Telemental health visits: Are they effective?

An unplanned experiment

In early March 2020, the Integrated Behavioral Health Department at Reliant Medical Group, part of Optum Care, was providing outpatient mental health services in the usual way — with clinicians at primary care centers working face-to-face with patients.

Then, COVID-19 put an abrupt end to in-person visits. In a matter of days, the organization converted 98% of visits to telemental health — mental health services delivered with video.

The speed of the transition was impressive. But how confident were front-line clinicians that telemental health provided the same quality of care as in-person appointments? The answer had significant implications.

If virtual care was found to have less favorable results, the organization should push for a return to the office as soon as possible. If not, going back would be less urgent.

A front-line nurse practitioner, Shari Harding, took the question to the Reliant Practice Research Network.

Uniquely ready to answer urgent questions

The Practice Research Network is an academic-quality research team that partners with front-line clinicians to surface immediately relevant questions to inform day-to-day clinical practice.

Like an academic institution, it employs PhD researchers, biostatisticians and research assistants. But it isn’t dependent on grants.

Instead, the Practice Research Network is continuously funded by Optum Labs to answer questions that arise in the natural course of practice.

As part of Optum, it can also incorporate EHR (electronic health records) in its data sets and invest hundreds of hours of clinicians’ time in its studies.

The Practice Research Network sought to answer Shari Harding’s question rigorously enough to merit publication.

To do that, Ben Barnes, director of Practice Research Network, connected her to a team of clinicians and researchers, including Mara Eyllon, associate director.

Working within the strengths, opportunities, aspirations and results framework (SOAR), the team surveyed clinicians across five disciplines. Then, the team evaluated the data to guide practice.

Surprising findings

The results were unexpected. Clinicians surveyed didn’t simply see virtual therapy as “good enough” compared to in-person visits. Eighty-five percent found it superior for patients in many ways.

Telemental health visits let clinicians encounter patients in their own environments rather than in a sterile office. Clinicians could see who was living in squalor, lacking privacy or struggling with constant noise.

Patients could walk over to the medicine cabinet during calls to find expired medications in real time.

Broader benefits

Telemental health offers other benefits as well. Sixty-eight percent of clinicians said virtual care made it easier for them to balance their work and personal lives, reducing burnout. Office space requirements fell 75%.

Another study from Practice Research Network showed fewer cancellations and no-shows, resulting in the completion of 6,000 additional appointments per year. As a result, telemental health is now the preferred method for patient care at Reliant Medical Group.