Building Lasting Tele-Behavioral Health Programs to Address Patient Needs

Kat Jercich, Healthcare IT News.

August 2021

In a HIMSS21 Global Conference Digital session, two experts discuss what it's taken for the University of Rochester to spin up a virtual behavioral health program over the past nine years.

Telehealth during the COVID-19 pandemic has allowed many patients – especially those in under-resourced areas – unprecedented access to behavioral healthcare.

But as Michael Hasselberg, senior director of digital health at the University of Rochester, discussed with Cleveland Clinic Director of Design and Best Practices Julie Rish during a HIMSS21 Global Conference Digital session, such programs have required being nimble and adaptable in the face of changing needs.

Hasselberg outlined the results of a tele-behavioral health model in effect at the University of Rochester, explaining that it grew from a pilot program aimed at primary care doctors to a full-scale initiative in nearly a decade.

But the pandemic, he says, ramped up demand – and the supply had to change in response.

"Like every health system in the entire country, overnight you had to flip the switch on, and essentially totally pivot to telemedicine," he said.

Having the infrastructure and years of experience allowed the team to shift within about a week to providing behavioral health services nearly entirely virtually. Even as vaccines have become more readily available, Hasselberg estimates that about 60% of the team's ambulatory services are being provided via telemedicine.

Interestingly, considering reports from other parts of the country, Hasselberg said the team has not encountered patient difficulties with broadband access, even in rural areas – thanks in part to state government efforts to ensure connectivity throughout the region.

But one challenge, he said, has been gaining community trust and support.

"Learning to build those community partnerships, identify how the stakeholders are, doing focus groups … has allowed us to be successful," he said.

For other organizations looking to replicate the university's success, he said, start by reaching out to providers already in place.

"Build that partnership there. Find out where their struggles may be, where the gaps may be, how you can join forces to fill those gaps and truly partner," he advised.

He also suggests approaching the programs as iterative – being agile and flexible, and not allowing perfect to be the enemy of good. "Just get something out there: See what works and what doesn't work, and continue to build off of that," he said.

It's also vital to remember that not every service can be done via telehealth, he said. Having a support network to assist patients with technology is enormously helpful.

Rish noted that it's not just about access alone. It's also about comfort and about trust.

"Having somebody from your team who can get to the community, who can be onsite – that's really important," said Hasselberg.

Hasselberg said it's been useful to examine who can most benefit from telehealth because of transportation hurdles or other barriers to in-person care.

"Finding parking at an academic medical center is not an easy thing to do!" he laughed.

By merging that information with electronic health record data, he said, the team can get specific about how best to target services.

As far as care delivery predictions, Hasselberg said he saw telemedicine as the "tip of the iceberg."

"I think the future of behavioral health will be an a la carte array of options," he said.