Podcast: Is Telehealth Efficient?

In in the present day’s COVID world, many psychological well being sufferers are discovering themselves “pressured” into seeing their docs on-line reasonably than in individual. However how efficient is telehealth? What are the advantages and downsides? 

Immediately’s visitor is psychiatrist Dr. Frank Chen, who completely explains the entire new world of telemedicine and why it doesn’t must be scary. In truth, many sufferers, together with Gabe, have discovered it to be fairly handy!






Pc Generated Transcript for ‘Frank Chen – Is Telehealth Efficient?’ Episode

Editor’s ObservePlease be aware that this transcript has been pc generated and subsequently might comprise inaccuracies and grammar errors. Thanks.

Announcer: You’re listening to the Psych Central Podcast, the place visitor consultants within the subject of psychology and psychological well being share thought-provoking data utilizing plain, on a regular basis language. Right here’s your host, Gabe Howard.

Gabe Howard: Hey, everybody, and welcome to this week’s episode of The Psych Central Podcast, I’m your host, Gabe Howard, and calling into the present in the present day, we’ve got Dr. Frank Chen. Dr. Chen is a practising psychiatrist in Houston, Texas, who focuses on grownup psychiatry. Dr. Chen is the chief medical officer at Houston Behavioral Health Care Hospital and Houston Adult Psychiatry. Dr. Chen, welcome to the present.

Dr. Frank Chen: Hey, Gabe, thanks for inviting me to your present throughout these unusual instances.

Gabe Howard: Nicely, we’re very glad to have you ever and hear, we’re going to speak about telehealth. Now, telehealth has been round for a number of years now, however due to the worldwide pandemic and ensuing quarantines and social distancing, we’re listening to a lot extra about it. It’s even develop into a well-liked subject within the mainstream media. Now, this podcast has been sponsored for a number of years by BetterHelp.com, which is on-line remedy, which, in fact, is telehealth. So all this to say is that our listeners are fairly accustomed to the idea. However that is the primary alternative we’ve needed to talk about this with a supplier, with a medical physician about the usage of telehealth, for instance, to prescribe remedy or to diagnose. Is there a distinction between telehealth as used for remedy and the usage of telehealth for extra sophisticated or critical points?

Dr. Frank Chen: Definitely, all of us needed to adapt to a distinct means of getting medical care throughout this pandemic. As you guys all know, the physician’s ready room could also be a breeding floor for the unfold of varied totally different contagious illnesses. And so we don’t need to exacerbate the state of affairs. And numerous totally different regulatory companies and third-party payers have made the transition into telehealth far more accessible beginning March of 2020. We needed to actually speed up the development into nearly full transformation of affected person care to telehealth. This has been troublesome for each sufferers and in addition clinicians. All of us expertise technical difficulties related to partaking within the telehealth modality. However as we develop into far more accustomed to this modality, evidently there’s been far more optimistic approval of therapy via a telehealth platform. Most of our sufferers had been very hesitant about partaking with the clinician in digital trend. They’re used to the head to head and particularly in psychiatry, the place there’s an look of privateness within the confines of the 4 partitions. So, it took a while for adaptation. A few of our newer sufferers who had made appointments previous to the pandemic canceled appointments as a result of they needed to attend and see somebody in individual.

Dr. Frank Chen: Nonetheless, as time went on, an increasing number of sufferers are adapting to this platform. Increasingly clinicians are getting accustomed to this platform. Now, your query, Gabe, about whether or not or not it’s simply as advantageous getting therapy by way of the telehealth platform for remedy functions. And the reply is sure. In a latest Alkermes Harris ballot, it seems that on the time, one in 4 sufferers have began utilizing the telehealth platform. And 62% of the tele psychiatry customers surveyed say that they might not be capable of get the care they want with out the telehealth service. And 67% agree that the telehealth service that they’ve been utilizing helped them keep on with their therapy routine. We began entering into the telehealth platform out of necessity. However I believe that there’s broad adaptation at this level that persons are beginning to really feel that that is the norm reasonably than the exception.

Gabe Howard: My complete perspective of telehealth is from the affected person perspective. I’ve by no means been a physician, I’ve by no means been a clinician, I’ve by no means seen sufferers. So, it’s fascinating to me one thing that you just mentioned there, which is the practitioners are having bother adjusting. Are you able to discuss that a bit of bit? As a result of we simply assume that each one docs had been like, yeah, telehealth. We don’t have an issue with this. That is straightforward. But it surely sounds such as you’re saying that there have been some rising pains on their facet as effectively. And I believe that may make sufferers really feel quite a bit higher.

Dr. Frank Chen: When you have a look at the historical past of telehealth, it’s evident that there have been some crucial infrastructure that will enable this platform to happen. So telehealth has in all probability been performed round with for the final three many years. And initially you mainly wanted gear that’s tens of hundreds of {dollars}. And due to regulatory necessities and in addition third-party necessities, these well being platforms had been remoted to rural areas and possibly the jail system. And it was over the last decade when there’s far more bandwidth and in addition the portability of know-how that we began seeing telehealth getting used on a retail degree. I bought to let you know, I had been utilizing telehealth as a part of the choice for our sufferers, my workplace is the suburban space in Houston, and we typically see working clientele. And though there’s a comfort issue the place you don’t must drive into the workplace, evidently most of our purchasers had been very a lot entrenched in coming in seeing us within the confines of our workplace as a result of they do really feel safe in there. Particularly for psychological well being therapy. And it’s not till this pandemic that there was international adaptation to this platform. Evidently our sufferers are beginning to ask for telehealth now reasonably than wanting to return into the workplace. And it’s due to the comfort issue. We appear to expertise far more of a relaxed setting with telehealth sufferers of their properties. And we really are making house visits. We get to see a slice of their on a regular basis life. We’re capable of seize clientele that we usually might not be capable of seize. So, as an illustration, I’ve a affected person with schizophrenia who refused to take medicines and he or she would find yourself within the hospital due to exacerbation.

Dr. Frank Chen: And for the reason that creation of know-how and telehealth, I’ve been capable of do house visits along with her and was capable of see that she has a stunning household who’s caring for her, that her home is clear and he or she was partaking. The affected person would find yourself within the hospital a couple of times a 12 months due to noncompliance with medicines, however as a result of I used to be capable of beam myself into her home, I used to be capable of deal with her. So, it actually opens up availability of therapy for sufferers. As a result of among the rules have been relaxed by the federal entities and state entities that govern the follow of medication. We at the moment are capable of prescribe medicines and set up new affected person appointments via telehealth. And this has actually been a godsend for lots of sufferers who’re unable to return into the workplace or who’ve difficulties navigating that workplace go to. Sufferers are displaying up at practically 100% present fee as a result of it’s fairly handy. They don’t must drive in and we’re capable of seize a slice of their life. Now, there’s some disadvantages. Chances are you’ll be sharing a room with relations or you might have roommates and also you don’t essentially have the privateness. Typically if you do these telehealth appointments from a clinician’s perspective, we’ve seen bizarre locations the place folks determine to interact in telehealth therapy. I’ve performed remedies with sufferers whereas they’re operating. I’ve performed remedies with sufferers whereas they’re partaking in dinner. So it truly is a problem generally getting them to noticeably take part within the topic at hand from a doctor’s perspective. However we’re capable of do the whole lot that we do in workplace with this platform.

Gabe Howard: Now, you’re a medical physician, if someone involves you and says, I really feel like I’ve a psychological well being situation, can you meet with them and provides them a analysis with out ever sharing house with them simply over video chat, Skype or Zoom?

Dr. Frank Chen: Completely. Gabe, you bought to do not forget that psychiatry is a is an space the place correct historical past taking is what we want. We’d like data on sufferers’ background. We’d like data on their signs. And people are all expressed vocally. Now, generally, , it does assist to see the sufferers and see their habits, however for probably the most half, to reach at an correct analysis, it’s historical past taking. Though we’re not in the identical house on the identical time, we are able to get some minimal data visually via tele psychiatry. And so long as we’re capable of precisely get to the related data that assists in making an correct analysis, we don’t actually must be in the identical bodily house. I really suppose that generally it’s extra crucial for remedy. While you’re doing remedy, you may very well lose some data when the affected person just isn’t within the room. As an example, generally the therapist might purposely introduce the awkward silence and see what occurs to the affected person. It’s much less probably that the affected person can be uncomfortable on a digital platform as a result of there’s a scarcity of personalization nearly. They’re on digital camera. From my perspective, evidently so long as I can get knowledge, whether or not from the affected person, whether or not it’s from the household, I’m capable of give you a comparatively correct analysis.

Gabe Howard: We’ll be proper again after we hear from our sponsors.

Sponsor Message: Gabe right here and I needed to let you know about Psych Central’s different podcast that I host, Not Loopy. It’s straight discuss concerning the world of psychological sickness and it’s hosted by me and my ex-wife. It is best to test it out at PsychCentral.com/NotCrazy or your favourite podcast participant.

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Gabe Howard: And we’re again discussing telehealth with Dr. Frank Chen.

Gabe Howard: I take into consideration earlier than the pandemic, and folks would say to me, Gabe, what do you concentrate on telehealth? I imply, telehealth goes to be a factor. They’re doing the whole lot on the Web. What do you concentrate on seeing a physician on-line? And I didn’t prefer it. Gabe Howard was not a fan of telehealth. I understood it for remedy. Individuals are busy. Relying on the kind of remedy you want, the place you’re at, and so forth., maybe this might be a superb factor. And naturally, I all the time left room for nevertheless folks discover restoration is their very own enterprise and it’s not my enterprise. However personally, I used to be not a fan. After which, in fact, the pandemic occurred. I wanted to see my psychiatrist. The one means that I might see my psychiatrist was via telehealth. I made the appointment and I assumed, hey, I want a med refill. And she or he’s unwilling to do it except I do that telehealth factor. So, I leap via the ring out of full necessity. I need to be very clear. I used to be pressured. I used to be pressured to do it. It was unimaginable. I cherished it. I bought to attend in my own residence. I didn’t must battle site visitors. It was good. She talked to me for twenty minutes. I bought all my medicines refilled. I’m now full 180. I’m a whole fan. Are you discovering the folks which can be quote unquote pressured into this are having related outcomes? 

Dr. Frank Chen: So, Gabe, you’ll be glad to know that you just’re in all probability one of many regular folks round with that have. That’s the hallmark of what I’ve seen as we provide telehealth via the final 5 to 10 years in my workplace. Nobody needed to do it. And once more, if you find yourself somebody within the rural neighborhood and you don’t have any suppliers round and the one place you could get care is at a neighborhood psychological well being heart and thru telehealth with a physician in a metropolitan space, it’s important to do it. However there was not an entire lot of adaptation. Once more, folks really feel that there’s a reference to the clinician if you go in there and see them and so they’re prepared to spend an hour driving to a psychiatrist, an hour ready within the ready room, after which one other hour going again house. However since we had been all pressured into this, the ideas have modified. The preliminary response for our sufferers is that they don’t need to do it. A number of the new purchasers canceled as a result of they needed to check out the clinician in individual. A few of them canceled the appointments and say, we’ll wait till this pandemic is over.

Dr. Frank Chen: Clearly, it’s not over but and so they must get their medicines. And so we’re all pressured at this level to interact on this platform, whether or not you’re in well being care, whether or not you’re in enterprise. And so the extra that we have interaction with sufferers on this platform, the extra happy the sufferers are with the comfort of this platform. Individuals are really calling in saying, hey, are you continue to doing telehealth? Are you continue to offering care over the Web? As a result of I don’t have time to drive in there. There’s a whole shift within the idea of telehealth. They’re not interested by the uncomfortableness of speaking nearly. They’re requesting it as a result of it’s far more handy. And I bought to let you know, Gabe, that is opened up therapy for lots of my sufferers. 

Gabe Howard: I’m very lucky, I stay in central Ohio, which is a really huge metropolitan space. I’ve quite a lot of choices. I may be very choosy. I can. I’ve very area of interest choices that aren’t accessible in, say, the small city that I graduated highschool in. And I take into consideration that small city. I believe there was 3,000 to 4,000 folks there. We didn’t also have a hospital. We didn’t have a movie show. We didn’t have a bowling alley. It was a really small city. And as such, all people knew all people. So, if I had a really particular drawback or I needed to see a really area of interest therapist, one they won’t be accessible, however two, even when they had been accessible, all people would see me stroll within the door and so they’d be like, oh, Gabe goes to that, , area of interest therapist. And now all people would know that I had this subject or probably had this drawback. The gossip mill would begin. That is resolved by way of telehealth, is it not? You will discover that area of interest therapist wherever in America and you’ve got extra of an expectation of privateness since you by no means really go away your individual house.

Dr. Frank Chen: I believe that at this level, your therapist is an in-home therapist, your psychiatrist is an in-home psychiatrist, it’s not a chore to drive two hours away in case you’re dwelling in a rural city to see a psychiatrist who can give you the care. It’s as handy as filling out a kind on-line to request an appointment. The broader adaptation of telehealth has additionally made clinicians far more snug about accepting sufferers who stay 100 miles away. Individuals across the nation can all obtain excellent care from anybody practising inside their jurisdiction. And it is a big transformational second in our trade. Individuals are not restricted to these choices inside their confines. They will search out applicable assist in any distant locale as conveniently as driving down the road. That is actually a godsend for lots of sufferers who’re caught by way of not with the ability to get ample psychological well being care, particularly in these rural areas.

Gabe Howard: One of many criticisms that I hear is that it’s important to be tech savvy, it’s important to have a pc, it’s important to have quite a lot of bandwidth, it’s important to perceive how computer systems work. After which folks begin saying issues just like the older era doesn’t know easy methods to do it or rural areas don’t have good Web or what in case you don’t personal a pc? Are these simply excuses? Is this really a actuality for folks or are you discovering that that is actually comparatively easy? And, effectively certain, there’s someone that will have an issue with it, by and huge, it is a very simplistic course of that persons are embracing and aren’t scuffling with in any respect.

Dr. Frank Chen: I believe over the past six months, as we’re thrust into this platform, firms are adapting to the wants of each the clinicians and the sufferers. They’re making this course of simpler and simpler. Your telehealth session may be began by a clinician with a hyperlink to your textual content and also you press on the hyperlink and also you’re related. Previously, there’s actually some challenges. A number of the firms that present this tele psychiatry platform might make you join an account. You’ll have to signal right into a ready room. You’ll have to attend round not figuring out your standing. However over the past six months the businesses that present these platforms are working with clinicians in addition to sufferers to refine the method in order that it may be simplified for lots of sufferers, even aged sufferers. We do have challenges by way of bandwidth, however we are able to all the time reconnect. After getting used to a platform, we all know among the typical difficulties that we might encounter. As an example, generally when you’ve a name coming in, as you’re doing all of your telehealth session, your telehealth session could also be dropped. And everyone knows that now and so we are able to reengage with the sufferers. It’s actually a strategy of adaptation, however I believe we’re all, as a society, getting used to having our well being care delivered on this trend.

Gabe Howard: Dr. Chen, how has the trade responded to this? Something coming from insurance coverage firms or payer sources that makes telehealth both higher or worse?

Dr. Frank Chen: Gabe, I believe quite a lot of our third-party payers, Blue Cross Blue Defend, Cigna, they perceive the necessity for sufferers to remain out of ready rooms throughout the pandemic. They’re much extra receptive concerning the telehealth platform. And as a matter of reality, there’s one other facet of this telehealth that’s being launched. The Facilities for Medicare & Medicaid Providers have relaxed quite a lot of guidelines related to face-to-face visits. So I work at a hospital referred to as  Houston Behavioral Health Care Hospital in Houston. As we began getting ready for the pandemic, we additionally began organising the infrastructure for telehealth in an inpatient setting. That is to ensure that the docs don’t find yourself spreading airborne viruses to their sufferers as they’re making rounds. That is actually a metamorphosis in the way in which during which we take into consideration getting care in an inpatient setting. It’s been considerably profitable. You actually take care of a a lot increased acuity of sufferers who’re manic sufferers who’re psychotic within the setting. However we’re capable of seize most of their habits with collaboration and supply ample look after our sufferers with out that face-to-face go to.

Gabe Howard: From the angle of a physician, from the angle of a supplier, is there something that you really want sufferers to know that you’ve got discovered being on the supplier facet of telehealth?

Dr. Frank Chen: I’ve bought to inform the viewers that don’t be afraid to interact on this platform. You’re going to adapt to this identical to you adapt to the whole lot else. And it’s so far more handy for my sufferers to get care wherever they’re situated. It’s a easy strategy of getting the remedy electronically transferred to their native pharmacy. It’s problem free by way of making appointments with a few of these platforms. And so I’d like everybody to attempt to embrace this platform as a result of I do consider that that is going to proceed after the pandemic.

Gabe Howard: So it sounds such as you suppose that telehealth is simply going to get larger and greater and that you just like that concept, you don’t see that as a step backwards. That could be a huge step ahead.

Dr. Frank Chen: Completely, I believe that clinicians are adapting to this platform. They will work wherever they need, they’ll transmit prescriptions to any pharmacy. It’s really making the work circulate quite a bit simpler. You might have quite a lot of clinicians who’re half time clinicians and so they’re prepared to return on-line now as a result of it’s very straightforward for them to rearrange their schedules. You might have far more availability of care with this platform. And I believe that individuals will settle for this platform in psychiatry and this can proceed. We lose some knowledge by way of not having the head to head engagement. It’s troublesome to see nervousness in some sufferers after they’re simply staring on the digital camera, however they’ll let you know. Regardless of shedding some knowledge, we additionally achieve quite a lot of data. We are able to see the sufferers of their pure setting. We are able to see whether or not or not they’re really getting taken care of. We are able to visualize points of their life that could be worrisome as a result of we’re making that house go to. And so there’s large benefits to persevering with with this platform. And I believe that our future can be a mixture of face-to-face, but additionally a great deal of telehealth included within the care of psychiatric sufferers.

Gabe Howard: Dr. Chen, thanks a lot for being on the present, we actually appreciated having you.

Dr. Frank Chen: Thanks, Gabe.

Gabe Howard: Thanks to all of our listeners for tuning on this week to The Psych Central Podcast. Wherever you downloaded it, please subscribe. Additionally, fee us, rank us, use your phrases and inform folks why they need to hear too. Additionally share us on social media. We love that. Talking of social media, we’ve got a secret Fb group that I’d like to ask you to hitch. Right here’s a fast hyperlink to search out it: PsychCentral.com/FBShow. And keep in mind, you may get one week of free, handy, reasonably priced, non-public on-line counseling anytime, wherever just by visiting BetterHelp.com/PsychCentral. We’ll see all people subsequent week,

Announcer: You’ve been listening to The Psych Central Podcast. Need your viewers to be wowed at your subsequent occasion? Characteristic an look and LIVE RECORDING of the Psych Central Podcast proper out of your stage! For extra particulars, or to ebook an occasion, please e mail us at show@psychcentral.com. Earlier episodes may be discovered at PsychCentral.com/Show or in your favourite podcast participant. Psych Central is the web’s oldest and largest impartial psychological well being web site run by psychological well being professionals. Overseen by Dr. John Grohol, Psych Central provides trusted sources and quizzes to assist reply your questions on psychological well being, persona, psychotherapy, and extra. Please go to us in the present day at PsychCentral.com.  To study extra about our host, Gabe Howard, please go to his web site at gabehoward.com. Thanks for listening and please share with your pals, household, and followers.


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