InnovaTel Telepsychiatry

1. InnovaTel Telepsychiatry Jonathan Evans President & CEO InnovaTel Telepsychiatry

2. Course Objectives • Define telemedicine • Discuss trends in telemedicine • Telemedicine providers

3. What is Telepsychiatry • Telepsychiatry is the application of telemedicine to the specialty field of psychiatry. The term typically describes the delivery of psychiatric assessment and care through telecommunications technology, usually videoconferencing.[1] Telepsychiatry services can be offered through intermediary companies that partner with facilities to increase care capacities, or by individual providers or provider groups. Most commonly, telepsychiatry encounters take place at medical facilities under the supervision of onsite staff.

4. Current Trends • Significant increase in demand • Accountable Care Act • Improved programming enhancing access to care • Systematic downsizing and closing of the long term (State Hospital) level of care • Increase in merger & acquisitions creating large provider organizations

5. Current Trends • Shortage of qualified clinicians, Psychiatrist, Certified Nurse Practitioners, Licensed Clinical Social Workers • Challenging pace and complexity of regulatory requirements • Complexity and acuity of patient presentation • Movement to Integrated care • Improvement in psychopharmacology

6. Health Care Costs Continue To Rise SOURCE: U.S. Department of Health & Human Services. (June 2006). The High Concentration of US Health Care Expenditures.

7. Demand For Psychiatry Increasing SOURCE: *Geriatric Mental Health Foundation

8. Psychiatrists by Age

9. The Challenge for Community Clinics • Over the past 22 years have had over 25 psychiatrist • At best uneven/inconsistent care for patients • Wide range in prescribing patterns • Locums option is costly and quality is in question • Significant challenges with access to care

10. Lessons Learned • Each community based clinic is unique • Each state has a unique set of regulations • Licensing and DEA requirements can be time consuming and costly • Development of tech specs

11. Lessons Learned • Telepsychiatry is an effective modality in maintaining quality of care across several locations and populations • Treatment outcomes and patient satisfaction scores are essentially the same as traditional psychiatric care • Access has been enhanced in rural and correctional settings

12. Future Trends • Increasing acuity & co-morbidity • Estimates of adult mental illness from 2011/2012 based on SAMSHA National Survey, indicates among adults 18 and older, the rate of SMI equals 4% or 9.3 Million • U.S. Census data estimates that approximately 4,329,680 individuals will turn 20 years old each year • Using the rate of 4% we can estimate that approximately 173,182 new individuals will be SMI each year SOURCE: SAMHSA. (February 2014). State Estimates of Adult Mental Illness from the 2011 and 2012 National Surveys on Drug Use and Health

13. Positive Changes • Recent legislation waiving state licensing requirements for telepsychiatrist providing care to active duty service members. Congressman GT Thompson has provided the leadership at the federal level • Additional legislation proposed to include licensing across State lines for Medicare patients care • Medicare & Medicaid in all states cover telepsychiatry • 30 states have legislation requiring private payers to cover telepsychiatry • Movement towards reciprocal licensing between states SOURCE: American Telemedicine Association. (May 2015). State Telemedicine Gaps Analysis: Coverage & Reimbursement.

14. Jonathan EvansPresident & CEO InnovaTel Telepsychiatry LLC jon.evans@intelpsych.com 814-434-6315