1. TeleHealth & Broadband Conference
October 19, 2012
Prattville, Alabama
A Story of Clinical Success:
the DMH Telepsychiatry
Consultation Program
11/06/12 Last Update: 10/18/2012 1

2. Overview
 the Problems – Timeliness and Hospital
Emergency Department (ED) Behavioral Health
(BH) Costs
 the Partnerships
 The Duke Endowment, SC Department of
Health and Human Services, SC Department
of Mental Health, and the SC Hospital
Association
 the Proposal – an initial Three-year Grant
 the Purpose – Achieving Tomorrow, Today
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3. Primary Goals
 Timely Psychiatric Assessment and Rapid
Initiation of Treatment
 Increased Quality of Care
 Reduced Lengths of Stay (LOS)
 Comprehensive Discharge Planning
 Savings to the Hospital and Community
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4. Partnership Baptist
Easley
Carolinas
Carolinas
Marion
Chester Clarendon
Diagram
Conway
Upstate Fairfield
Upstate George-
Carolina SC DHHS town
Wallace Grand
Thomson Strand
Wacca- Roper McLeod McLeod McLeod
tRMC Springs Laurens Hampton
maw Berkeley Seacoast Loris Dillon
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5. Remote Site Locations
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6. Clinical Office Locations
Columbia, Charleston,
SC SC
(2)
Aiken, SC Conway, SC
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7. Consultation Process
 Patient Presents in ED
 ED Physician Requests Consult
 Psychiatrist Reviews CIS/SCHIEx
 Patient Consulted
 Encounter Ends
 Psychiatrist Electronically Signs Consult
 Recommendations Sent to ED
 Hospital Dispositions the Patient
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8. Consults & Patients Kept (2012)
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9. Clinical Operations
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10. Diagnoses
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11. Dashboard - Time
 Current program impact results in a 44%
discharge rate for same day of consult for
those seen
 Even with a 40% increase in BH patients
presenting in ED’s, “Snapshot Average
Wait Times” (09/2009 v. 09/2012) have
not significantly increased (~2%)
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12. Turn-Around
 6.25 hours from initial ED request for
Telepsychiatry to patient discharge
(10/2012)
 11.9 consults every 18 hour day (09/2012)
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13. Data Resources
 CIS – DMH patients (past/present) *
 EMR – DMH Intranet-based medical
assessment form
 SCHIEx – ORS repository for multi-agency
database downloads *
* 75-80% ED patients known across both databases
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14. 11/06/12 Last Update: 09/11/2012 14

15. SC UCAP
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16. Palmetto State Providers Network
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17. Satisfaction Surveys
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18. Survey Results - Physician
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19. Survey Results - Patient
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20. R01 Grant Research
 Collateral Effect: Reallocation of
Resources by ED’s to ED-appropriate care
 Reduced Commitment Rate to BH
Inpatient Beds
 Reduction in Average Inpatient LOS
 Produced Savings of $1,800 in BH
Inpatient Settings per Care Episode
 Equals (approx) $23 M in BH Inpatient
Savings
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21. Sustainability – Revenues
FY 13
12%
36%
25% PRI OR YEARS
27%
TDE SC DHHS
SC DMH Hospit als
100%
TDE
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22. Website
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23. For more information, please go
to our website:
http://www.scdmh.org/telepsychiatry
or contact our program office:
Ed Spencer, Program Director
(803) 898-8579
Ralph Strickland, Coordinator
rns42@scdmh.org
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