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The Transition of Academic Mental Health Clinics to Telehealth During the COVID-19 Pandemic

https://doi.org/10.1016/j.jaac.2021.06.003Get rights and content

Objective

A consortium of 8 academic child and adolescent psychiatry programs in the United States and Canada examined their pivot from in-person, clinic-based services to home-based telehealth during the COVID-19 pandemic. The aims were to document the transition across diverse sites and to present recommendations for future telehealth service planning.

Method

Consortium sites completed a Qualtrics survey assessing site characteristics, telehealth practices, service use, and barriers to and facilitators of telehealth service delivery prior to (pre) and during the early stages of (post) the COVID-19 pandemic. The design is descriptive.

Results

All sites pivoted from in-person services to home-based telehealth within 2 weeks. Some sites experienced delays in conducting new intakes, and most experienced delays establishing tele−group therapy. No-show rates and use of telephony versus videoconferencing varied by site. Changes in telehealth practices (eg, documentation requirements, safety protocols) and perceived barriers to telehealth service delivery (eg, regulatory limitations, inability to bill) occurred pre−/post−COVID-19.

Conclusion

A rapid pivot from in-person services to home-based telehealth occurred at 8 diverse academic programs in the context of a global health crisis. To promote ongoing use of home-based telehealth during future crises and usual care, academic programs should continue documenting the successes and barriers to telehealth practice to promote equitable and sustainable telehealth service delivery in the future.

Key words

COVID-19
telemedicine
videoconferencing
ambulatory care

Cited by (0)

Drs. Folk and Schiel are co-first authors of this article. Drs. Fortuna, Fornari, and Myers are co-senior authors of this article.

The authors have reported no funding for this work.

This study was presented as an abstract at the American Academy of Child and Adolescent Psychiatry 67th Annual Meeting; October 12−24, 2020; virtual.

Dr. Oblath served as the statistical expert for this research.

Author Contributions

Conceptualization: Folk, Schiel, Feuer, Sharma, Khan, Doan, Kulkarni, Ramtekkar, Hawks, Fornari, Fortuna, Myers

Data curation: Folk, Oblath, Feuer

Formal analysis: Oblath

Project administration: Schiel

Visualization: Folk, Schiel, Oblath

Writing – original draft: Folk, Schiel, Oblath, Feuer, Sharma, Khan, Doan, Kulkarni, Ramtekkar, Hawks, Fornari, Fortuna, Myers

Writing – review and editing: Folk, Schiel, Oblath, Feuer, Sharma, Khan, Doan, Kulkarni, Ramtekkar, Hawks, Fornari, Fortuna, Myers

Disclosure: Dr. Folk has received salary support from the National Institute of Mental Health (T32MH018261) and the National Institute on Drug Abuse (K23DA050798). Dr. Schiel has served on the Behavioral Health Steering Board for Epic. Drs. Feuer, Fornari, and Fortuna have received salary support from the Patient-Centered Outcomes Research Institute (PCORI). Drs. Oblath, Sharma, Khan, Kulkarni, Ramtekkar, Hawks, Myers and Ms. Doan have reported no biomedical financial interests or potential conflicts of interest.

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