.
Telehealth is critical to the future of health care, which is why the AMA continues to lead the charge to aggressively expand telehealth policy, research and resources to ensure physician practice sustainability and fair payment.
Wider reach, more patient options
Overall, the major benefits that patients and clinicians at VCU Health saw early on have matured and have mostly been weaved into how they deliver care, said Dr. Findling, a child and adolescent psychiatrist.
“If a patient needs to be seen in person, we can see them in person without the same challenges as before,” he said. “If they don’t need to be seen in person, we can meet them where they live. If they want to come in because something is lost by being in a different room, we can do that.”
And virtual care has allowed the Richmond-based health system to reach patients in rural Virginia that they previously couldn’t deliver care to. In addition, letting patients decide whether to come in or schedule a virtual visit—unless a hands-on evaluation is a medical necessity—has allowed the health system’s no-show rates to remain “remarkably low.”
“We are meeting the needs of our patients, I would argue, perhaps better than ever before. And the patients who might not ever have been able to see us are grateful that they now have access that they might not have had previously. I mentioned rural locations, but some of our patients are infirm, and getting around is not easy. And there’re lots of data that many of the things we do are equally well-delivered virtually,” Dr. Findling said.
Visit AMA Advocacy in Action to find out what’s at stake in supporting telehealth and other advocacy priorities the AMA is actively working on.
Lasting effects of pandemic
Although the federally declared COVID-19 public health emergency has expired, Dr. Findling said COVID-19’s psychological and emotional aftermath continues unabated. The demand for behavioral health services has drastically increased and they have hired more master’s-prepared, licensed therapists and nonphysician providers. Virtual care has meant they have not needed extra office space.
Now that certain patients are expected to be seen in person, the challenge revolves around maintaining the high level of virtual care they’ve been able to provide without reverting to the way things were pre-pandemic.
“The idea is to allow things to be thoughtful going forward and just for people to remember that for psychiatry, the pandemic is still with us, and it will be with us for years to come,” he said.
