Health board tables Eastpointe tele-psychiatry collaboration
By Phyllis Moore
Published in News on July 7, 2016 1:46 PM
Wayne County Health Director Davin Madden was so optimistic about a proposal to introduce mental health screenings at the Health Department that he invited this year's teen essay contest winners and their families to stay for the business portion of the recent Board of Health meeting.
In a departure from the usual noontime session, the June 29 evening meeting was primarily taken up with presentations of the winning essays -- which, coincidentally, all dealt with mental health needs -- prompting Madden to encourage the audience to stick around afterward.
Instead of a warm reception to the tele-psychiatry collaboration with Eastpointe, however, the board voted to table the proposal, citing the need for more information.
Madden said this week that he had anticipated receiving a copy of the Eastpointe contract in time for the meeting. It arrived the next day.
With mental health, and access to care, being hot topics everywhere, he said he was receptive to the tele-psychiatry approach brought forth by Eastpointe, which recently received a grant.
"I think it's good from a standpoint looking at trying to integrate a full level of comprehensive care," linking up patients with mental health resources, he told the News-Argus.
He told the board he had been contacted by Dr. Venkata Jonnalagadda, medical director for Eastpointe, which received the three-year grant.
"What they have proposed to the Health Department is collaboration to set up a kiosk in the Health Department that will help to screen for mental health issues," he explained. "This is going to be recognized on the same level as when you go into, for example, Walmart, and you get a blood pressure screening. People can sit down in this kiosk -- it has a video screen, it has a telephone and will hook into an encrypted wi-fi system and will have a privacy panel so a person who's having any issues or just wants to do a self-assessment on mental health, can go in and fill out this electronic mechanism and if there's any red flags they can actually get linked in right away (through a video camera) to a mental health specialist that can work with them, setting up an appointment for resources."
The resource would cost the Health Department "very little," he said.
"Our main component will be to have the responsibility of a contact person that will be mainly in charge of making sure the kiosk is functioning," he said. "Some have printers, some do not. If it does, we'd have to check it periodically. That is about the bulk of our responsibility.
"They do all the maintenance. They do all the upkeep on it. They will even come in and offer mental health, first aid training to our staff and our nurses, to work with them if we'd like that as an additional benefit."
Madden suggested the board approve the effort, partnering with Eastpointe in installing the kiosk on site.
"My recommendation is that if we can find an appropriate place -- the space is not that much from what I understand, about the size of a small desk area," he said.
The move stalled, though, after a brief discussion by the board.
Potential costs and privacy issues were among the biggest considerations, several said.
"I really think, Davin, we need a private place so that everyone isn't looking at someone answering the questions on the screen," said board member Dr. Kim Larson. "Is there such a place available in the Health Department to put this?"
Madden said he believed there were options available, noting that Eastpointe would be responsible for the "privacy part," providing a partial wall for the kiosk.
Board chairman Bob Cagle questioned the costs associated with the move -- a dedicated phone line, the Internet and ongoing costs.
"I don't know the actual costs but they mentioned that they would be willing to help us expand our wireless interface through the Health Department," Madden said. "It would use a certain amount of our broadband. We wouldn't create a separate one.
"It costs nothing for us. They're getting it through a grant. There's really no investment from our end because of the wi-fi component."
Cagle was hesitant.
"I think I'd like to just table this until our August meeting, bring it back at that point in time with a little more detailed proposal. Ask those kinds of questions that we've asked, the cost to run a new phone line, those kinds of things," he said.
Ms. Larson asked if there had been data on the effectiveness of the tele-psychiatry model.
Madden said Wilson and Johnston counties have used it and the feedback indicated a "positive experience."
Ms. Larson asked if there was a time factor attached to the proposal, since it was grant-related.
"I don't know when the deadline was," Madden replied.
Cagle said if that proved to be the case, the board has the option to conduct business through email and an electronic vote. He said he preferred to table the topic and seek more specific answers.
"What specifically do you want to know?" Madden asked.
Cagle asked for more details on potential costs to the Health Department.
"Find out from the other counties that have been using it, what their experience is, numbers of people that they think have been using it, how are they set up," he said. "I know that you've got a privacy screen, it says, but where is that privacy screen? Is it set up right in the middle of a hall so that even if it's a privacy screen, you see somebody going in and out of it, you know they're going in and out for mental health issues. That, to me, is not right.
"Where, more specifically, would we locate it where there can be some privacy, more than just a screen?"
"I would really like to see some results on some research, if they have any," Ms. Larson added.
Madden said Wednesday he will provide answers to the board from the contract, but there is still a time-dated component.
"I think (Eastpointe) wanted to implement it in July, according to the grant," he said. "If we really want to go and strike it, it could be taken to another county where the network is interested, but I hope that will not be the case as Wayne County is ideal (for this). If they (the board) don't, it's still tabled."