OSF HealthCare Pilots Telepsychiatry Support for Emergency Rooms

In the face of a mental health workforce shortage, OSF HealthCare, which operates 16 hospitals in Illinois and Michigan, is partnering with Boston-based Amwell to provide 24/7 365 telepsychiatric consult support to emergency departments at nine hospitals as part of a pilot to provide mental health assessments more quickly to help speed treatment for those in crisis.

Samuel Sears, M.D., psychiatrist, director of Behavior Health Physician Services at OSF HealthCare, explained that hiring psychiatrists is nearly impossible with a nationwide shortage and when competing with larger hospitals in desirable coastal cities. So the Behavioral Health team looked at third-party providers for telepsychiatry services and chose Amwell because of its reputation and its success helping much larger, well-known health systems.

“If they can handle Cleveland Clinic's volume and intensity, they would be a good partner for us. And then really looking at cost as well,” said Sears, in a statement. 

The pilot with Amwell began at OSF HealthCare Saint Francis Medical Center in Peoria, a busy, Level 1 trauma center, and at two hospitals in rural locations – Alton, Ill., and Escanaba, Mich., where there is no psychiatrist on-site but growing demand from patients showing up at the emergency department. 

Danielle Bess, L.C.S.W., lead psychotherapist at OSF Saint Francis Medical Center, said patients in crisis were waiting hours to be assessed.

“Having those patients sitting in the ER waiting eight plus hours to be seen by a therapist is upsetting,” Bess said in a statement. “You know, for anyone that works in the mental health field that has a passion for this we know that those patients need help fast. So, with those extended wait times, patients just were not getting the help that they need.” 

Bess pointed out a hospital emergency department doesn’t offer a therapeutic setting, and long wait times put pressure on providers and mental health monitors who sit with patients to make sure they don’t harm themselves or others.

For OSF Saint Francis, Bess said, two-thirds of the patients coming into the emergency department who were seen by an Amwell psychiatrist have required inpatient treatment so having them assessed more quickly can help speed up the process of finding a treatment facility, which is done through the OSF OnCall Care Hub. When patients can be evaluated overnight, that frees up the backlog the Care Hub faced each morning trying to find appropriate placement for individuals who need an inpatient facility.

Sears said that based on success at the first three hospitals, six more have been added to the pilot and they are reporting success. He added that for the most part, Amwell has been able to meet the goal of providing a psychiatric assessment within one hour. OSF Saint Francis is also now using Amwell telepsychiatry for other patients admitted to the hospital, including those in the ICU.

A more detailed analysis of return on investment is under way, but Sears said it’s clear that even four months into using Amwell services, patients are being assessed more quickly, providers feel less stress, and patients’ medication is being better managed, helping prevent longer hospital stays. 

Based on the success of its pilot, OSF HealthCare plans to continue deploying Amwell telepsychiatry services to all 16 hospitals on a rolling implementation schedule.