Posted: September 30, 2019
On Tuesday, April 24, 2018, the Senate Committee on Health, Education, Labor & Pensions (HELP) unanimously passed the Opioid Crisis Response Act of 2018. This bipartisan committee consulted with officials and subject-matter experts from the US Food and Drug Administration (FDA), the Centers for Disease Control (CDC), the National Institutes of Health (NIH), the Substance Abuse and Mental Health Services Administration (SAMSHA) as well as mental health experts, state governors and families affected by drug abuse to establish initiatives for responding to this health crisis.
A key component of their response involves increasing the utilization of Telemedicine.
The growing presence of electronic technology in the health service professions is redefining the boundaries of counseling services. Commonly referred to as telehealth, utilization of electronic communication strategies to expand connectedness has opened new frontiers in behavioral health through applications ranging from digital phones, interactive video sessions, to virtual supervision. Substantial research suggests that telehealth is generally equal in effectiveness to traditional forms of treatment, especially for those individuals struggling with substance abuse problems. Unfortunately, research also suggests that telehealth is often underutilized when it comes to providing addiction treatment services. Telehealth trends in Colorado were examined using a Telehealth Survey consisting of 29 items. Participants consisted of 125 members of the Colorado Association of Addiction Professionals. Similar to research published elsewhere, 65% reported that they do not currently use telehealth technologies. Furthermore, findings illustrated that actual use can vary by ethnicity, age group, type of organization, as well as service location. Participants’ reluctance to implement telehealth is related to concerns associated with training, confidentiality, clinician/staff acceptance, and reimbursement. Future research, employing both quantitative and qualitative methods, is recommended to further explore both the challenges and solutions to promote telehealth use, as well as methods to expand relevancy and awareness.
Citation: //doi.org/10.1007/s41347-018-0057-3
Among the 11 technologies assessed from the 363 organizations, the average percentage of organizations that had high interest (or high or very high interest on the Likert Scale) in the different technologies ranged from 35.54% for virtual worlds to 69.97% for computerized screening/assessments. The overall average high interest in all the technologies listed in Table 2 was 37.10%. The percentage use of the different technologies was less than the percentage of high interest in their use. Virtual worlds had a higher percentage of high interest (35.54%), but a low percentage of actual use (.55%). Computerized screening assessments had a high percentage of high interest (69.7%) with an actual use of 44.63%, the highest among the technologies assessed. On average, the difference between the percentage of organizations that had high interest and actual use was 37.32%, with over a third of the organizations having high interest in a technology, but not using it. Texting appointment reminders had the largest gap (55.18%) between high interest and actual use, while the lowest gap between high interest and actual use was in telephone-based therapy (20.67%).
These data suggest that SUD treatment organizations in the United States are interested in greater use of telemedicine technology. Use of telemedicine in SUD treatment settings will probably begin with computerized assessments and texting appointment reminders, followed by the use of telephone, video, and mobile health applications. Citation: https://doi.org/10.1155/2018/3932643
Barriers to outpatient treatment many times are transportation. We have poor show rates for substance abuse clients primarily because they can’t get there…well, I shouldn’t say primarily, but in many cases because they can’t get there. And you know, they don’t have the resources and the car is broken down or whatever, and there just is not the same availability of funds and transportation and things like that, that help them to make it and be successful. Transportation…is the number one problem for many of the folks we have. They no longer have a driver’s license; they abused that privilege and lost it. They can’t get to 12 step meetings, they can’t get to work, they can’t get an IOP or any kind of counseling session, and they live 20 miles away from wherever. Without public transportation these people are having to rely on rides from other family members who have been enabling or using with them, or friends who have been enabling or using with them.
Relatedly, rural participants in this study emphasized the impact family ties may have on treatment. According to rural counselors, the family context of rural clients may be a contributing factor to their substance use, subverting efforts to recover: When they go through treatment, especially residential, most of eastern Kentucky is family oriented and they are close-knit families. And when that client leaves treatment, 9 times out of 10 they are going back into the same situation they came out of. And so that is going to really lower their chances of staying in recovery. While support from family and friends can encourage entry into treatment and sustained sobriety, it is clear that in rural communities where substance abuse may have become an unfortunate family legacy, it can present a major barrier to treatment interventions. It is evident from this study that tailoring treatment to rural areas must include recognition of client-level barriers to effective treatment experiences – like transportation challenges, disadvantaged socioeconomic status, and close familial ties that may facilitate, rather than discourage, substance use.
Multiple studies have found that the therapeutic relationship is preserved during telebehavioral health vs. face to face treatment sessions. Clinical outcomes appear comparable to the same interventions delivered in-person and superior to care that is routinely available in rural communities. The evidence-base supporting the effectiveness of telebehavioral health includes existing research, published reports, and clinical expertise indicate that telebehavioral health is feasible, acceptable to referring Primary Care Providers (PCPs) as well as to patients and their families, and increases access to care for youth who are not well served by traditional models of care. The telebehavioral health model addresses three nationally recognized barriers to behavioral health care: patient identification and proactive engagement, access to care, and quality-assured delivery of best-practice care.
Our rationale for population of focus: Mobile devices provide an emerging way to deliver telebehavioral health. According to the Pew Research Center Internet, Science & Tech Report, in 2015, approximately 91% of the adolescent population access the internet on a mobile device. Given adolescents' and families technology literacy and their increasing access to mobile devices opioid treatment, clinical supervision and peer recovery in rural communities could be the ONLY alternative to reach isolated out of service populations with evidence-based treatment. Anecdotally, many families are using videoconferencing for social purposes, including Skype® or Face Time" with relatives and friends across the country and the world. This familiarity is anticipated to enhance overall comfort using videoconferencing for clinical applications, including telebehavioral health.
Proposed solutions to increase access, engagement and recovery support for substance use disorder clients.
Let’s talk Interactive was established to be a leader in the field of Virtual Telemedicine and Telemental Health Solutions. We are excited about the future of Virtual Healthcare as it is quickly becoming a mainstream service for Hospitals, Clinics, Substance Abuse Facilities, Long Term Care Facilities, Physicians and Mental Health Providers. It offers greater access and convenience for patients while demonstrating significant cost savings.
TO THIS END LETS TALK INTERACTIVE (LTI) OFFERS:
Our Telemedicine platform is one of the most successful Telemedicine platforms in today’s healthcare space. Let’s Talk Interactive and its subsidiaries have been providing telemedicine and teleconferencing solutions since 2001. Our Secure and HIPAA compliant platform currently has over 100,000 active Providers who complete over 3 Million minutes of successful Telemedicine visits monthly.
Our software platform is currently used by the nation’s top enterprise Organizations, Universities and Hospital Networks, to include but not limited to: University of North Carolina at Chapel Hill, Pepperdine University, Texas Tech, Brown University, University of Texas at Austin, Cardinal Health, Prospect Medical, LifeBridge Health, Arcadian Telepsychiatry, and many of the nation’s largest Employee Assistant Programs.
Our systems unique cloud-based virtual office and its functions are fully HIPAA compliant and have imbedded all the tools necessary to recreate a brick and mortar facility. Features included but limited to: Provider and Patient Facing Scheduling, Secure Payment portals, HIPAA Compliant E-Documents sent, filled out and signed through your virtual office electronically, Session Recording Capabilities, Cutting edge compression that allows up to 99 participants and 1 host on a single Video Call, HIPAA Compliant Chat, Text Messaging and Document transfer, Automated session reminders sent to clients with ability to RSVP and reschedule, Session notes stored on HIPAA cloud, BAA to cover all HIPAA Compliance on all functionalities.
To further our systems functionality, Our Kiosks and Virtual Medcarts have the ability to push live analytics to a provider from anywhere in the world. These systems, like our basic software platforms, are fully customizable, to include the “white labeling” and branding of the system to your specifications and have the ability to integrate into your EMR/EHR or other software platforms with our restful application interface (API). The system allows for the pushing and integration of over 41 peripherals, to include but not limited to; EKG, Blood Pressure, Pulseox, Stethoscope, Otoscope and more.
Our platform is fully compatible with any and all operating systems, browsers and mobile devices. Offering Medical & Mental Health professionals with a convenient, secure, affordable, and most importantly, an effective form of treatment for Medical & Behavioral patients.
Let’s Talk Interactive manages and has access to one of the nation’s largest behavioral health networks in the United States consisting of over 13,000 certified and licensed mental health providers along with nearly 30,000 licensed Physicians.
Our network of providers cover multiple disciplines, including primary care, internal medicine, cardiology, neurology, psychiatry, psychology, social work, marriage/family therapy, and counseling specialties. Our Medical & Behavioral Health specialists are independent practitioners who practice Telephonically, Virtually and face to face in their own offices. LTI provides secured consultations for those consumers wishing to use these modalities to communicate with our Medical & Behavioral Health experts. Confidentiality, and safeguarding a patient's personal information is our primary ethical commitment.
Our M3 Behavioral Health Assessment is NCQA certified and preapproved with Medicare, Medicaid, the Veterans Administration and a majority of private pay insurers. Our assessment was independently tested and validated at the University of North Carolina at Chapel Hill. This validation found that it not only was able to identify more mental health issues but that it was far more accurate than more of the widely used assessments.
This helps Physicians and Behavioral health providers manage medical and mental health treatment, as well as improves patient treatment by monitoring patient progress with an unbiased tool. This allows for the combining of medical and mental health evaluations and refocuses providers on appropriate treatment recommendations. Over time, repeated behavioral health assessments are used to track an individual's mental health longitudinally and monitor treatment effectiveness.
LET’S TALK INTERACTIVE is pioneering the next step in EMDR treatment for trauma and substance abuse patients.
EMDR (Eye Movement Desensitization and Reprocessing) is a behavioral health treatment that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences. Repeated studies show that by using EMDR therapy people can experience the benefits of psychotherapy that once took years to make a difference. It is widely assumed that severe emotional pain (trauma) requires a long time to heal. EMDR therapy shows that the mind can in fact heal from psychological trauma much as the body recovers from physical trauma. When you cut your hand, your body works to close the wound. If a foreign object or repeated injury irritates the wound, it festers and causes pain. Once the block is removed, healing resumes. EMDR therapy demonstrates that a similar sequence of events occurs with mental processes. The brain’s information processing system naturally moves toward mental health. If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR therapy training sessions, clinicians help clients activate their natural healing processes.
More than 30 positive controlled outcome studies have been done on EMDR therapy. Some of the studies show that 84%-90% of single-trauma victims no longer have post-traumatic stress disorder after only three 90minute sessions. Another study, funded by the HMO Kaiser Permanente, found that 100% of the single-trauma victims and 77% of multiple trauma victims no longer were diagnosed with PTSD after only six 50-minute sessions. In another study, 77% of combat veterans were free of PTSD in 12 sessions. There has been so much research on EMDR therapy that it is now recognized as an effective form of treatment for trauma and other disturbing experiences by organizations such as the American Psychiatric Association, the World Health Organization and the Department of Defense. Given the worldwide recognition as an effective treatment of trauma, you can easily see how EMDR therapy would be effective in treating the “everyday” memories that are the reason people have low self-esteem, feelings of powerlessness, and all the myriad problems that bring them in for therapy. Over 100,000 clinicians throughout the world use the therapy. Millions of people have been treated successfully over the past 25 years.
EMDR therapy is an eight-phase treatment. Eye movements (or other bilateral stimulation) are used during one part of the session. After the clinician has determined which memory to target first, he asks the client to hold different aspects of that event or thought in mind and to use his eyes to track the therapist’s hand as it moves back and forth across the client’s field of vision. As this happens, for reasons believed by a Harvard researcher to be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, internal associations arise, and the clients begin to process the memory and disturbing feelings. In successful EMDR therapy, the meaning of painful events is transformed on an emotional level. For instance, a rape victim shifts from feeling horror and self-disgust to holding the firm belief that, “I survived it and I am strong.” Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation, but from the client’s own accelerated intellectual and emotional processes. The net effect is that clients conclude EMDR therapy feeling empowered by the very experiences that once debased them. Their wounds have not just closed, they have transformed. As a natural outcome of the EMDR therapeutic process, the clients’ thoughts, feelings and behavior are all robust indicators of emotional health and resolution—all without speaking in detail or doing homework used in other therapies.
Our Virtual EMDR Addictions Program is a complete, online EMDR Eye Movement Therapy Program specifically designed to use at-home and online with the guidance of an EMDR trained Therapist. Our Virtual EMDR treatment can be used to eliminate unwanted emotions like Depression, Anger, Anxiety, Low Self-Esteem, stop Symptoms of Trauma, PTSD from Sexual and Physical Abuse, end Disturbing Thoughts and Flashbacks linked to being a Victim of a Crime, Survivor of Domestic Violence, or experiencing or shorten Grieving Time after a Loss, and remove Fears and Phobias. All of these above factors contribute significantly to an individual’s addiction. The removal or remediation of these issues with EMDR treatment can go a long way in breaking the addictive cycle and brining the individual to drug sobriety.
Let’s Talk Interactive offers a free, no risk 14-day trial of our Telemedicine Virtual office. Contact us today for your free trial, information our Telehealth Solutions and/or a free Telehealth readiness assessment.