Building and Sustaining a Statewide Telepsychiatry Network: Lessons Learned from the North Carolina Statewide...

Area of Science:

• Telepsychiatry
• Behavioral Health Services
• Healthcare Access

Background:

• Persistent psychiatric professional shortages in North Carolina, especially in rural areas, lead to long emergency department (ED) boarding times and unequal access to care.
• The North Carolina Statewide Telepsychiatry Program (NC-STeP), established in 2013, is a leading statewide initiative addressing these challenges.
• NC-STeP operates across diverse settings including EDs, community clinics, maternal health, pediatrics, and universities.

Purpose of the Study:

• To comprehensively review the evolution, deployment, results, and key learnings of NC-STeP.
• To assess the program's impact on psychiatric care delivery in various healthcare environments.
• To identify areas for improvement and future development of statewide telepsychiatry.

Main Methods:

• Data compilation from NC-STeP operational records, service utilization statistics, and academic publications.
• Analysis of program data spanning from 2013 to 2025.
• Synthesis of information to evaluate program effectiveness and identify lessons learned.

Main Results:

• NC-STeP conducted 67,543 psychiatric assessments in EDs, averting 11,802 hospitalizations and saving $63.7 million.
• Telepsychiatry facilitated more safe discharges from EDs and reduced boarding times.
• The program improved access to psychiatric services but also highlighted ongoing disparities in care equity.

Conclusions:

• NC-STeP serves as a replicable statewide telepsychiatry model that enhances patient flow and decreases unnecessary hospital admissions.
• The program effectively expands equitable access to behavioral health services across North Carolina.
• Lessons learned from NC-STeP offer valuable insights for scaling telepsychiatry initiatives nationwide.