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.