TELEHEALTH : CREATING REMOTE CONNECTION WHEN PEOPLE NEED IT MOST

Telehealth: Creating Remote

Connection When People Need It Most

As the coronavirus crisis continues to wreak havoc on our daily lives, the need for mental health support is more important than ever. Anxiety is flooding our lives as we worry about loved ones, health, finances, stability, and how to best navigate a new normal. For individuals and families who grappled with behavioral health and mental health issues before the pandemic, the economic and social upheaval brought on by this crisis has compounded their struggles. Amid this extraordinary time of social-distance, isolation and limited human contact, telehealth has provided a lifeline, delivering critical care at a distance.

“Before the pandemic, we were just starting to have conversations about telehealth,” says Scott Louiselle, who oversees outpatient programs for Child & Family Services. “We were looking at ways to accommodate our families in any way we could. The coronavirus kicked this up to “ light speed. An initiative like this could easily have taken a year, and we were looking to implement in a matter of hours or days -- as quickly as possible so our families would not go without our service during lockdown.”

A telehealth consultant was hired shortly after the pandemic hit, to help the agency ramp-up their effort and do it the right way for both providers and clients. Issues of infrastructure, compliancy, security and etiquette all needed to be addressed. “Our goal was to make telehealth and live videobased interactions with our clients a normal part of RMHS operations,” says CEO Dick Courcelle. “The result has been a telehealth protocol that is managed well and is thus far performing well.”

The quick pivot to telehealth within Rutland Mental Health Services was due to an extraordinary effort by the IT team, led by Jit Singh. They first had to ensure that staff – working from home -- had the equipment, software and internet access to connect remotely to the agency. iPads had already been issued to all community-based staff as part of last year’s EMR rollout. “The fact that we had iPads out there that could easily convert to use for ZOOM put us ahead of the game,” says Singh.

Jit’s team worked round the clock to troubleshoot issues as they arose – everything from staff comfort levels, to increased bandwidth in the office, to expanded WiFi coverage into the agency’s parking lot for clients to access. Zoom, Doxy, and multiple other screen-sharing platforms were vetted, monitored, and pushed out to staff.

“It was like a crisis response,” says Doug Norford, Director of Child & Family Services. “Within about a two-week span, we went from doing very little or no telehealth, to it being our primary mode of service.”

Norford says one of the biggest challenges for Child & Family Services was connecting with their existing client families, and helping them find the right equipment, or connectivity. “We quickly found that some clients caught on very well, and preferred the remote access. It increased the level of parent engagement in some cases, and turned out to be very successful.”

“We found that, more than expected, families had the correct technology,” says Louiselle. “If that was an issue, we were able to bring them into designated conference rooms at the agency, to connect with their clinicians that way. We accommodated them anyway we could.”

Hillary Ward is the Director of Adult Services on the Behavioral Health side. She says technology has been a struggle for many adults in her programs – particularly the CRT population -- and staff has had to find innovative ways to connect with them. Some have spent long hours teaching clients how to use technology. But despite the difficulties for this population, Ward says telehealth has been essential to providing service during the pandemic. “The ability to lay eyes on our clients has made a huge difference. We can only do so much over the phone. The ability to see facial expressions, body language, and even their environment gives you that added connection.”

Some adult groups offered through telehealth brought unexpected insights. “We noticed fewer no-shows,” says Norford. “It really worked better for some participants. To be able to just walk into a room is a real time saver for that person. Moving forward, nothing prevents us from offering both.”

Nine months into this pandemic, the demand for mental health services is still growing. Intakes are up across the agency, along with the level of intensity. Continual access to health care services is critical at any time, but especially now when stress and anxiety are running high “Mental health is woven into every aspect of this pandemic,” says Louiselle. “Whether it’s working with someone who is having issues directly related to the pandemic, or someone with underlying needs that have been intensified by the pandemic, in both situations we’ve really had to take a look at what we’re doing, and make sure we’re doing it the right way.”

Singh says that currently, about ninety percent of the agency’s services are being done through telehealth. And although everyone is anxious to return to Covid-free life and more human connection, he acknowledges that telehealth is here to stay. “Knowing that you don’t have to put staff in harm’s way; knowing you are fully capable of doing your job remotely; offering flexibility to those we serve – these are some of the great advantages of telehealth.”

“It’s important to mention that telehealth is not one size fits all, says Louiselle. “What we’re realizing is that we really need to create a shared position around an individual or family, and offer flexibility to meet their given need. In some situations, we can get better outcomes through the use of telehealth.”

OUR GOAL WAS TO

MAKE TELEHEALTH

AND LIVE VIDEO BASED INTERACTIONS

WITH OUR CLIENTS

A NORMAL PART OF

RMHS OPERATIONS. ” - Dick Courcelle, CEO