Evidence-Based Telehealth Network Program: CoxHealth
The Georgia Health Policy Center recently spoke to Shamim Jaleel and Terri Slattery, both from CoxHealth in southwest Missouri, about how the pandemic enabled expansion of behavioral health services and chronic disease management through telehealth enabled by Microsoft Teams.
To date, what has been the biggest accomplishment of your telehealth program?
Shamim: I think one thing that we are really proud of with our telehealth program is working with our partners, both our 10 partner clinics and also our community partner, a mental health center. The clinic partners have been eager to learn about the program and then also share information with their staff and providers.
Terri: I schedule and reach out to the patients, and for me that is a big deal. They all live in a rural community and there is a big need for behavioral health care. I feel really proud that we have been able to get more and more patients on board to receive the help they need. As we completed year one, we had a total of 146 unique patients go through the program with a total of 274 telehealth encounters. It has just been increasing since then.
What is a tip you would share with an organization launching a similar telehealth program?
Terri: I learned early on it is always good to keep communicating with all of your clinics and your providers. Just reach out to them occasionally. They are so busy that sometimes they forget that we are here and we have this service available for their patients. Keep in touch with them consistently.
Shamim: Be flexible. Sometimes things do not necessarily happen the way that they are written down — real life comes in — real-life partners, real-life clinics, real-life patients. So just be flexible and try to anticipate challenges and think of solutions. Do not be afraid to go back to the drawing board and try something else. It is important to fulfill your objective but it may happen in a different way than what you had originally thought or written down. So just being flexible and willing to adapt is the key.
How does participation in the Office for the Advancement of Telehealth’s grant program impact your broader health improvement efforts?
Shamim: This program definitely fits into the larger community health improvement initiatives of the health system by bringing access to multiple telehealth services, including behavioral health care, chronic disease management services, and community health worker services. They all bring benefit to patients in different ways. Bringing awareness is a big goal of this project. Clinics are so busy providing care to patients, but this program adds to the continuum of care by bringing more integrated care. We are able to leverage services that are already provided within the system as well as outside in the bigger community.
Terri: Originally a patient would come in to the office and do their telehealth visit in the primary care office. Sometimes we could piggyback appointments so that the patient did not have to come into the office twice. They might have a visit with their provider and then they could follow-up then with a visit with the behavioral health provider. Transportation in all of our clinics is really an issue. So, telehealth really helps a lot.
What will your organization be doing more of or differently to emerge stronger from the pandemic?
Shamim: When the pandemic hit our previous project was mainly focused on providing telehealth for behavioral health services in-person meaning the patient goes to their home, primary care clinic to be connected for telebehavioral care on an iPad. But when the pandemic first hit, there were limitations on what type of appointments were allowed. Initially, we saw a loss of telebehavioral health appointments for our behavioral health counselor. So, one big adaptation that we did, with the approval of HRSA, was to move all appointments from in-person to virtual so that patient could connect to our behavioral health counselor from home. That is where Microsoft Teams came in. Since the whole organization moved to that platform, we leveraged that as well and it brought this project in a different direction to direct-to-consumer care, which we have continued for our current EB TNP program.
Terri: The pandemic really brought a bigger awareness for mental health. A lot of people were suffering because of the pandemic. The pandemic forced us to do this transition with technology, and we ran with it and I think it has been the best thing overall for our patients. Sometimes patients have to wait months to get in with a behavioral health provider, but this makes it much more flexible and our counselor can serve as a bridge and talk to them sooner while patients are waiting to see someone at a community mental health center, such as the Clark Center.