Walk-in telemental health clinics improve access and efficiency: a 2-year follow-up analysis.
BACKGROUND
Telemedicine has demonstrated potential to improve access and quality of mental health services in underserved areas. Use of telemedicine to deliver health services may enable a range of synergistic innovations in care practices, but such innovations will require rigorous evaluation.


METHODS
We evaluated a telemental health program designed to increase access by eliminating clinician travel time in a multisite rural community mental health center. The program included both traditionally scheduled and "open scheduled" clinics provided via telemedicine. An initial 13-month evaluation showed better access, quality, and sustainability compared with similar services delivered using traditional methods available elsewhere within the organization. A 24-month follow-up analysis was undertaken to determine if initial findings remained consistent.


RESULTS
Telemedicine clinics continued to show remarkably consistent advantages in both access and quality compared with traditional services. Cost-efficiency gains were also robust, maintaining a 20-percentage-point advantage in conversion of scheduled time to billable time over traditional clinics. Much of this advantage was attributable to the 20% of clinic volume that was open-scheduled or "walk-in" in nature.


CONCLUSIONS
This study confirms earlier findings that telemedicine technology can support synergistic innovations in service format (such as "open scheduling") and maintain measurable advantages in access and quality along with cost-efficiencies past the initial implementation period.
1 Upper Midwest Telehealth Resource Center , Terre Haute, Indiana.
Jonathan
J
Neufeld
Ruth
R
Case
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration; D019035:Rural Health Services; D017216:Telemedicine; D055815:Young Adult