Telepsychiatry and Service-learning: Providing rural access to behavioral health care while training the next generation of psychiatrist Susana Helm, PhD, Dan Alicata MD, Ruby Agoha MD, Brett LU MD, Michael Fukuda, MSW University of Hawai i-mānoa, JABSOM Department of Psychiatry 2013 Hawai i Health Workforce Summit: Improving Provider Satisfaction and Practice Sustainability April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 1 Potential of telepsychiatry in meeting the challenges for rural Hawai i Workforce shortage: address the workforce shortage in child and adolescent psychiatry Access: improve access to care for children and families living in rural or impoverished areas Optimization: Bring mental health services to youth in a variety of settings such as schools, community based treatment programs, inpatient hospital transition, Juvenile Justice (detention center, youth corrections), primary care Barriers: Identify and overcome the barriers preventing telepsychiatry from being fully integrated into routine practice April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 2 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 1
Concept Improve Quality of Care clinical & non-clinical Improve Consult to Primary Care Eliminate Mental Health Disparities Increase Compliance Improve Workforce Development residents/med students clinical & research academic & community participate follow recommendations access April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 3 Training, Education, Practice Department s Mission: Train residents to become competent psychiatrists, Educate medical students to the discipline, Provide health research that improves minority and disadvantaged populations in Hawai i and the Pacific. Service-Learning: Requires a structured experience that combines service and to understand the connection to academic work. Telepsychiatry: Combines the service work with technology allowing trainees to resolve issues of distance and time in serving rural areas. University of Hawai`i Rural Health Collaboration April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 4 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 2
Education & Training Residents & Fellows: service learning before graduating telepsychiatry curricula Primary Care: care coordinators, physicians/nurses, educators, juv.justice April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 5 5 Practice: Telehealth Initiatives Child & Adolescent Mental Health Division, Family Guidance Centers Geriatric Telepsychiatry, Nursing Homes Adult Specialty Clinic Community-Based Prevention with Youth April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 6 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 3
CAP rural telepsychiatry partnerships DOH-CAMHD Mayo Clinic UH Department of Psychiatry Department of Education mental health contracting agencies community child and adolescent psychiatrists, family physicians and pediatricians April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 7 Curriculum AACAP Telepsychiatry Practice Parameters Mayo Clinic Collaboration Service Learning April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 8 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 4
Resident Clinical Schedules Faculty Supervision First CAP specialty clinic started 09/2008 Faculty recruitment to support growth Currently eight rural VTC clinics / week: quarterly travel for FTF (more frequent based on family needs and fellow s goals) Coordinate with multi-systems/levels of care Program expansion match education/training objectives April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 9 Administrative Core IT Core Research Core Infrastructure Specialty Consult Core: Mayo Clinic role of telepsychiatry in global service; training and education; research; and workforce development April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 10 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 5
Teamwork in CAP Telepsychiatry Main Elements Roles Patient Engagement Specific Components University-Based, Telepsychiatrist Community-Based, Care Coordinator Enhancing Patient Engagement System of Care Medication Management Communication IT Sustainability Financial Models April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 11 April 20, 2013 Helm, Alicata, Agoha, Lu, Fukuda 12 Susana Helm, PhD ~ HelmS@dop.hawaii.edu 6