A new telehealth venture is coming to the valley.
By midsummer medical practitioners will have access to psychiatrists 24/7, 365 days a year, thanks to a new contract between St. John’s Medical Center and Align Health, a national psychiatric startup company.
The service will mainly allow local health care providers to talk with psychiatrists to get treatment plans, as well as provide the option of therapeutic sessions if a patient requests that.
Telehealth means using telecommunications technologies to enhance health care, public health and health education.
IPads with access to those psychiatrists will be put in five locations: the St. John’s emergency room, the intensive care and urgent care units, another central location in the hospital and the St. John’s internal medicine clinic in Wilson.
Community providers who aren’t working for St. John’s Medical Center will also have access to the services.
Hospital CEO Dr. Paul Beaupre said a shortage of psychiatrists in the valley prompted the entrepreneurial effort, which allows locals to contact 2,500 psychiatrists remotely.
“We can’t go dark in psychiatric care in Jackson any longer,” Beaupre said.
There are two practicing psychiatrists in Jackson, Drs. O’Ann Fredstrom and Stuart Sugarman, a married couple, who can’t manage the entire county’s needs by themselves. Fredstrom, who provides services to most of the organizations working in the mental health field, as well as to private patients, said she will retire this year.
Facing a shortage
The St. John’s Hospital Foundation Mental Health Report indicated an impending lack of psychiatric services as an “important and urgent need” that if left unfilled would leave “a tremendous void.”
But when hiring psychiatrists is difficult nationwide, how could not just one but ideally, two or three or four be lured to Jackson?
“I could have gone out and tried to beat the trees,” Beaupre said, “but you can’t recruit just one psychiatrist.”
Beaupre said the amount of work to be done in a community this size is “pretty daunting” on top of the personal lifestyle choice to live in the valley. It’s also a challenge in similar resort communities like Sun Valley, Idaho, and Aspen, Colorado, which also grapple with one generation of psychiatrists retiring without enough younger doctors to take their place.
And no matter how talented local therapists are, there is a difference between therapists and psychiatrists, namely that psychiatrists can prescribe medication.
“You limit the services that are provided to a community based on the level of training that your providers have,” Beaupre said. “So we could have incredibly skilled therapists — and we do in Jackson — who are very good at their job.
“But there are patients in this community who need medication on top of just a counseling session … there’s a choke point to access.”
Beaupre said not all of the 2,500 psychiatrists on-demand need to be licensed, only five or six point people.
No psychiatrists, more angst
“Let’s take a world without psychiatrists,” Beaupre said. “If you have a psychiatrist-less community, everybody is frustrated. And that’s a big concern in Jackson.”
Beaupre said that everyone from therapists to emergency department doctors run up against a wall. While doctors are incredibly qualified, not all are going to have the knowledge of which antidepressant is better for a particular patient or the best course of action in a mental health crisis.
A pregnant woman, for example, might need to be on medication for postpartum depression. But without a psychiatrist, how does a doctor choose which medication to prescribe if they all have side effects?
“That’s where psychiatrists can sort through all of that and help you make that decision,” Beaupre said.
Beaupre also said more patients seeking psychiatric care are coming into the emergency room, something he called “not an ideal situation.”
The partnership with Align Health will allow doctors in the emergency room and elsewhere to have immediate access to specialists who can access the situation and provide advice. Specialties include adolescent patients, geriatric patients, addiction and bipolar disorder.
“The interface is not so much between the patient and the machine,” Beaupre said. “It’s between the provider — who has this information now — and the psychiatrist at the end of the line.”
The initial yearly contract with Align Health costs roughly $60,000. Therapeutic sessions with a psychiatrist cost an additional fee per click, so it could turn out to total a little more.
The personal connection
Beaupre admitted that he wasn’t completely sold on the second part of the telehealth contract — direct video sessions with a psychiatrist at a patient’s wish.
“This is going to be interesting,” he said. “And I’ll say that because if I personally needed to be in therapy, I think having that person-to-person interaction is really, really important. I’m trying to put my mind around the fact that we’re going to be doing this through an audio-visual component.”
However, adolescents who are familiar with a screen might be more at ease with the idea than those in older generations, Beaupre posited.
Beaupre also said the telehealth service isn’t meant to replace therapeutic sessions and he’s “not doing this in any way, shape or form to go into competition with the therapists in town.”
St. John’s is one of the first rural hospitals to take on such a telehealth program, which has been successful in other similar-size hospitals without a high number of psychiatrists.
“We’re piloting with them,” Beaupre said. “They’re hoping that this is a blueprint to take this model and offer it to a number of rural hospitals in the area.”
Beaupre is cautiously optimistic about the launch in services and excited for their impact on the community. He said the program has been approved in the budget and will be up and running when the next budget cycle begins by July 1.
“We’re really blessed,” he said. “This seemed to be the best of all worlds, to be able to bring this kind of opportunity to the community.”