ABSTRACT
Background: There is a relative paucity of data on the telehealth experience of health care providers. The present study helps to address this gap by examining the telehealth experiences of mental health providers. Methods: An IRB-approved anonymous survey (31 questions) was circulated in the state of Maryland at the Kennedy Krieger Institute, the Division of Child Psychiatry at Johns Hopkins University and at the University of Maryland, several community mental health practices, and professional organizations. Mental health professionals (physicians, psychologists, licensed social workers, nursing providers), and trainees (medical residents, post-doctoral fellows, and social work trainees) were eligible to participate in the survey. The survey focused on three key domains: patient care, work-life balance, and personal life. 175 providers participated in this survey Results: 75% of the respondents were female. 30% of respondents had been in practice for more than 20 years. 10% were trainees. The majority of respondents reported an overall positive impact of telehealth on their clinical practice. The comfort level with telehealth was high across the board. The impact on work-life balance and personal lives of practitioners was mixed with the highest negative impact (90%)reported by early-career practitioners. The majority of respondents reported a negative impact on education of trainees. Discussion: Several mental health disciplines were represented in the survey. Providers were comfortable with using technology and found benefits for patient care. Managing individual work schedules and maintaining the therapeutic relationship with patients seemed to be the areas of concern, especially for early-career providers. This may be due to relatively less control over their schedules and the presence of other competing responsibilities. Conclusion: The COVID-19 pandemic accelerated the establishment of telehealth services. The overall impact seems to be positive especially in the mental health field. In our attempt to understand the impact of this transition on the mental health providers, we found that there are specific trends for the degree of impact based on the duration of practice and field of practice of the providers. This information may help inform future clinical practices and policies, as telehealth will likely continue to be an integral part of medical care beyond the COVID-19 pandemic. References: 1. -19 and tele Health, education and research adaptations Wijesooriya NR, Mishra V, Brand PLP, Rubin BK. COVID-19 and telehealth, education, and research adaptations. Paediatr Respir Rev. 2020;35:38-42. doi:10.1016/j.prrv.2020.06.009 2. Donelan K, Barreto EA, Sossong S, Michael C, Estrada JJ, Cohen AB, Wozniak J, Schwamm LH. Patient and clinician experiences with telehealth for patient follow-up care. Am J Manag Care. 2019 Jan;25(1):40-44. PMID: 30667610.
ABSTRACT
Objectives: Successful management of chronic pain requires addressing physical symptoms and comorbid mental health conditions. Pharmacological and nonpharmacological interventions can be successfully provided by a multidisciplinary approach that is both effective and safe. This model can be delivered in different settings, including outpatient, intensive outpatient, and inpatient. In this module, we focus on assessing the patient’s presentation, establishing the appropriate level of care, detecting the need to transition or modify settings, and understanding the prevalent challenges due to the COVID-19 pandemic. Methods: Souraya Torbey, MD, will: 1) highlight the distinction between outpatient clinic program and intensive day treatment, with an emphasis on the advantages and challenges of each model;2) clarify the intensive day treatment programs, their types, and structures;3) discuss medical decisions in the appropriate level of care;4) review the referral processes;and 5) discuss treatment modalities in the setting of COVID-19, including telehealth. Results: Outpatient pain treatment programs allow the child to stay at home in a familiar environment. However, such arrangements may lack the intensity, consistency, and integration necessary to make progress. Intensive day treatment or partial hospitalization programs are a midway between inpatient and outpatient. They provide a smooth transition from inpatient to outpatient through the support of a structured treatment program. The COVID-19 pandemic has resulted in an increase in pediatric chronic pain and mental health issues, concomitant with a decrease in availability of in-person psychiatric and rehabilitation services. The development of telehealth/hybrid models arose to respond to these needs and to increase access for those who might not be close to big centers. We discuss the implementation of these virtual platforms in the outpatient treatment models of chronic pain. Conclusions: This presentation aims to explore the distinction between outpatient clinic and intensive day treatment, highlighting the advantages and challenges of each model respectively, including the effect of the COVID-19 pandemic. Attendees will also be equipped with the necessary tools to implement alternate multimodal approaches in communities where such multidisciplinary programs are scarce. MDM, PAH, TVM