Gastonia, North Carolina-based, 435-bed CaroMont Regional Medical Center is the anchor facility of a five-county, two-state, not-for-profit health system and value-based care provider, CaroMont Health. The medical center features a Level III trauma center.
The hospital has approximately 250,000 patient encounters every year, and because of its location in the growing Charlotte region, continues to experience increases in patient volume.
With these volume increases, the emergency department has been affected most acutely by the increased patient load, especially for patients seeking psychiatric services.
“By having a psychiatric nurse assessor interact with the patient to address immediate concerns and gather information first, the telemedicine psychiatrist receives a more thorough background and review of the patient’s unique needs.”
Char Biamonte Stockl, RN, CaroMont Health
The medical center needed a scalable technology that enabled its psychiatrist to focus efforts on inpatient care. Clinical leadership turned to telemedicine technology and services vendor SOC Telemed to help ensure patients have expeditious access to appropriate psychiatric consultation.
“The health system reached out to SOC Telemed and began the preliminary work to implement the vendor’s Telemed IQ platform and thereby extend provider resources in the emergency department,” said Char Biamonte Stockl, RN, director of psychiatric services at CaroMont Health.
“The neurology department at CaroMont Regional already used Telemed IQ for its nationally recognized stroke program, so integration of psychiatric services into the existing platform made sense,” she added.
Today, CaroMont Regional uses the telemedicine platform and SOC psychiatrists in cases where the decision to discharge or admit the patient is unclear to the attending emergency department physician and when the on-staff psychiatrist is not immediately available.
“With faster, specialized determinations from on-demand psychiatric experts, patients receive consultation more quickly,” Stockl explained. “This creates efficiencies in the emergency department and helps patients move to the next stage of care more quickly.”
There are many vendors on the market today offering telemedicine technology, including American Well, Avizia, GlobalMed, MDLive, Novotalk, SnapMD, Teladoc, TeleHealth Services and Tellus.
MEETING THE CHALLENGE
The collaboration between CaroMont Regional’s psychiatric nurse assessors, emergency department physicians and the SOC Telemed psychiatrists has been critical in making this partnership work for patients and the hospital, Stockl said.
“By having a psychiatric nurse assessor interact with the patient to address immediate concerns and gather information first, the telemedicine psychiatrist receives a more thorough background and review of the patient’s unique needs,” Stockl noted.
“The nurse assessor,” she continued, “then remains in the room with their patients during the telemedicine assessment and serves as a communication bridge between the telemedicine psychiatrist, the patient and the emergency department physician. Both physicians then work together to develop a plan of care.”
Since launching tele-psychiatry, the emergency department has reduced length of stay for psychiatric patients by approximately 70%. Addressing and treating this patient population more efficiently has meant that the emergency department has realized better patient flow for the unit overall, creating efficiency for patient flow across all areas of the department.
CaroMont now offers 24/7 psychiatry coverage, supporting onsite staff in cases where the decision to discharge or admit is unclear without a specialist consult, successfully reducing its annual Code Purple (overflowing ED) hours from 1,700 to just 148. With decreased consultation times and shrinking transfer rates, CaroMont is providing better patient quality of care and improved tele-psychiatry program workflows.
ADVICE FOR OTHERS
“Telemedicine can be a very effective tool in your program’s toolbox,” Stockl advised. “From efficiencies in patient flow to alleviating significant patient loads from employed providers, telemedicine can help extend your medical and clinical staff while ensuring your patients get the highly specialized care they require.”