Clinical Services

ePoster Presentation

(EP-106) Clinical Utility of Tele- Behavioral Health in Pediatric Mental Health Emergencies in the ED/UC Setting

Monday, April 24
4:00 PM - 4:14 PM
Location: Experience Zone - ePosters

Objectives
Evaluate differences in quality of care (time to disposition, transfer v. discharge and both patient and provider satisfaction) among children who received MHE at distant ED/UC sites utilizing Tele-Behavioral Health evaluation by MHS v. traditional evaluation by sending patients to the central location for same MHS evaluation.

Methods
Retrospective data collected from effort measured participation, utilization, economic evaluation to estimate the cost, effectiveness of telemedicine-enabled behavioral health consultations provided to children with behavioral health concerns over a one-year period from January 1, 2015 to December 31, 2015 within a children’s health system. Our primary data included 500 children and adolescents who presented to five distant urban-based network of acute care facilities and received either a tele-behavioral health evaluation or traditional in person evaluation to determine disposition, including discharge home for outpatient therapy v. transfer and/or admission for additional treatment. Patient and provider satisfaction with Telehealth was evaluated with a survey administered at visit completion.

Results
Type of disposition as to whether they were discharged to home or transferred to main facility was significantly different between groups (p < .001), Median charges were sig different ($3,493 vs $8,611, p < .001), and total wait time to disposition was significantly different (7 hrs vs. 10.4 hours, p < .0001). Patient and provider satisfaction Telehealth satisfaction scores for highly to extremely satisfied was 97%.

Conclusion
Our study indicates that the introduction of tele-behavioral health access achieved the aim of reducing patient transfers, lowering costs of care delivered, reducing the wait times for patients in the ED/UC setting, with improved satisfaction compared to the traditional model of care. This modality appears to have the potential to improve access to critically important MHS, increase provider and system capacities and may represent the optimal system for evaluation of patients with MHE's in the future.

John F. Thomas

Director of Telemedicine, Director of ECHO Colorado
Childrens Hospital Colorado, University of Colorado School of Medicine

Dr. John F. “Fred” Thomas holds a PhD in Psychiatric Epidemiology from the University of Texas Medical Branch, and is Director of Telemedicine for Children's Hospital Colorado and Director of ECHO Colorado for University of Colorado School of Medicine. Current work includes approximately 100 telemedicine efforts with 26 medical specialty areas.

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Lindsey Shaw

Clinical Practice Specialist
Childrens Hospital CO

Lindsey Shaw has been a nurse for 14 years, working exclusively within the field of pediatrics at three separate pediatric hospitals. Her experience ranges from the emergency room (ED)/urgent care (UC) setting, inpatient medical/surgical units and intensive care. For the past 7 years, she has functioned in the role of a Clinical Nurse Specialist for three urgent care, emergency departments and inpatient units within a larger pediatric tertiary hospital.
Her role includes the development, implementation and evaluation of departmental, divisional and organizational goals by participating in the quality improvement and research activities including problem identification, data collection and monitoring of department results. She advocates for the empowerment of patients, families and nurses by serving as a resource and clinical expert.

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Christina A. Olson

Pediatric Hospitalist
Children's Hospital Colorado

Christina Olson is an assistant professor of pediatrics at the University of Colorado School of Medicine and the telehealth medical director for Children's Hospital Colorado with interests in telehealth, global health, systems-based practice and patient safety. As a hospitalist she currently provides neonatal and pediatric inpatient care in both tertiary care academic medical centers and community hospitals, with previous experience as a primary care pediatrician in a remote location. She also serves as a Navy Reserve medical officer with 11 years of military service including humanitarian deployments to Asia and several years on active duty.

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Gerard Frunzi

Telehealth Services Manager
Children's Hospital Colorado

To be Filled in Later

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Alison Brent

Medical Director Network of Care Integration
Childrens Hospital Colorado

Dr. Brent is an Associate Professor of Pediatrics at the University of Colorado School of Medicine and Medical Director for Network of Care Integration at Children’s Hospital Colorado. She is an Attending Physician in the Emergency Department at Children’s Hospital Colorado. Her current administrative duties, research and outreach efforts are focused on new program development for the Network of Care at Children’s Hospital Colorado, which includes strategic initiatives in conjunction with the Director of Telemedicine to create innovative solutions for patient care and access throughout a seven state region. She is active in the APP where she chairs a subcommittee for the Section on Telehealthcare Medicine. Dr. Brent completed her residency in Pediatrics and fellowship in Pediatric Emergency Medicine at the Boston Children's Hospital.

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Assets

(EP-106) Clinical Utility of Tele- Behavioral Health in Pediatric Mental Health Emergencies in the ED/UC Setting



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