Dial in: fostering the use of telebehavioral health services in frontier Alaska

Telehealth programs continue to develop rapidly in the United States, with video teleconferencing leading the way in rural areas. Unfortunately, organizational factors can limit the use of these innovative services. Researchers explored key factors that foster initial or renewed interest, continued extensive use, and adaptations to barriers in implementing Telebehavioral Health Services in rural Alaska. A total of 18 key informant interviews were conducted with direct care staff, administrative staff, and information technology professionals. Summative interview narratives were thematically coded by hand. Results indicate that direct care and administrative staff were found to be interested in the following benefits of telehealth services: increased care, decreased patient travel, decreased organizational costs, and meeting a perceived patient preference. The fulfillment of these interests, coordination, adequate staffing, accessibility of equipment, and clinician competency all contributed to the use of telehealth services. Numerous adaptations to barriers were found involving coordination, personal oversight, acceptance of limitations, education, staffing, billing for services, consultation, modifying referrals patterns, and creating treatment alternatives. Information technology professionals identified communication and assistance, testing connections, resolving initial issues, maintenance, and vision and control as vital factors. Findings may aid programs in dealing with pragmatic issues to maintain organizational readiness.