Facilitated Roundtable Discussion
CS1-14 - Behavioral Health - Virtual Patient Navigation, Results from a Pragmatic Research Trial
Tuesday, May 1
11:35 AM - 12:00 PM
Location: Education Zone, Booth 2416, Zone 1
The number of patients presenting to emergency departments (ED) in the need of psychiatric care, continues to increase. With outpatient behavioral health resources and funding on the decline, oftentimes the attending ED physician must decide to admit a patient in lieu of discharge due to the lack of outpatient resources or the perceived inability of a patient to navigate a complex system. As a part of usual care, Carolinas HealthCare System currently offers 21 of its EDs 24-7 virtual access to licensed clinicians and psychiatrists who provide psychiatric evaluations and recommend dispositions (telepsychiatry). From a partnership with the Center for Medicaid and Medicare we developed and are evaluating a Behavioral Health - Virtual Patient Navigation program (BH-VPN), which provides short-term follow up navigation to patients receiving usual care. A patient navigator connects with the patient virtually prior to leaving the ED and then communicates during regularly scheduled calls and assists as needed in obtaining services or overcoming any barriers to treatment, for up to 45 days post ED discharge.
We designed a pragmatic, randomized research evaluation among patients in behavioral health crisis who present to an ED and receive a telepsychiatric consult. We describe team composition, design of the BH-VPN service, and enrollment status. The results herein focus on the effect this initiative has on the conversion from ED discharge to hospital admission.
Available evidence suggests that adoption and utilization of virtual care in tandem with wrap-around services may reduce utilization and improve health outcomes. However, variations in study designs limit our ability to draw definitive conclusions. By integrating virtual patient navigation into the existing telepsychiatry program, we expect to decrease the number of patients admitted for inpatient psychiatric treatment from the ED. The methods and results described here provide a template for conducting research to improve outcomes among behavioral health patients that present to an emergency department.
- Participants will possess a template for conducting research to improve outcomes among behavioral health patients that present to an emergency department.
- Participants will walk away with an understanding of lessons learned to implementing and managing a randomized research evaluation among patients in behavioral health crisis.
- Participants will be able to interpret the results of a virtual patient navigation program aimed at reducing conversion from ED discharge to hospital admission.