Clinical psychologist Patricia Arena, PhD, works 40 hours a week, seeing up to 10 patients a day from all across the eastern region of Tennessee. But she doesn’t do it from an office in the state. Instead, Arena evaluates clients, provides psychotherapy services and even interacts with other health-care providers, all from her home in Miami.
Arena is employed by Cherokee Health Systems, a nonprofit community health center with 21 locations throughout Tennessee. The organization has been using teleconferencing equipment and high-speed telephone lines to provide primary and behavioral health care to patients for more than 12 years, says Dennis Freeman, PhD, a clinical psychologist and Cherokee’s CEO.
“It would probably take about four hours to drive across our service area, so we’re always looking for strategies to get services to our patients,” Freeman says.
Arena worked out of Cherokee’s Morristown, Tenn., office until 2010, when she and her husband moved to Miami for his job. The technology allows her to treat adults experiencing a range of mental and behavioral problems, including mood disorders, anxiety, depression and drug and alcohol abuse. She also uses the technology to consult with other health-care professionals at Cherokee.
“The one thing I cannot do is involuntarily commit someone, but I’ve dealt with several crises and facilitated voluntary hospitalizations,” says Arena, who is licensed in Tennessee and currently pursuing licensure in Florida as well. “I’ve really dealt with the full range of situations just as effectively via telemedicine.”
Clients “see” Arena in her old office in Tennessee where a 32-inch, high-definition television screen and video camera has replaced her physical presence. At her home, she has a secure T1 line, television screen and camera that directly connect her to the office. Patients can sit anywhere — on the couch or in one of several office chairs — and Arena can zoom in or out with her camera to see them.
“I’ve found it to be really no different than talking to them face-to-face,” she says.
Clients, she adds, have adapted to the technology particularly well. “Initially, they say it’s a little strange and takes some getting used to, but after a few minutes, both established and new clients have commented on the fact that they completely forget that they’re talking to a TV,” Arena says.
Freeman agrees, noting that some patients even prefer seeing their health-care professionals via telehealth. They’ve told him they feel like they’re more likely to have the provider’s full attention. He also says Cherokee has reported higher rates of patient satisfaction and lower no-show rates with telehealth services.
Another advantage of telehealth, he adds, is that it may be one way to get more health-care providers into underserved areas, without forcing them to relocate.
“We have such a maldistribution of psychologists and other mental health professionals in this country, and this opens up real opportunities to work with these populations even if you don’t live in close proximity to them,” Freeman says.