Rapid expansion of direct-to-consumer telemental health during the COVID-19 pandemic: A case series

Editorial: Transition to Telehealth for Mental Health Clinics: Future Considerations

“…This is even more so for the field of psychiatry. 1 Whether an established telehealth program existed or not, the abrupt lifting of regulations and urgent need for access to care opened the telehealth flood gates. While video visits and telephone visits improved immediate access to care, they simultaneously challenged our ability to structure, organize, educate, operationalize, and track such visits.…”

“…While video visits and telephone visits improved immediate access to care, they simultaneously challenged our ability to structure, organize, educate, operationalize, and track such visits. 1 This swift shift in health care delivery forced providers, health care systems, and patients into a nationwide experiment to learn what works well via telehealth and what does not. The ground-breaking article by Folk et al.…”

“…Four main problems and solutions are highlighted below: Problem: Video platforms set up before COVID-19 did not account for sessions lasting 5 hours, greater than 10 participants, and the need to display all faces at once. Solution: Through provider and patient feedback, the behavioral leadership team as well as the broader UPMC telemedicine team found that Vidyo, Microsoft Teams, and Zoom all fulfilled these requirements, 1 though some of the platforms required modifications or upgrades to allow for extended length of sessions. One of the main limitations identified is the need for a reliable internet connection and appropriate patient devices.…”

“…Solution: The leadership team incorporated patient and provider feedback to create specific instructions for scheduling group sessions and connecting. 1 We held office hours weekly during the first 9 months of the pandemic to troubleshoot problems and disseminate workflows. Care was taken to avoid group e-mail invites to keep participant e-mail addresses private.…”

“…Solution: Group therapy leaders transitioned all education materials to screen share options, e-mailing information ahead of time and being mindful to maximize time for patients to see each other for optional engagement. 1 Several clinical leaders shared their lessons learned and “webside” manner tips through our weekly office hours, allowing for fastest adoption of group therapy across the system. 1 A limiting factor is that as a field we need to continue to investigate when an in-person connection is still optimal (eg, play therapy for younger children or for parent–child sessions).…”