For health systems seeking to provide high-quality inpatient psychiatric care, it’s essential to prioritize learning what patients need, how best to support them on their care journey, and how to connect with patients. While in-person care remains the gold standard, giving patients a virtual option can help reduce no-shows and ensure patients aren’t seeking behavioral health care in the ED.
In a webinar hosted by Becker’s Hospital Review, healthcare leaders from Carilion Clinic and Basset Health Network came together to discuss how they’re leveraging partnerships with telehealth organizations to overcome hiring challenges and help their communities get the best care possible.
They were also joined by two providers, Dr. Tisa Ayuso and Dr. Ghazanfar Khan, who shared their experience providing virtual behavioral health care in an inpatient setting.
How Carilion Clinic overcame staffing challenges during COVID-19 and beyond
Laura Taylor, the Program Director of Psychiatry at Carilion Clinic spoke to the organization’s challenges navigating call outs during the COVID-19 pandemic. At one point, the organization had to shut down the unit and then reopen. Taylor said, “It took a lot of time to navigate scheduling to make sure that we were staffed appropriately to meet the patient needs on the unit.”
From the hiring perspective, it took months for physicians to complete their credentialing. However, after partnering with Iris, Carilion was able to attain a reliable provider.
Reflecting on this time, Taylor said, “To have an established Iris Telehealth provider was incredibly important because it created reliability on the unit. We knew exactly what we were working with when we had the physician. She was very reliable, and it created continuity of care.”
Basset Health Network’s approach to staffing providers in rural New York
Basset Health Network is in upstate New York, where its patients are geographically dispersed across the region.
Amid cross-departmental changes, Basset found itself with a shortage of clinicians on the inpatient side.
While they were in the recruitment process, they couldn’t hire clinicians fast enough. They had leveraged locums to help run their inpatient unit, but they needed a long-term solution that would almost exclusively provide physician oversight on the inpatient unit. Dr. James Anderson, Chief of the Department of Psychiatry at Basset, said they wanted to expand their approach to virtual care.
Anderson said, “We thought in the long term, it was going to create a situation where we could offer more flexibility when looking at full-time staff members. Even if they weren’t working full-time in a virtual capacity, they would have that tool as part of their tool belt.
So, whether it was because of illness or convenience, it’s an important arrow in our quiver to be able to expand virtual health to include providing services on the inpatient end.”
The provider experience facilitating virtual care
While Dr. Tisa Ayuso has been with Basset for a short time, she says her role as Virtual Medical Director has been going well.
“We have our systems in place in terms of our morning rounds. We have the computer system up and running. We recently just got a fish-eye lens camera, so I have better visibility of seeing everyone in the morning meetings, which has been fantastic.”
Along with working with patients, Dr. Ayuso also works with Bassett’s medical students to demonstrate best practices for delivering effective inpatient psychiatric care.
Before working with Iris, Dr. Ghazanfar Khan started to experience the stress of the provider shortage and knew he wanted to make a change for his mental health. Since beginning his virtual inpatient role, Dr. Kahn enjoys focusing more on patients than commuting.
“I’ve been able to focus more on my patients. I have charts pulled out when I’m seeing patients so that I can see their labs and medications and the nursing and social work notes. It has been working great for me. The hospital staff made it more convenient for me to transition from in-person to virtual.”
The benefits and challenges of virtual care
Virtual behavioral health makes it easier for patients to attend appointments and helps improve satisfaction overall. At Carilion, Taylor says that having a blended model has enhanced patient care.
Reflecting on her observations, she said, “I had an opportunity to round with our telehealth psychiatrist, and rarely would I hear patients request a different provider. This provider was very good at building rapport quickly; they exchanged a wealth of information back and forth. I think patients felt very comfortable with that provider in a telehealth setting.”
Besides a few technical glitches and finding the right place to take the video calls, Taylor says telehealth has been “almost seamless.”
At Basset, Anderson says they’ve heard almost zero patient complaints about virtual care. He said the challenges they faced were mainly on the front end.
He said, “I wouldn’t say it was a challenge, so much as there were legitimate questions and concerns from staff on the unit about how we were going to operate on a daily basis. There were concerns about how we would get Dr. Ayuso in the room. It turns out that wasn’t as big of a deal as some anticipated.”
Anderson also expanded on the benefits, noting, “I just got an email today from our clerkship director who is in charge of the medical student’s psychiatry rotation. He said the students are having a fantastic experience, and they love Dr. Ayuso.
In some ways, there’s some suspicion that there’s even more contact with Dr. Ayuso than there might be if the psychiatrist was there on the unit. It’s been a surprise to some of the staff members on the unit about how non-disruptive it has been.”
Advice on finding the right telehealth partner
At Basset, Anderson said they considered several things when searching for a behavioral health partner. “First,” he said, was “the ability to become impaneled with our various insurers. We absolutely want people that are willing and able to accept Medicare and Medicaid.”
Next, Anderson said Basset was looking for a partner who could serve as a collaborating physician for their nurse practitioners. After talking with multiple telehealth companies, Basset landed on Iris Telehealth because of their ability to meet their needs.
Anderson said, “It was really strong communication and project management. To help us, we came in, and we sort of knew where we wanted to get to, but we didn’t know how to get there. Iris had this combination of knowledge and commitment to clear and confident communication. They had willingness to collaborate, but also had proven ideas that worked before – that was a big plus.
They also had a clear commitment to quality services. When Iris is presenting a clinician to us, we know that clinician has already been well vetted by Iris. By the time we’re talking to the clinician, there’s a little bit of a halo effect because of the trust we’ve built.
It’s not sign unseen. We build the partnership, and we see that things are working in other areas – it made it a pretty easy choice to go with Iris, and we’ve been happy so far.”
The importance of collaboration and quality support
For Carilion, Taylor said relationships and communication are incredibly important to finding the right behavioral health partner.
“Working with well-informed individuals who know exactly what to do, have had that experience, and can offer solutions while listening to needs. That’s what I’ve enjoyed so much about my relationship with Shannon.”
Shannon works as a Client Alignment Executive (CAE) at Carilion. Taylor says she’s enjoyed working with her CAE, who helps figure out what Carilion needs, how Iris can meet those needs, and the creativity of thinking outside the box.
“The ease of transitioning a provider into the Carilion system is flawless,” said Taylor. “Every need is thought of. Every detail is considered when it comes to invoicing and general backend operations.
Everything is very streamlined. It’s predictable, and there are no surprises. It’s been a wonderful experience. It’s meant to support Carilion and Carilion’s needs and not create barriers.”
Figure out your next steps
We’re so grateful for the time Laura Taylor, Dr. James Anderson, Dr. Ayuso, and Dr. Ghazanfar Khan generously shared with us. Thank you for your partnership and for all you do to help expand access to quality behavioral health care in your communities!
Weren’t able to make it to the webinar? You can watch the full video here.
If you’d like to learn more about integrating quality behavioral health programs into your organization, contact us today to get started!
