Effectiveness of Telehealth

WMU published research article supports effectiveness of telehealth

Kalamazoo, Mich.—Using technology to provide real-time communication between patients to health care providers could be a cost-effective solution to increase the quality of services and number of trained professionals in underserved areas, according to research by WMU psychology alumni.

Delivering health care, information or education at a distance using video conferencing, telephone calls or remote patient monitoring is especially relevant given the outbreak of COVID-19 and concerns about in-person contact.

The advantages of “telehealth” in training are explored in a recent article titled, “The Effects of Remote Behavioral Skills Training on Conducting Functional Analyses,” published in the Journal of Behavioral Education and made available online April 15.

Dr. Stephanie Peterson, chair and professor for WMU’s Department of Psychology, is the principal investigator of the lab responsible for publishing the study. She and three former WMU doctoral students investigated the effectiveness of delivering behavior skills training via telehealth to evaluate function of severe problem behavior.   

WMU alumni involved in the paper include Dr. Denice Rios, lecturer in behavior analysis at Georgia Southern University who co-authored the paper; Dr. Yannick Schenk, senior clinical director at the May Institute in Boston, and Dr. Rebecca Eldridge, clinical director at WMU’s Kalamazoo Autism Center.

“One day they came to my office saying they found an article for telehealth, and they said ‘We can do better.’ So, I told them to come to my office the next week with a plan and they did. We decided to go with it, and they were responsible for developing the study and the methods.  It was one of those moments as a mentor that you’re proud of,” said Peterson.

Rios, Schenk and Eldridge were motivated to create their own study based on a previous article and 20 years of field research on telehealth. The Peterson Lab at WMU began publishing on telehealth in 2009.

“Before the Covid-19 pandemic, I heard a lot about how telehealth is not effective and how it is not a viable modality.  However, telehealth is not an intervention. It’s a method of delivery for the intervention.  It’s important to realize that using telehealth as a method of delivery does not decrease its effectiveness,” said Rios.

“The publication of our article was timely in light of the current circumstances. Telehealth has so many applications, from the behavioral skills training in our study, to students who have been sent home,” added Schenk.

Recently, WMU has added telehealth services for students, staff and faculty to receive primary care and mental health services through Sindecuse Health Services.

“We also need to remember in light of the current circumstances that telehealth is not new.  It’s just newer.  It might be initially complicated to implement, but it can be modified as needed in order to make the delivery of the treatment or intervention as easy as possible,” said Schenk.

While the study demonstrated the successful use of telehealth, the authors admitted that there are a few misconceptions and drawbacks that make the implementation of the resource difficult.

“It’s a common misconception that you can’t be personable through telehealth, but you can definitely still build rapport and keep the same bedside manner behind a screen.  To be honest, I’m closer with some of my telehealth clients than I am with some of the clients that come into the clinic,” said Eldridge. 

Peterson agrees. “It’s easier to establish rapport through telehealth than you think and it’s a sign of the changing times.  Access to social media and other platforms has made it really easy to establish that relationship despite not meeting face-to-face,” said Peterson.

The study alleviated these misconceptions, but telehealth also requires technology in order for patients to communicate with providers. “There are a few drawbacks to telehealth.  Not everyone has access to the required resources and internet. All of the required technology can be expensive,” said Rios.

Getting technology is one thing, but getting technology to work is another.

“It can be hard to determine when to terminate a session or how to handle technical difficulties.  I’ve also seen those who struggle with mental health issue not reacting well to telehealth because they really thrive from that person-to-person interaction. It’s not for everyone, and you can’t always fully observe the full environment,” said Schenk. 

Nevertheless, the authors are encouraged and proud that their results demonstrated that telehealth was effective in delivering generalized treatment. “For those who are skeptical of telehealth, it’s important to remember that it’s not for everyone. It’s simply another option to increase access to those who need it,” said Eldridge.

The authors were also optimistic regarding how telehealth is applied in the current Covid-19 pandemic.

“Telehealth is effective over miles and miles, and it’s exciting because you can increase accessibility to services to those who can actually benefit from it. For example, if you think about those who live in the rural areas of Michigan, or even the upper peninsula, telehealth allows you set up a virtual clinic to act as a station of experts who can help people access state-of-the-art interventions,” said Schenk.

Private insurance companies and Medicare have recently modified their policies to include telehealth services.  Medicare telehealth services are now available in 48 states and the District of Colombia for substance use disorders, mental health disorders, renal dialysis facilities, and the diagnosis and treatment of stroke symptoms2. Thirty-two states and the District of Columbia also have some kind of private payer policy for telehealth services1.

Telehealth services are also being used to treat COVID-19 as of March 62

The published article can be viewed online at the Journal of Behavioral Education here: https://link.springer.com/epdf/10.1007/s10864-020-09385-3?author_access_token=eOfRXKiwSpTPQXN421DFpPe4RwlQNchNByi7wbcMAY7hMKkwa1dLHF2GJWsqBs1zX8ALl_MpY3KnpbFrv3XvoPwrld7FALoCow9Ql_KiG9qxz4UWhXtHtOzEmxnyum_oaPR3Slwekaf1GVtqftSE5w%3D%3D

The authors of the paper can be reached via their emails below:
Stephanie Peterson (stephanie.peterson@wmich.edu)
Denice Rios (dmojica@georgiasouthern.edu)
Yannick Schenk (yschenk@mayinstitute.org)
Rebecca Eldridge (rebecca.eldridge@wmich.edu)

References

1)      https://www.ncsl.org/research/health/state-coverage-for-telehealth-services.aspx

2)      https://www.medicare.gov/coverage/telehealth