The video screen shows a man’s face, and the picture is startlingly clear. With just a touch, the camera can center on his eye or zoom in to focus on his hand.
In South Carolina, Drs. Brenda Ratliff and Frank Clark are using sophisticated technology like this to change the way mental health crises are handled in hospital emergency rooms across the state. The unique system uses telemedicine to link 20 hospitals to each other and to psychiatrists, even though they may be miles apart.
“Through telemedicine, we’re helping emergency departments in all reaches of the state provide timely consultations and crisis stabilization,” says Dr. K.D. Weeks, the Trustee who leads The Duke Endowment’s Committee on Health Care. “Instead of waiting days, patients can receive a consultation within hours.”
The idea for the network took root through collaboration among the Endowment, the South Carolina Department of Mental Health and the South Carolina Hospital Association. Many people experiencing a mental health crisis were waiting in a crowded emergency room longer than necessary because psychiatric help wasn’t available. Through telepsychiatry, the emergency room physician and the consulting psychiatrist can determine if patients may be safely discharged and referred to treatment, or if hospitalization is needed.
Leaders launched the South Carolina network at Baptist Easley Hospital in Easley in 2009. Since then, the system — which is now a national model — has provided 14,500 consultations. Five full-time Department of Mental Health psychiatrists offer services 16 hours a day, seven days a week.
In 2012, the University of South Carolina School of Medicine received the first of two awards from the National Institutes of Health to evaluate the telepsychiatry network’s impact on quality and savings to the health care system. Already, the data are showing improvements in patient compliance with treatment plans, a better patient and provider experience, and more efficient use of hospital resources. Instead of a two- to three-day wait for assessment, the average wait is now just six to eight hours.
“Is this the future? Absolutely,” says Dr. Brenda Ratliff, the program’s medical director at the Department of Mental Health. “There aren’t enough psychiatrists, especially in rural areas, and the demand for services is only growing. This is an effective way to get professional help to people who are really hurting.”