Using Telepsychiatry to Enrich Existing Integrated Primary Care

Area of Science:

• Healthcare delivery innovation
• Digital health and telecommunications
• Integrated behavioral health services

Background:

• Integrated care models are diverse and evolving.
• Telepsychiatry offers potential to improve access, quality, and efficiency in integrated care.
• Primary care settings increasingly serve patients with complex physical and behavioral health needs.

Purpose of the Study:

• To describe the implementation process of telepsychiatry within an existing integrated care service.
• To evaluate the outcomes of adapting telepsychiatry for a complex patient population.
• To identify lessons learned from integrating telepsychiatry into primary care.

Main Methods:

• Telepsychiatry was implemented in a high-volume, urban primary care clinic in Colorado.
• Services included consultative, direct care, and educational encounters.
• Quality improvement measures tracked provider communication, process changes, and patient outcomes.
• An iterative team meeting process within a stepped care model was used for adaptation.

Main Results:

• Over 35% of psychiatry service requests were medication-related, with medication changes being the most frequent outcome.
• Forty percent of patients had multiple behavioral health diagnoses alongside physical health conditions.
• The adapted model successfully served a complex primary care patient population.

Conclusions:

• Telepsychiatry is a valuable component for hybrid integrated care teams.
• Flexible model implementation is key to tailoring services for specific patient panels.
• Successful integration of telepsychiatry in integrated care requires positive team attitudes.