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Community Success Story - Community Service Group (continued)
Implementing Telepsychiatry Services with High Customer Satisfaction
by Bruce Cohen, Aimee Tsikitas, Mary Chancellor, Susan Blue, Brian Levin, Idee Brown, M.D. Satisfaction with Telepsychiatry
Monitoring the effectiveness and satisfaction of telepsychiatry was an extremely important part of the quality assurance program. All of the organizations involved in developing this service were concerned about any resistance that consumers may have to interacting with a clinician remotely. To monitor these concerns, CSG instituted a brief, eight-question survey consisting of six Yes/No questions asking about the effectiveness of the session, one 5-point scale question asking the individual to rate the session from Poor to Excellent, and one open ended question asking for any other suggestions or comments regarding the program. Following each appointment, the survey was given to the individual receiving services by staff in Williamsport.
From June 2010 through December 2010, this survey was given after every telepsychiatry session. 312 surveys were administered and the results are presented in Table 1 and Table 2.
Table 1. Survey Results for Yes/No Questions
Table 2. Overall how would you rate your telepsychiatry visit today?
Respondents reported that they overwhelmingly felt comfortable using telepsychiatry (98.4%) and could hear (99.3%) and see (98.7%) their psychiatrist very well. Respondents were able to understand their clinician’s recommendations (99.4%) and the psychiatrist responded adequately to their questions and concerns (98.4%). 97.7% reported that they had an effective interaction with their psychiatrist. The average rating for the telepsychiatry visits was 4.12 out of 5.00. 73.4% rated their visit Very Good or Excellent. Although few comments were provided, they were primarily positive. Survey results were monitored monthly and showed little variation from month to month.
Discussion
The high satisfaction rates reported in the first six months since implementing telepsychiatry indicate the initial concern, that there would be resistance to telepsychiatry, were largely unfounded. Individuals utilizing telepsychiatry not only see and hear their psychiatrist, but overwhelmingly reported that they interacted effectively.
Several factors contribute to the high satisfaction rates. First, this service was developed through a partnership with key stakeholders. The resulting telepsychiatry service was not only focused on high quality services but also was designed to meet the financial, quality and regulatory needs of the various stakeholders. High satisfaction rates are also related to the quality of service provided at both ends of the video conferencing equipment. Each of the partners understood that while technology could increase access, the quality of the service delivered by clinical staff in Williamsport and the psychiatrist in Philadelphia would make or break the program.
High satisfaction rates are also related to the support given to individuals to help them become comfortable with telepsychiatry. This begins during the initial referral call when CSG Referral Management staff describe telepsychiatry to those requesting psychiatric services. At the first evaluation session, clinical staff remain in room site to assist both the patient and the psychiatrist with essential paperwork, referrals or collaboration with other clinicians or to answer questions. The clinical staff is then available to remain with the individual during ongoing medication monitoring appointments, as requested by the patient or doctor.
The Insight Telepsychiatrist also helps the individual acclimate to telepsychiatry by quickly engaging them in several ways. The Telepsychiatrist should be warm and allow his or her personality to come through immediately, rather than taking a more reserved approach, to eliminate any coolness for the technology. During the initial session, the Telepsychiatrist will greet the person and ask if they can see and hear adequately. The Telepsychiatrist may also ask if the person has ever seen a psychiatrist, often eliciting a response like "not on TV," providing an opportunity to discuss any concerns about telepsychiatry. Once engaged and comfortable, most people find that the TV disappears and they are able to communicate with their Telepsychiatrist like they are in the same room.
Conclusion
In implementing any new program or service, it is important to hear the voice of the customer to ensure that services are meeting their needs. This is particularly important when implementing a new way of providing a service. After implementing telepsychiatry in Lycoming and Clinton counties, CSG administered a brief satisfaction survey following telepsychiatry sessions. The results show with the right partners, careful planning and a high quality service, consumers will accept telepsychiatry and find it an effective treatment modality.
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