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This month's ARPA awardee profile features Bryan Telemedicine. Bryan's Andy Whitney tells us more about his team's project, which received support in the Telebehavioral Health Support in Rural Areas category.
Tell us about your project and what made you want to pursue it?
Our project has two components: Emergency Mental Health Triage via telemedicine and Outpatient Pediatric Psychiatry via telemedicine. The Emergency Mental Health Triage program was established in 2015 to provide emergency mental health assessments for rural hospitals. Bryan Health discovered 50% of the mental health emergency patients sent to Lincoln from surrounding communities for a mental health assessment did not meet the criteria for inpatient treatment. This resulted in unnecessary and often long drives to and from Lincoln, either by ambulance or private vehicle.
The Emergency Mental Health Triage program has successfully prevented hundreds of unnecessary trips, saving thousands of miles in travel. Patients who meet the criteria for inpatient treatment are directly admitted to the inpatient unit without needing further screening. Additionally, Bryan Health social workers coordinate bed placement, easing the workload for local emergency department nursing and medical staff. ARPA funding has allowed the program to expand into more facilities across the state. Bryan Health has also added additional social workers to the mental health emergency department to support the increase in the number of assessments completed as a result of this program.
The Outpatient Pediatric Psychiatry program is designed to bring pediatric psychiatry services to outpatient clinics in rural hospitals. In most rural communities, specialties like pediatric psychiatry are simply not available. Parents and guardians of children with psychiatric needs have faced significant burdens as they try to find quality behavioral health care for their children. ARPA funding from this award has allowed providers of pediatric psychiatry services to expand via telemedicine to rural hospital outpatient clinics across the state. This has provided parents and guardians of children with psychiatric needs access to care in or near their home community, saving travel time and the requirement to take long periods of time off work to travel for their child’s care.
The ability to provide care via telemedicine has brought efficiencies and has lowered the burden of care for rural residents across the state. More than that, it has provided hope that care is available and that access to quality behavioral health treatment is not out of reach for rural Nebraskans.
What do you find most exciting about the project?
This program has allowed for rapid expansion of these services. While the Emergency Mental Health Triage program has been in existence since 2015, adding new sites has been a process of presentations to rural hospitals one at a time. The ARPA funding has allowed for a more rapid expansion of the program, and while the award covers equipment and startup costs for participating sites, the assessment costs are covered by the sites, demonstrating the value they see in the service.
The telemedicine pediatric psychiatry service was born out of this project. This service was identified as a need in rural areas due to the lack of rural resources. Reducing the burden of care is at the core of what we do at Bryan Telemedicine. The partnership with Boys Town Child and Adolescent Psychiatry has allowed the region’s most trusted providers to reach additional patients they would not have been able to treat in the past due to the barriers of travel. Improving access to care for the youngest residents of Nebraska has been very satisfying.
What do you see as the biggest barrier to success for the project?
While many telemedicine programs are designed to serve facilities owned by large health systems, Bryan Telemedicine serves mostly independent facilities. This requires a contracting process that can add to the timeline for implementation. Additionally, as seen with many rural projects, leadership changes, changes to financial situations, or other concerns have caused some sites who were initially interested in the program to drop out, necessitating the contracting of replacement sites.
What learnings have you gleaned from the project so far?
This award has been extremely helpful for many rural communities across the state. It has allowed for the deployment of behavioral health services into rural communities that lack access to high-quality behavioral health care. As we have deployed the behavioral health services from this project, our discussions with rural health leaders have highlighted additional specialty needs. The ability to expand services beyond the scope of behavioral health, such as hospitalist and neurology and stroke services, would be another great benefit to rural communities. Access to care is not limited to behavioral health resources; many times, a bit of assistance with technology and upfront costs can go a long way with communities.
Learn more about Bryan Telemedicine here.
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