51.17 TELEHEALTH IN THE TIME OF COVID-19: EXPERIENCE FROM THE CONSORTIUM OF ACADEMIC PROGRAMS FOR TELEHEALTH

Abstract

Objectives The objective of this presentation is to describe the rapid transition of academic outpatient clinics to home-based telehealth (HBTH) in response to the COVID-19 pandemic. Telehealth (TH) includes the use of both telephone and videoconferencing in order to continue to safely deliver services during COVID-19. TH has entered mainstream mental health care, but most academic programs have not included HBTH, nor other TH opportunities, in their training. The COVID-19 pandemic revealed an important role for HBTH in delivering care during crises, as well as for updating training programs. Methods We describe the activities of a consortium of 8 North American academic programs that rapidly transitioned their outpatient clinics to HBTH. Each program completed a Qualtrics survey, reporting site-specific facilitators and barriers to rapid implementation, including patient populations, regulations, reimbursement, numbers of faculty and trainees, training of clinicians, and technology platforms. Descriptive statistics are reported. Results The sites were 50% public and 89% hospital based, and they served a mean of 38% Medicaid-insured patients. The patient populations were diverse in race/ethnicity and primary language. Prior to COVID-19, 78% provided TH and 33% allowed HBTH. Zoom was the most commonly used platform (56%); 33% identified software licensing as a barrier to TH ramp-up. The primary platforms were 100% HIPAA compliant, 33% integrated with interpreter services, and 33% integrated with electronic health records. Sites identified a lack of access to necessary technology or internet (78%), insufficient reimbursement (56%), patient/parent comfort with technology (56%), and patient/parent reluctance to participate (56%) as the most common barriers to HBTH. Site-specific barriers and facilitators were identified. Conclusions HBTH is a crucial service model to deliver mental health care to youth and families during crises. TH, including HBTH, is here to stay. Ramping up to implement HBTH during a crisis will encounter challenges that many academic programs are ill prepared to address acutely. Academic programs should train their faculty and learners in HBTH now to prepare for predicted future crises, as well as for the future virtual practice of mental health care generally. Best-practices protocols are needed to help programs to develop state-of-the-art HBTH services. TVM, AC, DS