Timothy W Brearly1, Courtney S Goodman2, Calandra Haynes3, Katherine McDermott4, Jared A Rowland5. 1. VA Mid-Atlantic Mental Illness Research, Education, and Clinical Centers, W.G. (Bill) Hefner Veterans Affairs Health Care System, Salisbury, NC, and Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC. 2. Mental Health and Behavioral Sciences Service Line, W.G. (Bill) Hefner Veterans Affairs Health Care System, Salisbury, NC, and Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC. 3. Research & Academic Affairs Service Line, W.G. (Bill) Hefner Veterans Affairs Health Care System, Salisbury, NC. 4. Mental Health and Behavioral Sciences Service Line, W.G. (Bill) Hefner Veterans Affairs Health Care System, Salisbury, NC. 5. Research & Academic Affairs Service Line, W.G. (Bill) Hefner Veterans Affairs Health Care System, Salisbury, NC, and Department of Psychiatry and Behavioral Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
Abstract
PURPOSE: To describe the implementation and initial outcomes of a pilot interdisciplinary telehealth clinic, Allied Transitional Telehealth Encounters post-iNpatient Discharge (ATTEND), providing clinical pharmacy specialist follow-up for veterans transitioning from inpatient to outpatient mental healthcare in a Department of Veterans Affairs (DVA) hospital. SUMMARY: The ATTEND clinic's primary intervention was providing medication management appointments through clinical video telehealth (CVT) to patient discharge locations through a DVA-provided tablet. An interdisciplinary team supported care through on-unit inpatient training, secure messaging, and self-help applications. Clinical outcomes were measured through readmission rates, wait times, self-report measures, and follow-up interview at the completion of ATTEND services. Twenty patients completed on-unit training, and 16 unique patients were seen for at least 1 outpatient appointment. Inpatient readmission rates were lower for ATTEND patients than with standard care (5% versus 19%, respectively). Wait times until first postdischarge mental health appointment were reduced by a mean of 18.6 (S.D., 8.8) days. The pharmacist made medication interventions, including dosing changes, education on incorrect administration, and medication discontinuation. Self-reported psychological symptoms decreased during ATTEND participation. Post-ATTEND interviews indicated high levels of acceptance and interest in continued tablet-based care. Primary challenges included unique technological limitations and effective care coordination. CONCLUSION: The ATTEND telehealth clinic provided postinpatient mental health follow-up that was more prompt and convenient than conventional on-site appointments. Psychiatric self-report improved during ATTEND-facilitated transition to outpatient care, and the recidivism rate for ATTEND patients was lower than the general inpatient rate during the same time period. Published by Oxford University Press on behalf of the American Society of Health-System Pharmacists 2020.
PURPOSE: To describe the implementation and initial outcomes of a pilot interdisciplinary telehealth clinic, Allied Transitional Telehealth Encounters post-iNpatient Discharge (ATTEND), providing clinical pharmacy specialist follow-up for veterans transitioning from inpatient to outpatient mental healthcare in a Department of Veterans Affairs (DVA) hospital. SUMMARY: The ATTEND clinic's primary intervention was providing medication management appointments through clinical video telehealth (CVT) to patient discharge locations through a DVA-provided tablet. An interdisciplinary team supported care through on-unit inpatient training, secure messaging, and self-help applications. Clinical outcomes were measured through readmission rates, wait times, self-report measures, and follow-up interview at the completion of ATTEND services. Twenty patients completed on-unit training, and 16 unique patients were seen for at least 1 outpatient appointment. Inpatient readmission rates were lower for ATTEND patients than with standard care (5% versus 19%, respectively). Wait times until first postdischarge mental health appointment were reduced by a mean of 18.6 (S.D., 8.8) days. The pharmacist made medication interventions, including dosing changes, education on incorrect administration, and medication discontinuation. Self-reported psychological symptoms decreased during ATTEND participation. Post-ATTEND interviews indicated high levels of acceptance and interest in continued tablet-based care. Primary challenges included unique technological limitations and effective care coordination. CONCLUSION: The ATTEND telehealth clinic provided postinpatient mental health follow-up that was more prompt and convenient than conventional on-site appointments. Psychiatric self-report improved during ATTEND-facilitated transition to outpatient care, and the recidivism rate for ATTEND patients was lower than the general inpatient rate during the same time period. Published by Oxford University Press on behalf of the American Society of Health-System Pharmacists 2020.
Authors: Debra T Choi; Yvonne H Sada; Shubhada Sansgiry; David E Kaplan; Tamar H Taddei; Jason K Aguilar; Michael Strayhorn; Ruben Hernaez; Jessica A Davila Journal: J Gastrointest Cancer Date: 2022-06-30