CONTRIBUTED

Community Care of the Sandhills (CCS) will use telemedicine to integrate psychiatry into primary care locations.

In an effort to bring quality behavioral health care to patients in remote areas, CCS has partnered with InSight Telepsychiatry, Easter Seals of North Carolina and Virginia, and FirstHealth of the Carolinas to pilot one of the first primary care telepsychiatry programs in the nation, a news release said.

This innovative approach was recently reported at the 2012 American Telemedicine Association meeting in San Jose, Calif.

Communities throughout the nation face a shortage of psychiatric clinicians. For example, three of the seven counties in CCS's territory do not currently employ psychiatrists, according to CCS.

Additionally, many of CCS's primary care doctors report that they struggle to provide psychiatric resources for their patients. The care options patients do have are in distant locations with long wait times, making psychiatric care costly, time consuming and impractical.

"The Sandhills region has a tremendous need for qualified behavioral health providers," said Dr. Robin Cummings, medical director of CCS. "This telepsychiatry program is going to connect patients to behavioral health care professionals directly from their primary care physician's office."

Telepsychiatry is psychiatric care delivered via video conferencing technology. It has been proven as an effective way to address issues of access to mental health care in underserved communities, particularly in specialty areas like child and adolescent psychiatry or substance abuse services.

A study of child and adolescent psychiatry patients who received telepsychiatry care at an outpatient facility in Kentucky found that 100 percent of children and 98 percent of parents were satisfied with the quality of care provided by telepsychiatry.

Telepsychiatry has been used to increase the behavioral health options in hospitals and outpatient offices throughout the nation for more than 13 years. However, CCS's use of telepsychiatry in primary care offices is one of the first programs like it in the nation, the release said. This innovative application of telepsychiatry means that patients can receive medical and behavioral health care in one centralized location.

"By integrating behavioral and physical health through programs like telepsychiatry, CCS hopes to empower patients to effectively manage their own health care," said Susanne Whiting, the behavioral health coordinator at CCS.

Cummings said a number of Sandhills primary care physicians report that many patients who come in for medical treatment also struggle with mental health issues.

"Traveling an hour to see a behavioral health specialist is just not feasible for many families," Cummings said. "Patients physical ailments are exacerbated by behavioral health problems, but primary care doctors are not trained to comfortably and effectively treat behavioral health issues. That's where telepsychiatry comes in."

The first phase of the telepsychiatry program started this month with Sandhills Pediatrics in Southern Pines and ABC Pediatrics in Dunn, both large pediatric practices with significant need for behavioral health care in their populations.

In the coming months, additional practices will be added with the goal of eventually serving 20 clinics in the Sandhills region. If successful, the pilot program will be replicated throughout CCS and into other North Carolina Community Care Networks across the state.

"The initial experience with this new model is very gratifying," said Dr. William Stewart, of Sandhills Pediatrics. "Our young patients seem to take to it right away. Our Community Care Network is to be congratulated on thinking outside the box and bringing this service to our patients and community."

Easter Seals, a mental health service provider in North Carolina and Virginia, will provide the pediatric behavioral health care via telepsychiatry, and FirstHealth of the Carolinas and InSight Telepsychiatry will provide the adult care.

CCS also anticipates that primary care telepsychiatry will reduce their rates of skipped appointments, in addition to increasing quality of care.

"When patients can just go to their primary care office to receive treatment from different medical specialties, they feel more comfortable," Cummings said. "It is also much easier for primary care physicians to hold patients accountable for their health care needs because the physicians can easily monitor patient attendance and progress at psychiatric appointments."

CCS's telepsychiatry program follows the Behavioral Health Integration Initiative (BHI) that was approved in February 2010 by the Division of Medical Assistance (DMA). This initiative called for an increase in the integration of behavioral health services in primary care practices.

"We have had extremely positive results with our telepsychiatry programs in other applications and locations throughout the nation, and we are very excited to see the increased access and improved levels of patient care that we anticipate to come from CCS's primary care telepsychiatry program," said Geoffrey Boyce, executive director of InSight Telepsychiatry, which is the service provider that will connect patients to remote psychiatric clinicians.

InSight has been providing telepsychiatry services throughout the country for the past 12 years. Five years ago, InSight established a partnership with Aetna Insurance to pilot the integration of telepsychiatry within local pediatric offices. InSight is adapting this model for North Carolina's primary care facilities.

Community Care of the Sandhills is one of 14 similar networks participating in the statewide health care quality improvement strategy called Community Care of North Carolina (CCNC), which coordinates the care of North Carolina's Medicaid population.

CCS is a local nonprofit network serving more than 64,000 North Carolina Medicaid enrollees in Harnett, Hoke, Lee, Montgomery, Moore, Rich-mond and Scotland counties. Its goal is enhancing health care quality, increasing efficiency, improving patient safety and lowering costs.

CCS helps primary care providers use evidence-based treatment guidelines, provides care management services to patients to reinforce treatment plans, and especially targets services to children and the aged, blind and disabled.

Anyone needing more information can call (910) 246-9806 or visit www.communitycare-sandhills.org.