Ed spencer file ppt int dmh affairs telepsych pres 20121019 al telehealth and broadband
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Transcript of Ed spencer file ppt int dmh affairs telepsych pres 20121019 al telehealth and broadband
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TeleHealth & Broadband ConferenceTeleHealth & Broadband ConferenceOctober 19, 2012October 19, 2012
Prattville, AlabamaPrattville, Alabama
A Story of Clinical Success:A Story of Clinical Success:the DMH Telepsychiatry the DMH Telepsychiatry
Consultation ProgramConsultation Program
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OverviewOverview the Problems – the Problems – Timeliness and Hospital Timeliness and Hospital
Emergency Department (ED) Behavioral Health Emergency Department (ED) Behavioral Health (BH) Costs(BH) Costs
the Partnershipsthe Partnerships The Duke Endowment, SC Department of The Duke Endowment, SC Department of
Health and Human Services, SC Department Health and Human Services, SC Department of Mental Health, and the SC Hospital of Mental Health, and the SC Hospital AssociationAssociation
the Proposal – the Proposal – an initial Three-year Grantan initial Three-year Grant the Purpose – the Purpose – Achieving Tomorrow, TodayAchieving Tomorrow, Today
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Primary GoalsPrimary Goals Timely Psychiatric Assessment and Timely Psychiatric Assessment and
Rapid Initiation of TreatmentRapid Initiation of Treatment Increased Quality of CareIncreased Quality of Care Reduced Lengths of Stay (LOS)Reduced Lengths of Stay (LOS) Comprehensive Discharge PlanningComprehensive Discharge Planning Savings to the Hospital and Savings to the Hospital and
CommunityCommunity
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Partnership Partnership DiagramDiagram
BaptistEasley
Conway
McLeodSeacoast
Chester
McLeodDillon
RoperBerkeley
Carolinas CarolinasMarion
GrandStrand
Clarendon
Fairfield
George-town
HamptonWacca-maw tRMC McLeod
LorisSprings
SC DHHS
Laurens
WallaceThomson
UpstateCarolina
Upstate
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Remote Site LocationsRemote Site Locations
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Clinical Office LocationsClinical Office Locations
Columbia, SC
Aiken, SC
Charleston, SC(2)
Conway, SC
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Consultation ProcessConsultation Process Patient Presents in EDPatient Presents in ED ED Physician Requests ConsultED Physician Requests Consult Psychiatrist Reviews CIS/SCHIExPsychiatrist Reviews CIS/SCHIEx Patient ConsultedPatient Consulted Encounter EndsEncounter Ends Psychiatrist Electronically Signs ConsultPsychiatrist Electronically Signs Consult Recommendations Sent to EDRecommendations Sent to ED Hospital Dispositions the PatientHospital Dispositions the Patient
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Consults & Patients Kept Consults & Patients Kept (2012)(2012)
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Clinical OperationsClinical Operations
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Dashboard - TimeDashboard - Time Current program impact results in a Current program impact results in a
44% discharge rate for same day of 44% discharge rate for same day of consult for those seenconsult for those seen
Even with a 40% increase in BH Even with a 40% increase in BH patients presenting in ED’s, patients presenting in ED’s, “Snapshot Average Wait Times” “Snapshot Average Wait Times” (09/2009 v. 09/2012) have not (09/2009 v. 09/2012) have not significantly increased (~2%)significantly increased (~2%)
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Turn-AroundTurn-Around 6.25 hours from initial ED request for 6.25 hours from initial ED request for
Telepsychiatry to patient discharge Telepsychiatry to patient discharge (10/2012)(10/2012)
11.9 consults every 18 hour day 11.9 consults every 18 hour day (09/2012)(09/2012)
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Data ResourcesData Resources CIS – DMH patients (past/present) *CIS – DMH patients (past/present) * EMR – DMH Intranet-based medical EMR – DMH Intranet-based medical
assessment formassessment form SCHIEx – ORS repository for multi-SCHIEx – ORS repository for multi-
agency database downloads *agency database downloads *
* 75-80% ED patients known across both databases
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Palmetto State Providers Palmetto State Providers NetworkNetwork
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Satisfaction SurveysSatisfaction Surveys
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Survey Results - PhysicianSurvey Results - Physician
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Survey Results - PatientSurvey Results - Patient
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R01 Grant ResearchR01 Grant Research Collateral Effect: Reallocation of Collateral Effect: Reallocation of
Resources by ED’s to ED-appropriate Resources by ED’s to ED-appropriate carecare
Reduced Commitment Rate to BH Reduced Commitment Rate to BH Inpatient BedsInpatient Beds
Reduction in Average Inpatient LOSReduction in Average Inpatient LOS Produced Savings of $1,800 in BH Produced Savings of $1,800 in BH
Inpatient Settings per Care EpisodeInpatient Settings per Care Episode Equals (approx) $23 M in BH Inpatient Equals (approx) $23 M in BH Inpatient
SavingsSavings
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Sustainability – RevenuesSustainability – RevenuesFY 13
36%
27%
25%
12%
TDE SC DHHSSC DMH Hospitals
PRIOR YEARS
100%
TDE
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For more information, please For more information, please go to our website: go to our website:
http://www.scdmh.org/telepsychiatry
or contact our program or contact our program office: office: Ed Spencer, Program DirectorEd Spencer, Program Director
(803) 898-8579(803) 898-8579Ralph Strickland, CoordinatorRalph Strickland, Coordinator