How to Build a Telepsychiatry Program for Your Hospital or Health System

Many hospitals and health systems have never implemented a psychiatry or telepsychiatry program. Other hospitals have dabbled in telemedicine by providing telestroke or teleradiology services. Now, due to the COVID-19 pandemic, many health systems and community hospitals are turning to telepsychiatry to help meet the enormous behavioral health needs of their backed-up clinics and swamped Emergency Departments (EDs) caused by a shortage of mental health providers.

If you’re considering launching a formal telepsychiatry program at your hospital to help support mental health patients in your EDs and beyond, keep reading! This post will break down the benefits of a telepsychiatry program, tools for analyzing whether telepsychiatry is a good fit for your hospital, criteria for evaluating vendors, and helpful hospital implementation logistics.

How a telepsychiatry program can benefit your hospital or health system

Since the onset of COVID-19 in March 2020, hospitals have seen overdose and relapse rates of patients dealing with substance-abuse disorders increase by 30%. Patients are dealing with more stress and anxiety about the pandemic and the subsequent economic and health fallouts. At the same time, more and more mental health patients are turning to EDs for care — which they may not be able to provide with current staff.

Fortunately, changes in healthcare regulations are expanding hospitals’ abilities to offer telepsychiatry in new settings that will help improve timely access to high-quality behavioral healthcare. That means, when caring for patients, hospitals will have additional opportunities to provide telepsychiatry and meet patients’ behavioral health needs more quickly and seamlessly.

Telepsychiatry services can be beneficial for patients with comorbidities of psychiatric conditions coupled with existing medical challenges (this combination often contributes to more severe health risks, higher utilization of EDs, longer hospital stays, and higher cost per patient). In addition, telepsychiatry benefits populations living in rural areas as they can have the opportunity to access health resources and services.

All things considered, when implemented effectively, a telepsychiatry program can go a long way towards helping hospitals meet their quadruple-aim goals of better outcomes, higher patient satisfaction, reduced costs, and improving the clinician experience.

Setting yourself up for success with your hospital’s new telepsychiatry program

Once you’ve determined a telepsychiatry solution may be a good fit for your hospital or health system, you should first evaluate the goals for your program. Plan for a long-term relationship with whatever telepsychiatry solution you choose (whether it’s a vendor like Iris Telehealth or an individual, local provider).

Initial steps should include: Identifying gaps and pain points, auditing your EHR to understand how often you’re addressing psychiatric conditions, discussing staff feedback on current processes and needs, and working through your overall psychiatric needs (including potential hourly and budgetary needs to launch a successful program).

As with any implementation plan, it’s important to outline how you’ll measure success. You should determine which metrics you plan to track to ensure your telepsychiatry program works well for your organization and your patient populations.

Potential metrics might include:

  • ED boarding times
  • Resources spent on sitters for behavioral health patients
  • Med/Surge behavioral health patient volumes per shift or diagnosis type
  • Financial metrics
  • Patient satisfaction measurements

Later, you’ll look back at these goals and metrics to determine how successful your telepsychiatry program has been for the community and patients you serve.

Free Whitepaper: Building a Sustainable Telepsychiatry Program

Choosing the vendor or telepsychiatry partner who’s right for your hospital

Choosing a vendor can feel like an overwhelming process — because it’s often difficult to tell if someone will be a good fit for your organization.

But there are some key steps that can help you make your decision (and be confident it’s the right one):

  1. Create a checklist to understand your non-negotiable requirements for a telepsychiatry program to ensure potential vendors meet your needs.
  2. Request referrals from current or past clients from similarly-sized hospitals serving patient populations like yours.
  3. Research the leadership structure of potential vendors and the company’s ownership (companies run by physicians will likely have more experience providing quality care).
  4. Ask for quotes from potential telepsychiatry vendors.
  5. Analyze their bandwidth for technology support, support hours, and whether they’ll be ready by your program’s go-live date.

Keep in mind that vendors with Joint Commission accreditation are typically a step ahead of competitors. Joint Commission accreditation speaks to the quality of the vendor’s services and the vendor’s ability to enforce compliance and maintain effective processes.

Implementing a telepsychiatry program at your hospital

The implementation process for a telepsychiatry program can be time-consuming. Still, it’s worth doing it right so you’re setting your program up for success as soon as it officially goes live.

One of the biggest hurdles to launching a telepsychiatry program is the process of licensing and credentialing your telepsychiatry providers. This process involves confirming the clinician’s work history and education history while verifying references to provide an in-depth vetting of the clinicians. You’ll also contract and panel with health plans including Medicaid and Medicare as well as local, regional, and relevant private health plans.

If you choose to partner with Iris Telehealth, Iris can provide complete credentialing packets from our own Joint Commission accredited privileging process. Our TJC accreditation enables you to take advantage of credentialing by proxy and eliminates a large portion of your team’s workload while dramatically cutting down the time to go live with services dramatically.

Along with licensing and credentialing, we also recommend you assemble an on-side implementation team and a telepsychiatry care team to work with your telepsychiatry vendor as you prepare to launch.

You’ll also want to train your front desk and medical support staff on any necessary workflows around your telepsychiatry program.

Launching a telepsychiatry program can seem like a lot of work — but it’s worth it

Starting a new telepsychiatry program at a hospital or health system can seem like a daunting task. It involves understanding your patients’ needs, evaluating telepsychiatry companies, facing new logistical and workflow challenges, and leveraging technology effectively on both your and your patients’ end. But it can go a long way to alleviating pressure on your EDs, reducing unnecessary psychiatric bed holds, and decreasing your length of stay.

Plus, if you choose the right telepsychiatry vendor, they’ll be with you every step of the way to ensure your program is a success.

To learn more about how Iris Telehealth can help you build a successful telepsychiatry program at your hospital or health system, contact us, and we’ll get you the information you need.

The Future of Mental Health Care in the Virtual World

The way we talk about mental health has changed during the pandemic. Over the past year, COVID-19 and the subsequent mental health crisis have helped decrease the stigma around discussing mental health and have increased awareness of the vast need across the country for access to quality care. And, with the emergency telehealth protocols, we’ve seen an improvement in access to care across the country.

However, we also know because of the pandemic, there’s a higher need for care across patient populations, which will likely persist for years to come.

So what does that mean for the future of mental health care?

We need to keep breaking down barriers to high-quality care

Some of the barriers, thankfully, have been eliminated during the COVID-19 emergency protocols:

  • Insurance payers are reimbursing for virtual care where they weren’t in the past, which signals an improvement in the types of visits that are covered and what’s considered “mental health care.”
  • The philosophy of what is the point of care has been stretched and become more creative so we are providing continuity of care.
  • The stigma around mental health care is improving because of our shared challenge and experiences during the pandemic.

Now, we’re starting to see more and more states make their temporary protocols permanent, which will help behavioral health organizations better incorporate telehealth into their long-term strategies and continue to increase access to mental health services.

On top of these policy changes, I hope that, moving forward, more people will see the incredible need for mental health care and hopefully go into the field. Because, one of our biggest, persistent barriers to care is our ongoing psychiatrist shortage.

Embrace hybrid-models of care as the key to future success

Throughout most of the pandemic, folks have relied on virtual resources to help them connect with friends, loved-ones, and co-workers. But, long-term, exclusively virtual contact can still feel isolating for many people.

As things are starting to open back up, many people are longing for those in-person interactions, which is completely understandable. As a result, many healthcare organizations who pivoted quickly towards telehealth when the pandemic started may wonder how best to move forward.

It’s important to note that there won’t be a sudden change back to the way things were. The transition will be very gradual, and will likely result in a hybrid care model where both in-person and virtual appointments are available.

There will certainly be circumstances where providers want to see clients in person. But, over the past year, we’ve learned that telemedicine can be a fantastic option for certain kinds of care — particularly in the behavioral health space.

As people are slowly getting back to the new normal, there are still unknowns. People will have understandable anxieties about exposures, and there will be a subset of patients who will prefer to continue virtual care. So, a combined approach where organizations and providers offer different kinds of care will be important.

Patient challenges and demographics might be different moving forward

The pandemic has uprooted families for well over a year. Across the board, we’ve seen an increased need for caretaking within the home. With school closures, the shift to virtual learning, and parents figuring out how to care for their children while still maintaining their careers, there’s been a substantial impact on families and family life. Now we’re understanding how this long-term trauma is affecting kids, and what the school closures have meant in terms of social and emotional learning for these children.

As schools open back up and we inch ever-closer to “normal,” providers and healthcare organizations on the whole should expect to see an influx of children in need of mental health care, with different challenges than we’re used to.

On an individual level, providers and patients should work to ensure they’re taking care of themselves emotionally

This pandemic has impacted everyone to a degree, and we all can’t help but be affected emotionally and mentally by the past year. There’ve been so many unknowns during this time that it’s just brought emotional wellness into the forefront. That shift has directly improved awareness of mental health needs and decreased any negative stigma that was attached with mental health.

As we look to the future, I hope people will be less hesitant to take care of themselves emotionally and make sure they have the support they need.

However, there are so many resources available now that it can be overwhelming. If you ever have a question about a health or wellness app, ask your healthcare provider what they recommend. One resource that I personally have been recommending is the American Academy of Child and Adolescent Psychiatry has a COVID-19 resource library with recommendations and guidelines for parents and families.

At the organizational level, we should all work to continue improving access and expanding behavioral health care programs

From a healthcare policy and delivery perspective, we’ve seen an increase in depression, anxiety, and substance use behaviors over the past year. But we’ve also had more conversations about the need for treatment as well as the need for access. My hope is we continue in this direction, work to improve access, and continue to think creatively about how to deliver it — whether that be virtual, in-person, or through new, innovative mediums.

It’s important that we pay attention to what our patient populations want and need, and don’t move behavioral health programs and mental health services backwards. Already, more and more states are taking permanent steps to support telehealth and audio-only virtual care. And, patient and provider preferences are here to stay, so continuing with that flexibility will be important for the long term success of your programs.

If you’re hoping to build out a sustainable telepsychiatry program at your organization but don’t know where to start, Iris Telehealth is here to help. Contact us and we’ll help you get all the information you need.

What Pediatricians Need to Know About Diagnosing and Treating Pediatric Anxiety

This is our second piece in our series on pediatric behavioral health conditions. Check out our first post on diagnosing, treating, and supporting children experiencing pediatric depression here.

Over the past few years, child and adolescent anxiety has become an increasingly common and concerning trend. And, over the past year, COVID-19 and the resulting school closures have only exacerbated the situation. As a pediatrician or healthcare organization providing pediatric behavioral health services, you’re likely experiencing the impact of that trend first-hand.

Keep reading for a breakdown of the increased demand on pediatricians, the most common anxiety orders in the DSM-5 anxiety disorders, best practices for screening and assessment for anxiety in primary care, and the algorithm for treating pediatric anxiety.

Anxiety disorders are the most common mental health condition for children and adolescents

Anxiety disorders have a 30% lifetime prevalence, meaning 30% of people in a population develop anxiety disorders at some point in their lives.

According to The Journal of Pediatrics, of the 4.4 million children aged 3-17 years with diagnosed anxiety, more than one in three have a behavioral disorder, and about one in three are experiencing depression. Only six in 10 children aged 3-17 years with anxiety received treatment. The disparity between the number of children with anxiety versus the number of children in treatment is alarming, and it speaks to the role providers must play in screening and raising awareness about anxiety disorders for children and families.

The DSM-5 classifies anxiety disorders in children

If you or your healthcare organization are providing behavioral health services to children and adolescents, you should be able to differentiate between the unique DSM-5 childhood anxiety disorders as you diagnose and treat patients.

The most common DSM-5 anxiety disorders we see include:

  • Generalized anxiety disorder: excessive worry about a variety of subjects such as grades, family relationships, or relationships with peers.
  • Separation anxiety disorder: developmentally inappropriate and excessive anxiety concerning separation from attachment figures.
  • Selective mutism: a newly added anxiety disorder in DSM-5, selective mutism is a consistent failure to speak in specific social situations in which there is an expectation for speaking despite speaking in other situations.
  • Specific phobia: marked and persistent fear of a specific object or situation that causes significant distress and interferes with usual activities.
  • Social anxiety disorder: also known as social phobia, social anxiety disorder is an intense fear of social and performance situations and activities (for example, being called on in class or starting a conversation with a peer). Social anxiety can significantly impact school performance and attendance as well as the ability to socialize with peers and develop friendships.
  • Panic disorder: diagnosed if a child suffers at least two unexpected panic or anxiety attacks followed by at least one month of concern over having another attack.
  • Agoraphobia: fear of going into certain situations where they may experience panic or be uncomfortable and without help.
  • Substance/medication-induced anxiety disorder
  • Anxiety disorder due to another medical condition

As a healthcare provider treating pediatric anxiety, you should be wary of differential diagnoses

Many symptoms of anxiety disorders overlap with other conditions. It can be difficult to determine whether symptoms stem from real anxiety diagnoses or other diagnoses or reactions to acute events.

Some differential diagnoses include:

  • Adjustment reactions to acute stressors
  • General Anxiety Disorder vs. OCD
  • Bullying
  • Substance Use Disorders
  • Autism Spectrum Disorder
  • ADHD
  • Excess caffeine/energy drinks and/or nicotine use

In addition to differential diagnoses, your medical workup of conditions that can present with anxiety symptoms should include investigating other conditions and reactions to medical treatments.

Screening for pediatric anxiety is quick, free, and easy

The Pediatric Symptom Checklist-17 is generally the first step for evaluating anxiety and screens for cognitive, emotional, and behavioral problems in children ages 4-17. If you see a total score of 15+ points, you should conduct a formal assessment.

After a score of 15+ points, your next steps will include a clinical interview and using the applicable symptoms rating scale.

Use SCARED (Screen for Child Anxiety Related Disorders) for ages 8-18

  • 41 item inventory
  • Parent and child version
  • Score 25 or greater significant

Or GAD-7 (Generalized Anxiety Disorder 7) for ages 12 and up

  • 7 item inventory
  • 1-2 minutes to complete
  • Score 10 is moderate, 15 is severe

Assessing for avoidance is the most important step, as avoidance of activities and circumstances that provoke anxiety often are the most disabling aspects of anxiety disorders for children and adolescents. Remember avoidant behaviors often become habitual and may be reinforced by family members and teachers.

In addition to avoidance, be sure to assess for acute and chronic stressors which may be contributing to presentation, current, or previous self-injurious behavior or suicidal ideation. Other common co-occurring psychiatric diagnoses include ADHD, depression, and Substance Use Disorders.

The patient and family-first approach to treating anxiety disorders

An anxiety disorder diagnosis can be scary for families new to mental health discussions. Be patient as you’re determining a treatment plan, and be sure to determine treatment based on the severity of the child’s anxiety disorder.

For subclinical to mild anxiety, you can prescribe supported self-management and follow-ups, including at-home guidance for children and families. For moderate depression or mild depression that does not respond to supported self-management, you’ll have to provide a therapy referral (Cognitive Behavioral Therapy preferred) or a medication trial. For severe anxiety, you should always refer patients for therapy (Cognitive Behavioral Therapy preferred) and medication until the child’s anxiety is stable. Be sure to establish clear goals, expectations, and communication workflows to support families through severe anxiety treatment — it can be an emotional time.

SSRIs: the gold standard

SSRIs are the gold standard of care for treating anxiety. Whenever you prescribe SSRIs, you should conduct an in-depth screening for family history of bipolar disorder or suicide, establish a plan for follow-up and emergency access to care, and educate the family about potential side effects and protocols for adequate trials. SNRIs can be used as a second option if SSRIs treatment isn’t successful.

Fluoxetine and Sertraline are the two most studied SSRIs and, consequently, are recommended the most. For both medications, you should give test doses and closely monitor the children’s response. If a child responds well to treatment, you or your providers can slowly taper them off the medication while reevaluating their reaction throughout.

Evidence from a 6-year CAMS (Child/Adolescent Anxiety Multimodal Study) indicated that a combination of Sertraline and Cognitive Behavioral Therapy showed the most benefits for patients compared to treating with just one or the other. This is an important reminder that medication is not a “cure-all” for all mental health conditions, and approaches to anxiety are often complex and multi-faceted.

Treating anxiety disorders requires a holistic regimen and candid conversations with children and families throughout the process to provide the best possible care.

Next steps: resources for providers

Treating childhood anxiety will become increasingly important as anxiety rates continue to rise. As always, Iris Telehealth is here as a resource for providers and healthcare organizations that need support. If your organization is feeling the weight of an influx of patients experiencing pediatric anxiety, contact us today. We’d love to talk to you about how we can help!

How FQHCs Can Build an Effective, Sustainable Telepsychiatry Program

Many Federally Qualified Health Centers (FQHCs) have never implemented a formal psychiatry program — much less a telepsychiatry program. But as COVID-19 continues to impact communities around the country, you and your team may find yourselves considering how to build a telepsychiatry program that provides safe, accessible psychiatric solutions to your patients.

Starting a program to provide behavioral health services from the ground up can feel overwhelming. But following these guidelines can help you successfully build a telepsychiatry program for your FQHC that meets patient needs and helps you achieve your holistic care goals.

First, Complete an In-Depth Needs Assessment to Determine Whether a Telepsychiatry Program is Right for Your FQHC

Follow this checklist (in order) to evaluate how a telepsychiatry program would fit into your organization and determine what kind of vendor or telepsychiatry program would meet your needs:

  1. Audit Your EHR: Start by auditing your Electronic Health Record (EHR) to understand how often your organization addresses psychiatric conditions. Note which behavioral health conditions you’re diagnosing most frequently. Also, evaluate medications prescribed to understand which medications your FQHC prescribes the most.
  2. Analyze Psychiatry Referrals: Look at external psychiatric referrals to evaluate how many referrals your primary care physicians are making to external psychiatric facilities — and how long the approximate wait times are for those referrals.
  3. Discuss Staff Feedback: Anecdotes and qualitative information will help you understand how your FQHC’s culture would fit into a telepsychiatry program. Consider surveying your counselors, social workers, primary care providers, and patients to identify care gaps and evaluate your stakeholders’ current thoughts on your organization’s psychiatric care.
  4. Understand the Scope of Psychiatric Needs: Consider your patient demographics, the language and gender of your patient populations, and the complexity of your cases to inform how you approach a telepsychiatry partnership.
  5. Hours and Budget: Understanding the number of hours required and how that compares to your budget will help you shape your telepsychiatry program and the kinds of providers you’ll need to hire. You can also pursue grant funding opportunities if there is a disparity between hours needed and budget.
  6. Regulations: Consider regulations in your state and how they might impact telepsychiatry practices, licensing, and prescribing. Regulations might include whether Psychiatric Mental Health Nurse Practitioners (PMHNPs) can practice independently in your state or state regulations about caring for acutely suicidal patients.
  7. Provider Type: You’ll also need to determine whether a physician or psychiatric nurse practitioner best meets your needs. Your state’s regulations will likely inform this decision, as some states might have supervision requirements for PMHNPs.
  8. Other Legal Requirements: Requirements around facility regulations and board certification requirements might affect your ability to implement your telepsychiatry program. If you need help navigating these, let us know. We’re here to help.

After you finish your preliminary needs assessment, you should take a step back and reevaluate your telepsychiatry goals and outline how you plan to measure the success of your program moving forward.

Once You’ve Completed Your Needs Assessment, Evaluate Potential FQHC Telepsychiatry Vendors

You can start evaluating potential vendors if your needs assessment results have proven that your FQHC has the need and the budget to implement a telepsychiatry program.

The first thing you’ll have to do during the evaluation process is to create a checklist to understand your non-negotiable requirements for a telepsychiatry program to ensure potential vendors meet them. Also, ask vendors how their providers are vetted before being recommended for your clinic. Be sure to request referrals from current or past clients to understand how the vendor operates in the FQHC environment. Anytime vendors have Joint Commission Accreditation (JCO), it typically speaks to the quality of their services and their ability to enforce compliance and maintain effective processes.

Because telepsychiatry employs technology differently than traditional psychiatry solutions, you’ll want to evaluate the vendor’s bandwidth for technology support, support hours (whether availability for support is 24/7 or restricted), and whether the vendor will be available on the go-live date. Pay close attention to how they deal with privacy and security, as your telepsychiatry solutions will house sensitive patient information.

After You’ve Chosen a Telepsychiatry Vendor, It’s Time To Begin Implementing Your Program

Implementing a telepsychiatry program at your clinic can be a time-consuming process. These eight steps can help streamline the process:

  1. Credentialing: As soon as you select a member and are matched with a provider, start the credentialing process. Your provider will need to be licensed in your state. Then you’ll need to obtain a license from the DEA and begin credentialing at your facility. This process will vet the provider’s work and education history and verify their references.
  2. Assembling Your Implementation Team: You should begin assembling this team during the credentialing process, and the team should include your clinical lead and key decision-makers.
  3. Assembling Your Telepsychiatry Care Team: Your telepsychiatry care team will be separate from your implementation team and may include desk staff, nurses, medical assistants, counselors, telepsychiatry providers, and administrators.
  4. Training Your Staff: Create workflows specific to your front desk, support staff, and billing/coding team with the ability to scale as your telepsychiatry program grows.
  5. Review Your Technology Workflows: Carefully plan how your technology use and workflows will fit with your telepsychiatry provider before your program’s go-live date, and consider retraining your team on your privacy and security standards.
  6. Decide Your Provider’s Schedule: Consider how many days and hours you will need your telepsychiatry provider to work and ensure you have adequate staffing for that plan.
  7. Market Your Telepsychiatry Services: We recommend beginning recruitment for referrals six weeks before your go-live date — beginning with internal counselors and primary care physicians.
  8. Go-Live: Make sure you plan to do a test run a few days before you’re ready to go live, then you’ll be ready to launch your program!

By Following These Guidelines, You’ll Be Well On Your Way To Starting a Successful Telepsychiatry Program For Your FQHC

Starting a new telepsychiatry program can be intimidating, but fortunately, you don’t have to reinvent the wheel. We’ve seen many FQHCs create successful telepsychiatry programs to serve their communities in creative ways.

To learn more about how Iris Telehealth can help you get your program off the ground, contact us, and we’ll get you the information you need.

Why CMHCs should consider building a formal telepsychiatry program

Many Community Mental Health Centers (CMHCs) had never implemented a formalized telepsychiatry program before COVID-19. Then, the pandemic forced them and other behavioral health organizations to adapt quickly to a world where telepsychiatry was necessary. Now, many CMHCs are looking into building a sustainable future that incorporates telepsychiatry into their core services to support their patient populations.

It can seem like an overwhelming process at first! But, we’re here to help you get started.

How to build a sustainable telepsychiatry program for your CMHC

As a CMHC, you may face challenges dealing with patient surpluses, lack of quality providers, and difficulty achieving continuity of care – especially if you’re based in a rural community.

A formal telepsychiatry program can help alleviate some of these challenges by allowing you to pull from high-quality providers from different cities and states.

Fortunately, the steps you need to take to get your program started don’t have to be complicated.

  1. First, audit your EHR: Take note of how your organization addresses certain psychiatric conditions and your current patient wait times for mental health services.
  2. Talk about telepsychiatry with your team: Consider how a formal telepsychiatry program will fit into your CMHC’s culture and help you deliver comprehensive mental health care.
  3. Understand the scope of your needs: Think about your patient demographics, what provider type you need, how complex your cases generally are, your CMHC’s mission, and any other language or cultural considerations that are important for your community.
  4. Know your hourly and budgetary needs: Think through how long your current waitlist is and how many service hours would be a good fit for your organization.
  5. Check regulations for your state: Regulations can vary substantially from state to state. Understanding what the landscape looks like where you live is a critical first step.

Once you tick all these boxes, look back at your original goals and consider whether you need to make any changes or adjustments.

Once you lay out your strategy, it’s time to consider telepsychiatry vendor partners

It’s important to carefully vet potential telepsychiatry vendors to ensure they’ll be a good fit for your organization. Before you do anything else, create a checklist to understand your non-negotiable requirements for your telepsychiatry program.

When you’re talking to vendors, ask them how they vet their own providers. Make sure you request referrals and ask hard questions about their quality control processes, how they handle provider implementation, and how they track their own goals. This information should give you a good idea of how they would fit your CMHC’s culture and processes.

Also, analyze vendors’ bandwidth for technology support, their support hours (whether availability for support is 24/7 or restricted), and whether the vendor will be available on the go-live date.

CMHCs should find behavioral health providers who can adapt to their existing workflows and be long-term partners. And remember, the goal is not to replace in-person care but to supplement your existing team of behavioral health providers to better support your patients and improve your quality of care.

We can’t stress this enough – vendor culture fit is crucial to the success of your CMHC’s telepsychiatry program

The right telepsychiatrist can be an invaluable part of your team. For example, one of our Iris CMHC partners realized one of their local psychiatrists was responsible for over 50% of their patient population. They sought out a telepsychiatry partnership to mitigate their risk and diversify their pool of providers. Other Iris Telehealth partners were able to decrease their wait times from one year to five weeks and manage a 180% increase in client intake through their telepsychiatry programs.

As you’re building out your program and working with telepsychiatry vendors, it’s crucial that you carefully vet any potential clinical partners. You’ll want to ensure they provide high-quality care, have experience working with populations similar to yours, and share your CMHCs mission and vision for behavioral health care.

Once you’ve found the right vendor for you, it’s time for implementation and logistics

This process can be time-consuming, so make sure your schedule addresses these steps before your projected go-live date:

  1. Licensing and credentialing: Plan for this to be the longest part of your organization’s implementation process. You should start this process immediately in collaboration with your vendor partner.
  2. Put together your implementation team: This team should include key decision-makers who will be involved in the telepsychiatry program as well as your clinical lead. At Iris, we also recommend having a dedicated “Telehealth Champion” to act as your primary telepsychiatry liaison.
  3. Assemble your telepsychiatry care team: Your care team might include front desk staff, nurses, medical assistants, counselors, and administrators.
  4. Train your staff: You will likely have to create dedicated workflows to help your staff integrate your telepsychiatry program into your organization.
  5. Make sure your technology is in order: Review your technology use and workflows ahead of your go-live date. You may also be able to lean on your telepsychiatry vendor partner for tech support and guidance.
  6. Get the word out about your program:Ahead of your go-live date, start informing your patients and community about your new telepsychiatry services. We recommend doing this work six weeks before your launch date.
  7. Go-live: 24-48 hours before you plan to launch, we recommend going through a dry run to ensure everything is in order. Then, it’s time to officially start services!

Setting up your CMHC telepsychiatry program can feel like a lot of work, but it’s worth it

You can build a better future for your patients and communities by supplementing your critical behavioral health services with telepsychiatry. We’ve already helped many CMHCs create successful telepsychiatry programs to serve their communities.

To learn more about how Iris Telehealth can help you get your program off the ground, contact us, and we’ll get you the information you need.

The Role of Medical Credentialing for Remote Providers

Medical credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy. It is one of the most essential pieces of implementing a telehealth program in a timely manner. But what goes into this process for remote providers?

Keep reading to learn what it takes to get a remote provider licensed and credentialed in your state, what’s included in medical credentialing, and how taking the necessary steps for licensing and credentialing helps ensure patient safety.

What is included in medical credentialing?

Hospitals and clinics have a duty to their patients to thoroughly evaluate the experience and skills of their medical staff. They can be held liable for patient injury or mistreatment if they fail to do so. That makes working with an experienced partner who knows the ins and outs of medical credentialing essential.

Typically, the provider’s documents are collected and reviewed for the following:

  • Medical education
  • Postgraduate training
  • Medical licenses (active and historical)
  • DEA registrations
  • Controlled substance registrations
  • Continuing education credits and compliance
  • Board certifications
  • Employment history
  • Privileges/affiliations history
  • Professional liability insurance policies held
  • Malpractice claim history, including statements from the clinician and court documentation (if applicable)
  • Peer reference evaluations
  • Federal and/or state background check, often completed via fingerprint collection
  • Health screenings like drug/alcohol tests, general physical assessment, and anything necessary for physical interaction with patients, such as a TB test or flu shot
  • Online databases – the National Practitioner Data Bank, the Office of the Inspector General’s exclusion database, Medicare’s Opt-Out Affidavits database
  • Personal identification like (driver’s license, passport, and social security card)
  • Clinician’s personal attestation history
  • Disclosure of conflicting financial interests

The list can vary from facility to facility based on their bylaws and group accreditation requirements. Regardless of the requirements, the purpose is to protect the population from medical negligence and malpractice. While it seem that a physician “passing” the credentialing assessment from one facility would mean subsequent facilities should follow suit, history has proven that this assumption can be dangerous.

How medical credentialing helps ensure patient safety

The repetitive and detailed nature of credentialing is designed to protect patients and ensure the legitimacy of a physician’s medical license. However, it is possible to improve the efficiency and speed of credentialing without compromising quality, and this process is what our team at Iris does best. Our main goal as a telemental health company is to bridge the gap in the availability of psychiatric care across the country. We are successful because our goal is to prioritize quality care, and make thorough, diligent, and efficient credentialing our priority.

The role of provider matching in licensing and credentialing

At Iris Telehealth, we recruit and hire top-notch clinicians and help them find placement in our partner facilities across the country, a process we call “provider matching.” Provider matching helps ensure organizations get the best fit for their care team and patients.

Unlike many staffing agencies and locum tenens groups, these matches are meant to be as permanent as a typical onsite provider’s position would be. Providers are Iris employees and treated as independent contractors by the organization they are matched with. We also serve as mediators to ensure the relationship is successful for the long-term. This approach positions patients to get the highest level of care while also helping support the provider’s well-being.

One important benefit of the provider matching process is helping ensure the organization is matched with a clinician who can provide the right specialty care to patients, regardless of location. At Iris, we make that happen by getting the provider fully credentialed and licensed in the state where they’re placed. That way, nothing is standing in between your patients and they care they need.

About Iris Telehealth

Iris Telehealth has helped countless hospitals and community health organizations across the country add telemental healthcare to their list of services while matching them with the best providers for their communities.

We manage all the costs associated with recruiting, supervising, and supporting the best doctors, including paying their salary, PTO, medical benefits, 401k, malpractice insurance, licensing and credentialing fees, and CME expenses.

We believe everyone should have access to compassionate mental health care, and we have made it our mission to find innovative, affordable ways of making this possible! If you’d like to learn more about our services, contact us today.

A Guide to Mental Health for Healthcare Workers

This past year, we have spent countless hours celebrating our healthcare heroes. We are so grateful to everyone who has worked tirelessly to fight the coronavirus pandemic and all of the challenges it has presented. However, we know gratitude alone is not enough — healthcare workers are physically and emotionally exhausted, and they need a helping hand. A recent survey done by Mental Health America showed 93% of healthcare workers were experiencing high stress levels, and 76% were feeling the symptoms of burnout. Healthcare workers are absolutely essential to keeping our society up and running, but they need support and relief from the stress of their daily work.

Read on to learn more about the mental health challenges facing healthcare workers, as well as what they (and their organizations) can do to take care of themselves.

Healthcare workers face a unique set of mental health challenges

Healthcare workers are on the front lines every single day. Whether providing physical health services in an emergency department or behavioral health services in a psychiatric unit, they are constantly face-to-face with challenging and tiring work. Behavioral health providers in particular deal with difficult, heavy subject matter so often they can become desensitized to their work — or end up taking it home with them after clocking out.

During COVID-19, these challenges only amplified. Visits to the emergency room drastically increased, particularly for children and adolescents. Rates of suicide and substance relapse have both skyrocketed. And, the already high demand for psychiatric providers grew even higher as the U.S. faced a mental health crisis. Through it all, providers started seeing more and more patients in crisis, all while trying to manage their own personal lives and health — a combination that can lead to burnout.

If healthcare providers are struggling with their mental health, they’re not going to be able to take care of others as well. Some of the most common symptoms of burnout are isolation and avoidance. Providers may start to withdraw from their teams, becoming less involved in the workplace and less enthusiastic about clocking in every day. They may also avoid seeking care, convinced they can deal with their mental health challenges all on their own — which can lead to difficulty with focusing, concentrating, and decision making.

Healthcare providers need to keep up with their own mental health to ensure they are making the best decisions for their patients.

Provider burnout affects both providers and their patients

Many providers fall into the trap of thinking they’re not as susceptible to behavioral health conditions as their patients are. After all, they’re trained mental health professionals. However, no one is immune to mental health conditions or challenges — even psychiatrists and behavioral therapists.

If you are in a leadership role within your organization, consider taking preventative measures to ensure your providers are getting the support and resources they need. Some warning signs someone may be struggling with burnout are:

  • They are more irritable than normal
  • They aren’t attending team meetings, and seem to be withdrawing themself
  • They lose interest in activities or job tasks they used to enjoy
  • They are making more mistakes on the job
  • They seem to be more and more tired every day

A lot of provider burnout comes from being overworked, and some level of burnout is almost inevitable after the past year. However, it’s important to give your team the rest they need. Encourage your healthcare workers to prioritize both their physical and mental health and allow them to take time away from work when they need it.

One of the most important things you can do is have an open line of communication with your team and set realistic expectations for them. Being a healthcare professional is a challenging job, and your team should have a clear picture of what that looks like within your organization.

Resources are available to help

Fortunately, there are online resources readily available to help both providers and organizations dealing with burnout. One of the best sources is the Substance Abuse and Mental Health Services Administration (SAMHSA). Check out their comprehensive guide on dealing with stress and compassion fatigue and dive into what compassion fatigue looks like in providers.

Another resource available to your organization is telepsychiatry. Many organizations struggle with provider burnout because the few behavioral health care workers they have on staff are overworked. At Iris Telehealth, we understand the shortage of behavioral health care workers and want to work with your organization to bridge the gap. We recruit the best psychiatrists and psychiatric nurse practitioners from around the country and connect them with organizations in need.

Healthcare workers: let yourself rest

Mental Health America’s recent study on provider burnout gave us the startling statistic that 82% of healthcare workers feel more emotionally exhausted now than they did just a few months ago. Even more startling is over 40% of those participants said they didn’t feel like they had adequate emotional support. You should never feel ashamed to reach out for help, regardless of your profession. We’d like to leave you with a resource list in case you ever do feel the need to get help:

We understand that the healthcare industry is physically and emotionally taxing, and we’re so grateful to providers everywhere for all that they do. If your organization is feeling the weight of increased numbers of patients and burnt-out providers, contact us today. We’d love to talk to you about the difference telepsychiatry can make in your practice!

Breaking Down the Latest Grant Opportunity for CMHCs

Calling all CMHCs!

The SAMHSA Center for Mental Health Services (CMHS) is currently accepting proposals for their new 2021 grant program. They’re estimating about $825,000,000 in available funding for between 165 and 825 organizations. These funding awards are exclusively available for Community Mental Health Centers (CMHCs). If you’re a CMHC, this program could be a great opportunity for your organization to expand or improve your behavioral health services.

We broke down the program requirements, details, and deadlines so you could decide whether or not to pursue an award.

What the CMHC Grant Program entails

The FY 2021 CMHC Grant Program is an initiative to help enable CMHCs to offset the impact of COVID-19 on their behavioral health programs and empower them to improve or expand services. In particular, this program seeks to help organizations meet the needs of patients with serious emotional disturbance (SED), serious mental illness (SMI), or co-occurring disorders (COD).

Here are some of the key details of the project:

  • Applications for grant awards are due May 21, 2021
  • Awardees can expect to receive between $500,000 and $2,500,000 per year as part of the program
  • Funds will start arriving as soon as September 30, 2021
  • Awardees will receive their funds for up to two years

Organizations should plan to have at least one staff member to serve as Project Director. This staff member must complete work related to this project for at least half of their full-time work role.

What your CMHC needs to submit as part of your application

Each application must focus on the following required activities:

  • The total number of individuals you expect to serve as part of this project
  • How you plan to establish or improve your organization’s infrastructure to support HIPAA compliant telehealth services
  • How you’ll use this grant to provide services for individuals with SED, SMI, and COD
  • Plans to provide trauma-informed screening, assessment, diagnosis, and treatment
  • Provisions for clinical and recovery support services (such as psychosocial rehabilitation, case management services, and peer support)
  • And resources you’ll use to address the overall mental health needs of your CMHC

Your organization must submit a “Project Narrative” as part of your application. The Project Narrative should contain the following five sections and should not exceed 10 pages total:

  1. Population of focus and statement of need: In this section, you should identify your patient populations and their general demographics, how the pandemic impacted your revenue and ability to provide services, and the current state of need for patients with SED, SMI, and COD.
  2. Proposed implementation approach: In this section, you’ll describe the goals and measurable objectives of your project, how you plan to implement the required activities for this award (and any additional activities you plan to focus on), and a realistic timeline for how you plan to use the funds over the next two years.
  3. Proposed evidence-based service/practices (EBPs): In this section, you’ll discuss how each EBP you choose is appropriate for your patient populations and the outcomes you want to achieve.
  4. Staff and organizational experience: In this section, you’ll describe your CMHC’s experience providers services to patients with SMI, SED, and COD, a list of staff (with titles) who will be working on the project, your project staff’s experience, and any other organizations you plan to partner with for your project.
  5. Data collection and performance measurement: In this section, you’ll break down how you plan to collect data around your program — as well as how you’ll manage or monitor that data.

Note: The above list reflects the top line requirements for your application. If you’re planning to apply for funding, be sure to read the grant announcement in its entirety for more information on what you need (or are allowed) to submit.

How your CMHC can apply to this grant program

In order to apply for a grant with the 2021 CMHC Grant Program, you must register with NIH’s eRA Commons. SAMHSA recommends that you begin the registration process as soon as you think you want to apply. That means you should start the process ASAP so you don’t miss out on this potential opportunity!

In addition to eRA Commons, your organization should register with three more organizations to apply for a grant:

  1. Dun & Bradstreet Data Universal Numbering System
  2. System for Award Management (SAM)
  3. Grants.gov

Once you’re registered, you can complete your application using eRA ASSIST, Grants.gov Workspace, or another system to system (S2S) provider.

To get started, visit Grants.gov or the SAMHSA website and download all the required documents.

Be sure you read the full grant program announcement carefully before you start preparing your application materials. You can find all the details here: https://www.samhsa.gov/grants/grant-announcements/sm-21-014

This grant program is a perfect fit for CMHCs looking to impact their communities and improve their services in the wake of COVID-19. It also offers some excellent opportunities for CMHCs to incorporate more formalized telepsychiatry offerings into their organization. If your organization is interested in building a sustainable telepsychiatry organization as part of your grant proposal, check out our comprehensive guide for CMHCs.

Which Telehealth Grant Funding Source Is Right For You?

Once you’ve identified your organization’s telehealth needs, you can begin to search for grant funding sources to cover project costs and investments. In the early stages, this process can feel overwhelming — either from not knowing where to begin or from information overload. It’s important to learn the basics of how to find grant funding sources, including the different types of sources available to your organization.

We continue this blog series on telehealth grant funding with an overview of the four main types of funding sources — foundation funding, corporate funding, state funding, and federal funding — and common terminology to categorize them as you begin your research.

Foundation Funding

Aside from large national foundations, such as the Robert Wood Johnson Foundation, foundation funding tends to be either regionally based or specifically focused on the individual foundation’s area of expertise.

Securing grant funding from these foundations often relies on relationship building. Many foundations do not accept unsolicited applications unless they issue requests for proposals. Pivot your approach, identify foundation staff and the decision-makers on the foundation’s board, and develop those relationships.

Additionally, look at foundations that accept applications, and learn when that process takes place. Often foundations are made of family members or boards that may meet once or twice a year. But these foundations don’t always offer defined dates for when the next round of funding and its corresponding application deadlines will be. Still, dedicating time to researching these deadlines could mean opening up new doors to funding opportunities.

Corporate Funding

Project alignment with grantor goals is critical when seeking corporate sources as part of an overall telehealth grant funding strategy. Corporations may have specific goals or parameters for projects that may exclude or uniquely fit your particular telehealth project, particularly in terms of industry and geographic location.

Investing time into researching corporate funding also means determining how you should approach different corporations. Some corporations have set up separate foundations to handle grant funding, which you’ll be able to find while performing your due diligence. If that’s the case, you may try relationship-building with individuals employed by the corporation or on its foundation board in addition to responding to general requests for proposals.

State Funding

To utilize state-based grant funding, you need to determine which agencies at the state level are in charge of telehealth and related programs. After making those initial determinations, it’s essential to identify how they accept applications and distribute funds.

For example, some state agencies award funding through competitive applications, while others may distribute the funds based on an internal formula or have funding passed through another entity.

You should determine when agencies will present their schedule for applications so you can have adequate time to put together a competitive proposal. State funding often gives limited application windows, sometimes just six to eight weeks before a proposal is due. And if you’re looking at something complex, like a telehealth proposal, you need to work in advance. That way, when that schedule is released, you’ll know what’s required and expected of your application, and you’ll be more prepared to submit it.

Federal Funding

Federal funding typically represents the largest grants. Grantors announce these opportunities regularly on Grants.gov, you should pay close attention to the application submission window. This process takes time, organization, and planning ahead of time — including regular monitoring of the Grants.gov website.

Another aspect of sourcing federal grant funding is being in communication with the federal agencies and their staff. They will share information with you about the next cycle of funding and the amount of federal funding allocated to their programs, which predicates grant funding availability.

Note Whether Funding Sources Are Labeled Active, Inactive, or Pending

While performing your search for grant funding sources, you will come across terms like “active,” “inactive,” and “pending.” These may impact whether and how you include a particular grantor into your application timeline and schedule.

Active programs mean there is money presently available, and the funding source is welcoming new projects to apply for funding. Grantors may accept applications or letters of inquiry year-round or open for applications at limited periods of time throughout the year.

Inactive programs are not currently open to applications for funding. A program could become inactive because they accomplished their goals, revisited their goals, or experienced budget cuts that impacted their ability to fund projects. Inactive could signify an organization is permanently closed to applications, or they may be planning to return to an open, active status in the future.

Pending programs are programs that are not currently awarding grants. It may not be the time of year for their funding applications, or they may be waiting on federal budgets to pass so they can assess funding availability. Pending programs may be especially common during the COVID-19 pandemic.

Marian Chambers is a Grants Consultant at Professional Grant Writers, a full-service grant writing agency that works with nonprofit organizations to identify and apply for grants to fund their programs.

How and Why to Identify Your Telehealth Grant Funding Needs

Grant funding offers healthcare providers opportunities to implement and expand telehealth programs within their practices. But many providers’ grant-seeking efforts stop before they’ve really begun because they haven’t clarified their specific needs for telehealth services and funding.

By identifying your organization’s telehealth needs, you can gather and discover information that informs your grant search’s direction. This approach enables you to rule out opportunities that do not align and significantly narrows the search, making the process much less overwhelming.

Over the next few weeks, we’re putting together a blog series to help provide tips and insights that will help you through the grant funding process. In this piece, we’ll take a look at how and why your organization should identify your telehealth grant funding needs first before beginning the application process.

Ask Yourself Key Questions to Identify and Specify your Telehealth Needs

Before beginning your search for potential grantors, ask yourself the following questions to begin to identify and narrow down your telehealth needs:

  • What do you want to accomplish? Identify specific goals, metrics, or improvements you wish to see for your organization, community, and patient populations.
  • When do you need to have this completed? Consider the timing and urgency of your funding needs alongside the schedule and availability of grantor funds to guide your application choices and timelines.
  • What population(s) do you want to serve? What specific needs do these patient populations have, and what common challenges do they face that could be alleviated by telehealth access? Your program is more likely to succeed if you align your funding needs with their needs for services.
  • Where will the initiative be located? Your geographic location can limit the scope of an overwhelming grantor search while also generating leads for region-specific opportunities available in your area.
  • How much money will you need to secure to complete this project? The nature, size, and costs of telehealth projects can vary widely, as can the allocation of funding each grantor provides. Because application rejection is common and funds remain limited, you will likely consider multiple grant funding sources throughout the application process.

The answers to these questions will provide you with parameters you can use while reviewing various funding sources. These parameters focus your search and enable you to make more informed decisions about how to proceed.

If you’re unsure of where to focus your telehealth project, begin with the most common needs and most common sources of priorities for telehealth funding.

Consider medically underserved communities and areas of medicine where healthcare organizations struggle to attract and retain patient populations and providers. For example, rural areas, low-income communities, and tribal nations frequently generate targeted grant funding opportunities because grantors recognize that access to healthcare is a common need in those communities.

Another area that tends to attract greater needs and funding opportunities is communities with defined health disparities, particularly those that are well-documented by reputable third-party research. These can include comorbidities such as obesity, hypertension, and heart disease, which may be prevalent in a particular patient community. Similarly, grant funding opportunities may target common mental health comorbidities such as addiction and anxiety, mood, or personality disorders.

By considering common needs in the community you serve, your organization can better determine the scope of the project you want to implement. This also enables you to narrow your grantor search and identify potential funding sources that are more targeted and aligned with your telehealth goals.

Gather Input From Any Stakeholders, Especially Clinicians, as Well as Colleagues and Peers

Discuss goals and ideas with the individuals on your team who will be using the telehealth technology or are otherwise involved with the program, and gather their input and feedback. This includes your administrative staff and clinicians as well as any other departments, executives, or board members assigned to review and approve such projects.

These discussions should include your clinicians. Take the time to determine what they need, feel comfortable with, have time and energy for, and which systems they feel would best meet the needs of your organization’s patient base. Generating buy-in and input from your clinicians is critical to the successful implementation of telehealth services and technology once you receive funding.

Outside of your organization, speak with peers, colleagues, and even competitors for input on your telehealth goals and plan. Find out what has and hasn’t worked for their own telehealth efforts to inform your own plan and application. Some grantors share information about past grant award winners, who you can also contact for input and networking.

Grant seeking can feel overwhelming. But rather than looking at the totality of funds available, try to narrow your search strategically by clarifying your needs from the beginning. This saves you time later on in the process as you search for grantors and prepare your funding applications.

In the next post of our series, we’ll explore different types of grantors you can consider in your search for telehealth grant funding sources.

Marian Chambers is a Grants Consultant at Professional Grant Writers, a full-service grant writing agency that works with nonprofit organizations to identify and apply for grants to fund their programs.