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Using telemedicine in mental health emergencies increases access, lowers costs

SAN FRANCISCO — Using a telemedicine evaluation for pediatric mental health emergencies in ED or urgent care facilities may improve access to mental health services and reduce costs, according to recent study findings presented at the 2016 AAP National Conference and Exhibition.

“Pediatric mental health emergencies represent an escalating segment of pediatric psychiatric emergency services that impacts one in five children,” Alison Brent, MD, of Children’s Hospital Colorado, Aurora, wrote. “Pediatric emergency department and urgent care sites are vital for initial stabilization of patients with [mental health emergencies] in conjunction with evaluation and ultimate disposition by pediatric trained [mental health specialists]. A system that provides safe and timely evaluation of [mental health emergencies] is challenging from a resource perspective, especially when patients present at a site distant from mental health specialists.”

To assess impact of a telemedicine evaluation on quality of care for mental health emergencies in the pediatric ED, researchers conducted a retrospective chart review of 504 individuals aged 18 years or younger who presented to five ED or urgent care sites with mental health emergencies.

Telemedicine evaluation for mental health emergencies statistically significantly improved time to disposition, as 52% of individuals evaluated with telemedicine were discharged from remote sites directly home with a scheduled outpatient follow-up.

The majority of patients and providers (97%) reported they were highly to extremely satisfied with telemedicine services.

Telemedicine was associated with significant cost-savings, according to Brent.

“In many communities, ED/urgent care sites are considered the primary behavioral health provider for many of these children. Since most ED/urgent care sites are not staffed with [mental health specialists], the utilization of telemedicine appears to be a timely and effective mechanism for linking real-time consultation for pediatric patients with [mental health emergencies] in distant ED/urgent care sites with [psychiatric emergency services] and [mental health specialists],” Brent wrote. “This modality appears to have the potential to improve timely access to critically important [mental health specialists], while improving provider satisfaction, system capacities and reducing costs. Telemedicine utilization in the pediatric ED/urgent care setting may represent the optimal system for [mental health emergencies] evaluation in the future.” – by Amanda Oldt

Reference:

Brent A. The clinical utility of telemedicine in pediatric mental health emergencies in the ED/UC setting. Presented at: AAP National Conference and Exhibition; Oct. 21-25, 2016; San Francisco.

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