During the COVID-19 pandemic, Geisinger saw referrals for behavioral health services grow at a much faster rate than usual. Restrictions on in-person care and clinician shortages made access to care difficult, leading to long wait times for appointments and potentially worse patient outcomes. To address the backlog issue, the 10-hospital integrated health network in northeast Pennsylvania partnered with a telehealth vendor to develop a standardized intake and triage workflow, combined with expanding its clinician workforce.
Ben Gonzales, operations manager II with Geisinger's department of psychiatry and behavioral health, explained the challenges the system faced dealing with the growing numbers of behavioral health patients and explained how telemedicine was leveraged to address patient needs. Gonzales spoke with Health Exec at the Healthcare Information Management Systems Society (HIMSS) 2023 meetin,g where he presented on his hospital experience adding virtual care services.
"Being a health system largely in central and northeastern Pennsylvania, we have a very rural service area, so we had to get pretty creative. In the second and third wave of COVID, we started to see the demand far overshadowed our capacity. We reached a point where we were getting about 180 referrals per day, and that is still the case to this day," Gonzales explained.
The health system did some internal recruitment to try and bolster its psychiatry and behavioral health program, but realized they needed a much faster way to expand care for their patients. They contracted with Iris Telehealth to bring on more than 20 telemedicine providers.
Even though the pandemic is now in the past and telemedicine was used to address the needs during the COVID surge, Gonzales said telemedicine is here to stay in his health system.
"We are currently at 85% telemedicine encounters for outpatient encounters. For us, we see telemedicine growing. Now that we created that surge capacity, we are now looking at how can we enhance the telemedicine experience," he said. "For us, the amount of telemedicine will stay the same and it is now about honing that strategy and making it as effective as possible."
When patients visit a brick and mortar clinic or hospital, they usually are given a clipboard to fill out a lot of information before their visit. They are now working on doing something similar electronically for telehealth visits to streamline the process and the data entry.
"We already had a robust telemedicine offering and a full-fledged telemedicine team. Our patients and staff really do not know the difference between an Iris provider or a Geisinger provider. They are all using the same EMR, the same video platform interface to connect with patients," Gonzales said.
The health system uses TeleDoc as its telemedicine platform, which allows scheduling within the Epic EMR that sends appointment invites to the patients.
For health systems looking to build their telemedicine capacity, he said it is important to find a vendor that is seasoned so they can help work through and issues quickly because they have already dealt withy this things during previous telemedicine implementations. He said vendors that are willing to partner and co-develop the technology with you are also very helpful.