Lyniate Team

Telehealth Visits for Mental Health Require an Interoperability Layer

June 15, 2020

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Coping with the stress of the pandemic is difficult for many of us. People are dealing with social distancing, isolation, and job security; caring for young children at home; worrying about getting the virus or spreading it to loved ones; and wondering when life will return to normal.

Access to behavioral health services is more critical than ever, and many providers of behavioral and mental health services are relying on telepsychiatry — a subset of telehealth — to care for patients remotely via videoconferencing platforms.

Telehealth is one of the fastest growing areas of healthcare, and behavioral health caregivers are using it to achieve better clinical outcomes, increase patient satisfaction, improve resource utilization, and lower costs. Behavioral health experts expect the trend of telepsychiatry to continue post-Covid.

“When the pandemic eventually ends, psychiatry and telepsychiatry will be transformed,” the authors of a May 2020 JAMA Psychiatry article stated.

Doing effective telepsychiatry visits, however, requires data sharing with different systems, including billing and scheduling systems, EHRs and practice management programs, and payers. This level of data exchange calls for a robust IT infrastructure, including a layer of interoperability.

A Telepsychiatry Use Case

The behavioral health/telehealth scenario is simple to envision: a patient presents behavioral health concerns, such as substance abuse or suicidal thoughts, in an emergency department late at night. The patient needs to see a psychiatrist as soon as possible but there isn’t one available.

Most hospitals cannot afford to have mental health specialists on standby 24/7 in the ED. However, by using telepsychiatry an appropriate physician can be engaged at a moment’s notice for a remote session with the patient. This means the patient will be treated sooner and the hospital can handle the encounter without having a psychiatrist on call — provided the patient’s information is available.

As with any healthcare session, a psychiatrist needs a significant amount of clinical information to appropriately treat the patient. They need to know things like what past problems has the patient had? What is their social environment and living situation? What medications are they taking?

All of this information is locked in the ED’s EHR and it’s not always practical or desirable to provide access to outside physicians. Therefore, it’s necessary to exchange data bidirectionally, between the ED’s system and the psychiatrist’s record of the patient. The ED needs to send a patient summary and later, receive a care plan back from the telehealth software. Naturally, the formats will vary between systems, and that’s where an integration engine becomes critical.

Most hospitals will already have an integration engine to transmit data to the outside world. However, not every telehealth or behavioral health EHR has a flexible way of receiving that data, which is why an integration tool is helpful on the receiving end as well. This allows data to be sent and received as well as seamlessly integrated into the receiving system’s database.

A comprehensive engine should also integrate into the event-based workflow of a hospital and listen for ADT messages relevant to a telehealth scenario. Using the previous example, this means the patient with behavioral health concerns can automatically be sent to the telepsychiatry service, starting the workflow by assigning a specialist to see the patient and requesting the clinical documentation from the hospital’s EHR.

By enabling the workflows and data interchanges related to telehealth, integration engines can help clients realize this new model of delivering health care, along with the cost and satisfaction improvements that come with it.


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