When you visit your friendly neighborhood Community Mental Health Center, the gap between adaptation of the Electronic Health Record (EHR) in general healthcare and the behavioral / addiction treatment world becomes evident pretty quickly, especially if a consumer is filling out paper forms in the lobby with a worn-down pencil with no practically no eraser left.
It’s getting better.
Recently, in helping a large New York City agency select an EHR, I was surprised to hear they had no common Master Patient Index (MPI). That’s a program that can relate the EHR to other software, like the Human Resources system. The goal of that sort of internal interoperability is keeping the same demographic data common among all the software systems in an agency.
Small and mid-sized agencies end up having to pay software vendors extra to connect their programs, foregoing an MPI mostly because of the added expense. Few saw that this could blossom into a continuous pain, so internal interoperability, sharing of data among an agency’s software programs, takes a back seat to paying the electric bill or giving holiday bonuses (hallowed ground, the holiday bonus).
Most physical health hospitals spent a lot of time and money over the past few decades concentrating on the MPI because they don’t want their doctors and nurses to spend their high-priced time re-writing a consumer’s name, address and other demographic information. Mental health and addictions treatment is just catching up, but we still find licensed professionals and front line staff re-writing this information…oh, and don’t forget about that consumer in the lobby with the worn down pencil. That little metal thing that holds the eraser onto the pencil has just torn through the form for the eighth time…he could get frustrated any moment, and he just wants help with his mental health problem. Perhaps an MPI would help expedite his treatment
Most of the larger agencies bought software for programs piecemeal. First, the accounting department got their software, then the automated time-clock appeared, which by rights should share professionals’ information with the human resources software…you get the picture. The result was a plethora of disconnected software, and it’s not difficult to see how we got to the point of needing the MPI, but not knowing much about it.
If you have three software programs feeding into a central MPI, the MPI must be king of the data, so it can send updates to the consumer’s record out to all those other programs. Sounds simple, but it’s not. Vendors of MPIs charge a pretty penny for their software and support with good reason…brokering changes to a consumer’s health information is serious business, and you gotta get it right, every time.
The agency I mentioned earlier (with no MPI) grew into the need over time, adding different sorts of programs to help them serve people with developmental disabilities and mental health disorders. Not-for-profit agencies’ business priorities seem to have a history of underestimating the value of all those minutes that can be saved when staff, professionals and consumers don’t have to fill out their name and address with that worn down pencil over and over again…not to mention the great benefit of cutting down on graphite and rubber (eraser) pollution.
Like I said, it’s getting better. At least we know what an MPI is, and are learning the value of it in this age of mergers and acquisitions.
Read more →Because I am expected by my current healthcare provider, I spend less time in the waiting room and no time filling out forms. That’s a far cry from my experience with other healthcare professionals. In times past, an appointment didn’t matter; I was destined to wait, and was always filling out forms with the same information.
My current healthcare provider delivers physical and mental health treatment, everything except dentistry, and for every appointment, I receive a couple reminders, and that’s an effective perk for a forgetful guy like me. First, there’s a printed reminder in the mail. It’s a very clear letter that simply states the date, time and place for the appointment, and who I’m meeting. It’s a wonderful thing to have all this attention paid to me and my poor memory. Incidentally, I record the appointment both in Outlook on my desktop and synchronize that to my BlackBerry. A day or two prior to my appointment, I get a telephone reminder. I’m fond of reminders, and apparently a lot of folks appreciate them; a few years ago, a study at the University of Rochester in New York showed over 75% of those polled thought they were a good idea.
I go with the flow, and make my appointments. It’s easy for me to assume these sorts of systems work. The letter can be generated by many scheduling systems that are built into the EHR, and a number of automated telephone-reminder systems are available to integrate into the scheduling system. I searched the internet and immediately came up with an option that looks like it would work from Stauffer Technologies in Cleveland. If I was in the market, I’d check it out further.
The letter is generated by the computer as part of EHR, most EHR reporting systems will tap the database to send out form letters. The telephone calls are generated by the computer interfacing the EHR to an automatic system with a computer generated message. I am simply not a “No-Show” because of this attention, and since these reminders are automated, nobody needs to write or print a letter, and nobody has to call me. These technical solutions contribute to the bottom line and can help assure that struggling mental health clinics will be around to help consumers as the business continues to change.
In Community Mental Health Centers, No-Shows account for tremendous revenue losses simply because they leave professionals sitting around doing nothing, or perpetuating the myth that they need that time to catch up on their paperwork. In August, I quoted a study commissioned by the National Council (the mental health community’s most popular support organization). One of the agencies in the study showed a professional had a couple No-Shows a month and canceled another couple to “catch up on paperwork” (see my past posts discussing collaborative documentation for another solution).
I can’t help but think that the possibility of No Shows is decreased for more folks than me by the use of letters and telephone calls generated by the EHR…they certainly get me into the office.
Read more →I have a beef with every doctor’s office I’ve ever been to except one. It’s those forms I have to fill out and papers I have to bring when I come in for an appointment. They have all the information in (or available to) their computers, yet they insist on wasting ink…and I wonder how they can read my handwriting these days anyway.
There is no point to it or reason for it. My health information could be printed out for a quick review easily enough, or just left on the screen. If the professional treating me wants to know the results of an excursion to another sort of healthcare provider, that information’s available electronically, too.
Health Information Exchange (HIE) has been around a long time, and these organizations specialize in security of our health information while sharing it among professionals treating us. Information on my address, health conditions, or prescription for a psychotropic drug is nobody’s business except professionals who treat me, and I really want that information shared securely to those folks. Since treatment is so disparate, it’s good to know that the physical health doctors, hospitals and mental health and addiction treatment facilities we use can access a medication list, or a discharge summary from other providers.
I believe our body, mind and spirit are all connected, and if I’m unconscious or incapacitated when brought in for treatment, people treating my body may need to know what’s been going on with treatment for my mind…I’d rather not be subjected to a bad drug-to-drug interaction or mis-diagnosis of a symptom. HIEs go a long way toward eliminating possible problems like these, simply by sharing personal health information among professionals.
It’s a bonus that the HIE can share my address and phone number so I don’t have to write it down on that silly form. Still, I see that only at the VA because it’s a monstrous healthcare system that has concentrated on the Electronic Health Record (EHR) for decades, and my data is available coast to coast, only to professionals who I want to see it.
A lot of care providers simply don’t belong to the exchanges and aren’t about to turn lose of the monthly fee to pay for that sort of security and efficiency…they’d rather send a fax when sharing health information. Investing a few moments investigating could put dollars back into the professional’s pocket. InformationWeek shared that Dr Mark Sandcock’s primary care practice in South Bend, Indiana saved $1 Million in the first year of working with an HIE. So, his patients benefited, and presumably, so did his family with holiday gift giving.
Lab results can drag out treatment simply because the information takes a while to travel between healthcare organizations and get processed…outpatient addiction treatment facilities have learned that getting urine toxicology results quickly when testing for abused substances helps confront the consumer quickly, which aids treatment. The paperwork and people involved in getting the information between the healthcare facility and the lab and re-recording results in patient charts, also adds to the cost of healthcare, and that affects the price tag when we go for help. Experiences like Dr Sandcock’s give me hope that the healthcare system may actually be coming around to better serve consumers and prices may actually stabilize.
HIEs are growing, and the string of positive outcomes is impressive, from prompting better healthcare decisions because folks who treat us being able to see our medication history to quick receipt of lab data. One factor really stands out for me: soon, I won’t have to fill out those silly forms when I go to an appointment, even if I’ve never seen the professional before.
Read more →America recently swapped out a number of Democrats for Republicans with the promise to voters of decreased government spending. As a result, a number of mental health and addiction treatment facilities could face increased hardship. Their primary source of paying the rent is drying up…Medicaid funding looks to be continuing a downhill slide.
Once again, mental health and addictions facilities are faced with improving the way we do business and securing alternate revenue sources. Every time this challenge has arisen over the past couple decades we’ve overcome it by improving the way we do business. I’m particularly grateful about this because it’s allowed me to make a living helping these folks become more efficient and effective by using the Electronic Health Record (EHR)
I tend to agree with Chuck Ingoglia, Vice President of Public Policy for the National Council for Behavioral Healthcare (NCCBH), when he forecasts that Medicaid funding in our business is likely to decrease over the next few years.
So, as Medicaid dollars shrink, the agencies need to make up for that somewhere, and as the old story goes, it’s better to teach somebody how to fish than simply give them their next meal.
One way to make up for losses in funding is to sharpen up with better use of the EHR. A number of mental health and addictions treatment providers are trying to make better use of their software by encouraging use of central management of practitioner scheduling in order to make sure their workload increases. As that workload increases, collaborative documentation, writing the notes and developing treatment plans as part of a therapy session becomes more a part of daily business. Just using the EHR this way leads to shorter wait times for a consumer to see a professional for the treatment they need, and helps focus on the problems in the treatment plan rather than digressing into the crisis of the moment with no direction toward recovery.
Facilities taking care of business with creative measures like this will survive, and some of them will flourish.
Recent gains made in healthcare reform will face some losses, and popular mandates like mental health parity that assures insurance companies must pay mental health and addictions claims on par with physical health claims will likely stick around. Consumers who benefit from reform measures are more easily motivated to write their legislators and encourage them to support reform gains.
For the past couple years, a number of mental health and addiction treatment facilities have been successfully weathering business changes required by decreases in their funding. A small rehab in Wisconsin survived long enough with a grant in order to implement enough of the EHR to assure they collected payments (or at least partial payments) from self pay consumers…sometimes that’s as simple as asking for a payment at the time of service. Before the EHR, they simply had no working system to do that. A mental health provider in the Midwest lost their grant funding and started reaching out to gain new self-pay and insurance consumers. They instituted sliding fees where they were warranted, and tracked accounts for this new way of doing business with their EHR. They aren’t flourishing, but they’re still helping people as a result of these marketing and business changes.
These are examples of a fighting spirit. These are people willing to make significant changes and a few sacrifices in order to continue helping others recover from mental health and addictions problems. Lately I’ve been helping a couple agencies switch from one method of funding to another, and in the process, helping them make better use of the EHR. Ten years ago, staff would have groused and fought the change. Now, I’m met with growing enthusiasm. You know you’re making headway in the battle to succeed when the troops lead the way into change.
Read more →If people don’t feel included, for the most part, they just don’t bother to be involved at all, and may be quick to notice negatives and pass them around.
That’s why internal Implementation Blogs are becoming keys to increasing “buy in” into IT projects and avoiding disruption to the recovery process. A consumer is generally quite aware of the fact that new software’s being implemented where they receive mental health or addictions care. The activity is obvious, and usually affects every staff member. The consumer sees a different invoice, a different way of scheduling his appointments, and the professionals they work with will begin including them in writing up the summary of a session and the next steps in treatment in progress notes on the computer.
Sometimes the consumer hears about lingering problems with the system that aren’t being addressed. It’s good to avoid airing the dirty laundry like this. Much better to resolve problems that will affect the consumers early and communicating about those problems internally is better than sharing them with the consumers. The consumer comes to treatment to recover, not to hear about software implementation problems.
A few years ago a friend and customer who was implementing an enterprise software system in a Florida Community Mental Health Center (CMHC) shared that she started a blog page to increase staff involvement in the implementation. This accomplished a couple things:
1. Staff reported successes with the software increasing their efficiency and effectiveness in doing their job. 2. Staff complained.
The successes were little testimonials of great impact, and went on the page immediately. This helped people feel involved, like their efforts made a difference, and boosted morale.
If a complaint made it to the page, something needed to be done. It was OK to complain, and staff was coached in how to complain on the blog in such a way that the complaint wouldn’t bring people down and create negative attitudes about the project. Problems are meant to be solved, and any complaints included hope that the problem was temporary and a resolution was on the way. News of effective resolutions made it to the Implementation Blog really quick.
Negative comments were OK, and resulted in attention to the person making that comment. They seldom made it to the blog before the reporting staff edited the comment to show there was some hope, something was being done, or an alternate procedure worked around their problem…in effect, the blog was turning these negative comments into positive action.
I liked this idea and have suggested it in my work many times to folks about to implement software in their mental health or addictions facility. Usually, it’s viewed as one more thing to add to the ever-growing pile of things to do in an environment that’s already short handed. Of those who have instituted the Implementation Blog, Nobody’s wanted to back out. The staff buy-in to the project is much better, simply because staff feels more involved and like what they say counts.
Plus, the consumers heard very few negative comments about the software project, making it that much easier to focus on their own recovery.
Read more →In a lot of ways, the future has arrived with answers….now if we can figure out what to do with the answers; we may end up in better mental health.
I Googled “gene scans” and the first thing that came up is a company that sells such things, deCODEme. I can give them 2,000 of my hard earned dollars and they promise information to guide my life in areas from heart health to male pattern baldness (too late, check my picture).
A saliva test can tell us a lot about our susceptibility to certain diseases. I had a minor heart attack a few years ago, which may have been averted had I known earlier in life about my genetic leaning toward that problem. Evidently my father’s side of the family is where I inherited the heart disease problem from, and those relatives have remained mysterious and unknown to me. Although we know that sort of thing can “run in the family” I had no clue of a possible heart problem, so a gene scan may have helped me.
A friend didn’t realize diabetes ran in her extended family; perhaps she could have avoided or at least delayed the need for daily injections with a lifestyle change…if she knew of her genetic inclination toward the disease. Nutrition and exercise go a long way in preventing all sorts of physical health problems, and avoiding some foods can improve our immediate mental health. I quit caffeinated coffee and I immediately felt better, less anxious. Perhaps a diet change would have helped my friend.
A genetic test can nudge us toward lifestyle changes that can help us stay physically healthier, but can the test unveil mental health needs? If it can, what changes could I make in my life to avoid mental health problems?
I find the possibility of how this information can fit into our overall health maintenance is terribly interesting, and could augment how mental health professionals treat consumers. It’s a snap to connect a scan of the gene or printed readout of results into the Electronic Health Record (EHR). In the future, this could be a reliable map to help us avoid mental health problems or lessen severity of those problems. Having the genetic clues on the professional’s computer could guide therapy and medication, helping the professional zero in on problems and treatment solutions much more quickly. That sounds like something of value in this fast-paced instant-gratification world.
I can see a future that imports the gene scan results into the EHR, which automatically reads them and posts alerts in a consumer’s record that they may be susceptible to certain conditions like schizophrenia or depression. Other treatment resources within the EHR already suggest medications for certain conditions, and educational resources are all over the Web. Gene scan technology can be brought into treatment technology with a goal of improving diagnosis methods and providing treatment guidance. It’s nice for a professional to have just the information she needs at her fingertips.
Once again, my vision jumps the gun. The National Institute of Mental Health (NIMH) says that we simply don’t yet know how to read the genetic codes and glean information about our mental health. The body of evidence is too small to provide accurate forecasting. Scientists will need to methodically compare a bundle of gene scans for multiple gene patterns in a bundle of people in order to suggest how gene scans can be valuable in forecasting likelihood of mental illness.
Considerable research is under way, so one thing is certain: The future is near.
Read more →Average wait time from calling a mental health treatment organization for help and actually engaging in treatment with a professional can take a month. A lot of consumers cancel their appointment or just don’t show up.
From what I’ve seen, physical health has that beat.
David Lloyd of MTM Consulting shared this statistic recently in a talk on the web focused on improving quality; I found that an amazing amount of time to wait for help…Who would wait that long? According to Lloyd’s research, not many folks, and I agree, it’s a long time to wait for health, and I know a lot goes on in my mind in a month.
Regardless of whether the consumers who end up not consuming mental health services are classified as No-Shows or cancellations, or somehow justified as exempt from statistics, the fact is that a bundle of folks aren’t getting help. A key to getting the folks who are now not showing up for appointments is simple business logic. If we serve them quicker, with high quality service, for a reasonable price, they’re more likely to make their appointments. Plus, under these conditions, people improve and tell their friends how great the results of treatment at this particular facility were.
Maintaining quality treatment and delivering it quickly boils down once again to streamlining systems, and the best way I’ve found to assure streamlining happens is to tailor the Electronic Health Record (EHR) to guide clinicians through the treatment and documentation processes. If a professional has clear signposts along the way, the policies and procedures placed to improve quality and timeliness of treatment are more likely to be adhered to. Here are a few things that can be done with the EHR to increase the value of treatment in the long haul that are statistically proven to reduce no-shows and help consumers get better.
• Cut time spent on paperwork and redundant entry of consumer data…who likes to answer the same question six times? An effective EHR can save all data that’s entered one time, like the patient’s name, address, reason for coming, medications, etc, and automatically add it to any form that’s shown in a professional’s workflow where it’s needed; tune up the EHR to do this • Decrease the time a consumer spends waiting for help… Lloyd’s statistics show a lot of professionals are very busy with a lot of peripheral activities like catching up on treatment documentation when there are No-Shows; take scheduling out of the professional’s control, schedule people to come in NOW…or at least within ten days and No-Shows dwindle. • Help the professional! Start Collaborative Documentation now: Involve the consumer in writing assessments, treatment plans and progress notes during the session, with the consumer…it improves focus on treatment goals and objectives and gets the paperwork done on time, reducing a facility’s risk of falling out of compliance with state, and federal governments, helps adhere to accreditation rules, and avoids billing audit problems
I know. That’s all well and good, but who has time to do this?
There will never be enough time to do these three simple things. Facilities will need to hire EHR professionals, spending money they don’t have. The money will come as No-Shows dwindle. There are tons of statistics out there that show how great a tool the EHR can be, and the solutions above are proven to work nationwide, in a ton of studies over many years (I cite them a lot).
Now is a good time to start improving treatment using the EHR to help.
Read more →A bundle of concerns erupt when an agency providing mental health or addiction services implements an Electronic Health Record (EHR). Since the only reason these agencies are in business is to improve the consumer’s well being, a question arises: How can the EHR help improve the quality of consumer care?
When I work in mental health and addictions treatment facilities, I see just how tough it is for professionals to envision the EHR as a tool to improve consumer focus on recovery. Expanding the vision of professionals, consumers and even the software implementers to view the EHR as a tool to improve treatment is a team effort, and getting the team cranked up can be a trial.
If the up-front analysis of how people get their work done and such is solid, a professional implementer should get at least some of the software up and running effectively and quickly, and the benefits to improving consumer care should be evident within weeks of use. Professionals and consumers begin focusing more directly on treatment goals and objectives, which are the reasons folks enter treatment anyway.
All too often staff is overwhelmed by the ever-increasing documentation that’s required in treatment, so they view the software implementation as a burden, an expansion of bureaucracy. The complaint is that with all the required documentation, there’s no time to treat the patient. The EHR solution is to document with the patient during the session. Assessments with a lot of check boxes and radio buttons are easy…just walk through the questions one at a time and review the resulting score with the consumer. Treatment Plans can be more daunting because the fast way to write a goal or objective of treatment is to pick it from a drop down box on the screen, and that can lead to cookie-cutter documentation. Progress Notes generate the same concern.
Collaborative documentation with the patient is the answer, not just because you get paid for the time spent documenting the service. The consumer truly participates in her own treatment when discussing what happened in a session; how it relates to one of her reasons for being in treatment, and what she should be concentrating on in recovery before the next session. Mutual creation of the documents is what draws the patient’s attention to reaching their own treatment goals.
Using the EHR to improve treatment is not a new story. I stumbled onto an article comparing the effectiveness of a simple checklist used in treatment on the computer with a checklist on paper. It’s a short story, and to make it even shorter, a “to-do” list on the computer works darn well. The study says that both mood disorder screenings and treatment documentation improved using the computer maintained task list. The article from Dale Cannon and S Allen of the University of Utah, was ancient, from the year 2000.
A successful EHR depends on a successful implementation and “after-care”, to include continuously gaining buy-in from professionals using the system and making it grow to suit needs better. As these folks embrace central scheduling and treatment documentation with the EHR, the implementation, the effectiveness of the software, and possible improvements in treating patients are likely to increase.
Read more →Hospitals are a center point for the Electronic Health Record (EHR) and a key to the National Health Record’s sharing of health data among treatment teams. Less than 12% of them have effectively implemented software.
I was mortified to discover this. So shocked and disbelieving, in fact, that I needed corroboration of the original story run in Health Affairs, and found the Robert Wood Johnson Foundation reference that’s linked above.
A hospital has huge Information Technology (IT) resources, and can share data among ancillary specialty clinics, like your psychiatrist, your cardiologist, or your pulmonary specialist. The doctors are associated with the hospitals, and when a patient is released to a doctor’s care, the idea is that the doctor has availability to the electronic records in the hospital, as long as the patient signs a release of information and knows about it. This saves a ton of aggravation in filling out the same information many times, and delivers more accurate treatment data to these members of a consumer’s treatment team.
The combined information is suddenly available in a secure environment, so when the patient moves, or needs to share that health data with somebody not in that hospital’s network, it’s available with a release of information via another component of the National Health Record, the Regional Health Information Organization (RHIO), or other similar health data organization. The RHIOs are all connected into the National Health Record, or will be soon, so our health information is secure behind firewalls and other technological wizardry. The idea is that nobody gets that information without a patient’s say-so, and that when the patient says it’s OK, the data is instantly in the doctor’s hands.
Here’s a scenario. • Joe has a heart problem and a pulmonary problem • Joe also has terrible anxiety that gives him breathing difficulty • Joe goes to the emergency room, and the docs determine the current problem is a panic attack, and Joe’s medicated and released, with instructions to follow up with the psychiatrist’s Mental Health Clinic; the clinic is part of the hospital’s network because the psychiatrist is affiliated with the hospital • Joe goes to the Mental Health Clinic, and the notes, the medication order and the discharge summary from the hospital are available on line, so the psychiatrist knows the details • Later, Joe goes to his cardiologist, who is also affiliated with the hospital and can consult the record of the emergency room visit in the EHR • Ditto with the pulmonologist
Access to that record and the ability to treat the patient as a team, making sure all bases are covered so Joe not only doesn’t die, and also has the highest quality life possible, isn’t possible in 88% of the hospital service areas across the nation.
With only 12% of the hospitals effectively implemented, the National Health Record, which was mandated to be operational in a few years by then-president Bush, is essentially nowhere.
I’ve reported on the value of Rapid Cycle Implementation in getting an EHR up and running as quickly as possible. This method of solving the highest-priority problems that the software can address with target groups of professionals, then rolling out those features to all users, is nothing new…and it’s effective. Soon enough, the organization has a functional EHR and is fine-tuning it, making those features that are already rolled out better. I wonder how many of the 88% of the hospitals without effective EHRs are incorporating Rapid Cycle Implementation into their software rollout.
There are many reasons software implementations fail. It could be that the CEO isn’t promoting it with the staff effectively. It could be that the team doing the implementation is more interested in keeping good statistics on how much money’s been spent on manpower than actually getting a feature rolled out. Resources (usually people) could be in such short supply that the project is sabotaged.
In these failings are the keys to successful implementations. Setbacks are unavoidable, but I’d call this failure.
12%. Sheesh.
Read more →A friend insisted that I come to Baltimore to visit during an upcoming American Telemedicine Association conference. The conference is for pediatricians. I’m all about mental health and substance abuse technology. So why am I going?
According to the US Human Resources Service Administration (HRSA), New York has enacted legislation for Medicaid to pay for telemedicine solutions in Mental Health. It only makes sense for me to learn a little more about the solution.
At least one program, Project Teach, currently includes telephone interviews for psychopharmacologic concerns. The program is an example of how the state’s Office of Mental Health is making good on the promise in the 2010 statewide plan to extend technology in mental health. Presumably, if New York is using telemedicine as a technological strategy to decrease the “burden of illness”, other states must be on the same beam, and evidence I’ve seen shows New York is not in the lead in paying for expanding the technology.
An earlier research foray into telemedicine in mental health yielded a little knowledge on its use, and the first thing that usually comes up is that it’s a solution for “rural and underserved communities”. This friend I mentioned earlier said “what about the woman who lives in Queens, has a job there, and has to take a bus and two subway trains to get to her therapist in Manhattan?” Telemedicine seems a great way for her to work with her current therapist without having to take a lot of time off work.
The elements of telemedicine for mental health are pretty simple, really: Mental health services using live, interactive videoconferencing doesn’t require tremendously expensive equipment. Some finesse is involved, like good lighting and camera angles to help with the feel of a professional environment, however, the technical requirements are available to most people. At the beginning of the year I bought a Netbook computer for $400, and there’s a camera for videoconferencing. This seems like a pretty low-cost solution for rural use and for the woman who lives in Queens.
As long as there is a two-way video and voice communication between professional and consumer, a number of sessions, like visits to review medication effectiveness can easily be remote events and are worth paying for…and that’s good for business in your local Community Mental Health Center.
So, there is value to telemedicine in mental health. I can’t help but feel there’s more we can do with the technology, medication review can’t be the only service worth paying for. What about an individual therapy session? What about the use of social networks like Facebook for a sort of group therapy? Or actual group therapy with people connected via a teleconferencing service. If the value exists, then it’s worth paying for. It’s easy for a business man to see the value of how this technology can lower costs and increase productivity. Are insurance companies and Medicaid coming to realize the value of telemedicine in general practice of improving our mental health?
That’s why I’m going to the conference, and I’ll keep you posted.
Read more →