Call it the great technology experiment of 2020-2021. In just days, McLean—along with most other mental health care providers—transitioned from delivering care almost entirely in person to treating a majority of patients via videoconferencing or phone.
“We had been baby-stepping our way toward telemedicine. Then suddenly everyone had to do it, from the most to the least savvy patients and providers,” said McLean’s Chief Medical Information Officer Alisa Busch, MD, MS. “It’s been an amazing journey.”
One of the silver linings of the forced pivot to tech-enabled care has been the ability to extend access in new and more flexible ways.
“For populations like older adults, where no-shows tend to be higher because of obstacles, virtual care has eliminated these barriers,” said Ipsit Vahia, MD, associate chief of McLean’s Division of Geriatric Psychiatry and the hospital’s director of Digital Psychiatry Translation. “In our program, we’ve been seeing 30% more patients than before the pandemic. Our no-show and last-minute cancellation rates have dropped to almost zero.”
Hospital-wide, telemedicine has helped on the staff side of the equation, too. Clinicians can conduct after-hours admissions or consultations via video when their specific expertise is needed.
In addition to making McLean’s services more accessible, there have been other technology windfalls, according to Busch.
Seeing patients in their home environments provides important insights during therapy. Patients with obsessive compulsive disorder can do their “homework”—for example, engaging in an activity that triggers their symptoms to gradually lessen the impact—with their therapist watching and providing guidance. Therapy with family members in different locations becomes a cinch with Zoom.
And early concerns about telemedicine never came to pass: staff worried unnecessarily that certain patients would have trouble navigating the technology.
Technology Support Eases the Transition to Virtual
Some patients in the geriatrics division, however, did need extra support, which was revealed in a survey done early in the pandemic. Two research assistants (RAs) from Vahia’s program were reassigned as “virtual care support specialists.”
“Research was on pause at that time, so our RAs were available to make this shift,” explained Vahia. “We created protocols for them to reach out to patients, set up meetings to teach them about Zoom, and offer practice sessions so patients were proficient by the time of their appointments.”