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Telehealth expands access in troubled times

October 20, 2010
by Lindsay Barba, Associate Editor
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Telehealth platform gives CMHC more access to patients, and patients more access to care

Under financial pressure due to shrinking state funding, Bayview Center in Miami, Fla. couldn’t afford to do business the way it always had. According to Kathi Miller, Bayview’s strategic development officer, Bayview could no longer use state incidental funds to provide patients with public transportation vouchers, since recent cuts meant “we don’t have incidental monies anymore.”

But Miller knew that despite the funding loss, Bayview couldn’t afford the loss of an important and deserving clientele. With the help of the vouchers, Miller says that these patients were willing to travel in to receive services from outlying areas, “despite the need to catch two or three buses” or “risk of missing work and getting docked for their pay.” So, to serve these dedicated patients, Bayview partnered with MDLiveCare, a Web-based telehealth delivery system, to eliminate the problem of transportation altogether.

The new service is “an opportunity for us to reach more clients in light of the revenue shortages we’re currently experiencing,” says Miller, noting that the new telehealth service provides expanded access to care for Bayview’s patients and is reimbursable by private payers. In fact, the Agency for Healthcare Administration (AHCA), Florida’s Medicaid entity, is currently in the process of developing codes for reimbursement of telehealth services.

In addition to serving those who cannot travel to services, the telehealth option also expands access to those who can travel to the community mental health center for care, but would rather not. By using the telehealth service, patients can eliminate the need for taking time off work to see their clinician and eliminate the fear of running into a neighbor or co-worker in the waiting room.

“It gives folks much more access and as it relates to privacy and confidentiality, especially when you’re talking about professionals,” Miller says. “No one wants to leave work and to go to a psychiatrist’s office and see someone there they know.”

Assessing patients’ IT competence
Though the benefits of telehealth options were clear to Bayview, the organization at first was skeptical about whether patients would be willing and able to use it. “There’s a myth out there that our population may not have access to technology,” Miller explains.

To determine just how many patients could access counseling services on the Internet, Bayview conducted a survey to learn more about patients’ exposure to technology, specifically asking whether patients:

• Owned a personal computer and if so, what was its age;
• Had webcam capabilities on their personal computer;
• Personally felt proficient in using personal computer and Internet technology; and
• Used social media.

Miller says that Bayview was “pleasantly surprised” to find that the majority of its patient population responded positively in all of these areas, making “telehealth a lot easier to do.”

Once patients’ information technology access and competence were understood, Bayview’s next step was to gauge their interest in receiving telehealth services. This was done by Bayview counselors and case managers at regularly scheduled patient appointments. Again, the feeback was positive. Bayview's LiveCare platform, devleoped with MDLiveCare, gives patients instant access to round-the-clock care.

Easy access to expanded services
To log on to Bayview’s telehealth services, patients simply access Bayview’s Web site ( and select the Online Counseling tab in the navigation bar. Patients who have already registered online with Bayview can log into the telehealth platform with their user name and password, while new patients must register and select a user ID and password first.

The service is HIPAA-compliant, with all information transmitted over the Internet encrypted and secure. Patients whose mobile phones have video-conferencing capabilities don’t even need to use a personal computer. They can access Bayview’s telehealth services directly via their mobile phones.

Because the service through MDLiveCare is Web-based, patients don’t have to download anything or buy any additional software, says Miller. “All you need is a webcam and microphone or a headset.” With these accessories, a personal computer, and Internet access, patients can schedule and complete appointments with Bayview counselors 24 hours a day, seven days a week. To ensure that a Bayview counselor is always available for patients seeking unscheduled services, the organization has recruited counselors from around the country into its telehealth network.

Bayview notes that although only the delivery method—not the service itself—has changed, no-shows are down and more patients are keeping their appointments, even as they save time and money. It’s a relief, explains Miller, since Bayview often had “a huge number of no-shows on any given day for various reasons.” Now, patients can stay home if they like—and still keep their appointments.