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Telehealth Best Practices: Aimee Peters of Ascellus On How To Best Care For Your Patients When They Are Not Physically In Front Of You

Assess for the patient’s level of technical literacy — ensure that the necessary technical support is available. Be prepared to discuss the benefits and limitations of telehealth and what to expect if for example the connection is interrupted.

One of the consequences of the pandemic is the dramatic growth of Telehealth and Telemedicine. But how can doctors and providers best care for their patients when they are not physically in front of them? What do doctors wish patients knew in order to make sure they are getting the best results even though they are not actually in the office? How can Telehealth approximate and even improve upon the healthcare that traditional doctors’ visits can provide?

In this interview series, called “Telehealth Best Practices; How To Best Care For Your Patients When They Are Not Physically In Front Of You” we are talking to successful Doctors, Dentists, Psychotherapists, Counselors, and other medical and wellness professionals who share lessons and stories from their experience about the best practices in Telehealth. As a part of this series, I had the pleasure of interviewing Aimee Peters.

Aimee Peters has nearly 25 years of clinical expertise, strategic acumen, product and program development and leadership in the behavioral health industry. She has pioneered virtual behavioral behavioral healthcare, increasing access and high quality behavioral healthcare to many of the US’s largest health insurers across all 50 states.

Driven by a passion for promoting telehealth adoption, Aimee serves as Chief Clinical Innovation Officer at Ascellus, formerly IMCS Group.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?

Educational background — Master of Science in Clinical Social Work from Columbia University School of Social Work and a Post Masters Certificate in Family Therapy from the Ackerman Institute for the Family.

I began my career working for non-profit family services organizations building out and building new clinical programs to strengthen and reunite families impacted by social and mental health factors. For a number of years, I focused on advancing the continuum of care in a New York City hospital behavioral health department bringing evidence-based behavioral health care to individuals and families alongside a multidisciplinary team.

More recently:

Over the past decade, I pioneered the development of the clinical programs and delivery models for high quality, virtually and digitally delivered behavioral healthcare with proven clinical outcomes and medical cost savings. In my current role as Chief Clinical Innovation Officer at Ascellus, I am is focused on transforming behavioral health care in the US Workers Compensation space.

As a healthcare innovator leader I’m passionate about transforming the paradigm of behavioral health and envisioning models and systems of care and treatment that deliver value for diverse sets of stakeholders. I continue to develop solutions that draw on the latest science and technology to successfully strengthen emotional, physical and social health in today’s increasingly interconnected and rapidly evolving healthcare ecosystem and help prepare our next generation of clinicians as an adjunct professor at Columbia University School of Social Work.

Can you share the most interesting story that happened to you since you began your career?

While the current pandemic has had a negative impact on many individuals, families and communities, it has been rewarding that evidence-based telebehavioral health, which has been proven to work to improve access and outcomes, has been adopted at an accelerated rate and has successfully allowed the mental health community to respond at scale to the increased need.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Find something that you are passionate about and build a career around it.” Keeps me going in times like this.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

My mentors have both been subject matter experts and have been compassionate individuals with confidence in their teams. These are qualities I appreciate and that have helped me build innovative, driven teams.

Ok wonderful. Let’s now shift to the main focus of our interview. The pandemic has changed so many things about the way we behave. One of them of course, is how doctors treat their patients. Many doctors have started treating their patients remotely. Telehealth can of course be very different than working with a patient that is in front of you. This provides great opportunity because it allows more people access to medical professionals, but it can also create unique challenges. To begin, can you articulate for our readers a few of the main benefits of having a patient in front of you?

Assessing for risk of self harm and transferring an individual to an emergency level of care — most clinicians across the board are trained to respond in an in person model.

Typically individuals with severe mental illness (chronic high risk for suicide) will be treated in person while clinicans practicing telebehavioral health would implement standard screening tools and plan ahead to leverage a patient’s local emergency resources if the need arises.

Practitioners are used to leaning on in the in person setting to pick up important cues around family dynamics and the presence of culturally informed non-verbal communication. Assessment of these important areas require a higher level of attunement and incorporating interview questions that cover these topics when practicing in a telehealth setting.

On the flip side, can you articulate for our readers a few of the main challenges that arise when a patient is not in the same space as the doctor?

Creating a space that feels safe to share your feelings and what is on your mind. Patients also often have family nearby, which makes it hard for them to feel comfortable. On another hand, issues with connection can be a common challenge with telehealth.

Fantastic. Here is the main question of our interview. Based on your experience, what can one do to address or redress each of those challenges? What are your “5 Things You Need To Know To Best Care For Your Patients When They Are Not Physically In Front Of You ? (Please share a story or example for each.)

1. Assess for the patient’s level of technical literacy — ensure that the necessary technical support is available. Be prepared to discuss the benefits and limitations of telehealth and what to expect if for example the connection is interrupted.

2. Keep at top of mind that the standard of care is the same as in person. For example, ensure that processes are in place for informed consent, risk assessment and management, privacy and confidentiality.

3. Structured interventions are a key component of effective telehealth. Utilize evidence based interventions, assessments and outcomes measures. Track progress and inquire about patient satisfaction.

4. Attend to the therapeutic alliance. Several studies speak to the role of the therapeutic alliance on outcomes and have demonstrated that it is possible to establish a positive working alliance in a telehealth setting that is on par with in person care. Convey genuine, empathic understanding and positive regard. Bring energy, focus and be reading to tune into your patient’s needs.

5. Remain up to date on federal, state and professional licensure guidelines.

Can you share a few ways that Telehealth can create opportunities or benefits that traditional in-office visits cannot provide? Can you please share a story or give an example?

In the context of the COVID pandemic, several in person programs transitioned from primarily in person to almost exclusively telehealth delivery models — this allowed for continuity of care for millions of individuals who would otherwise not have been able to receive essential services, including telehealth. This was also the story of Ascellus — we quickly and seamlessly transitioned our care model to telehealth allowing us to be on the front line of responding to the increased mental health need and serving some of the heavily impacted — individuals who contracted COVID in the job and brought the illness home to family members and well as individuals with COVID who experience cognitive impairment as a result of the disease. We’ve been privileged to provide needed mental health and rehabilitation services via telehealth to accelerate healing and return to work.

Let’s zoom in a bit. Many tools have been developed to help facilitate Telehealth. In your personal experiences which tools have been most effective in helping to replicate the benefits of being together in the same space?

Video sessions have definitely been an important part in replicating the benefits of being in the same room as your doctor. Being able to see each other’s faces and body language takes away from the feeling of being isolated and I have found that it helps my patients feel comfortable with opening up and talking to me about what is on their mind.

Patient facing digital tools allow patients and clinicians to collaborate, track and celebrate progress and discuss changes to the treatment plan when needed.

If you could design the perfect Telehealth feature or system to help your patients, what would it be?

I’ve actually been really impressed with the telehealth features and services my company, Ascellus, offers workers affected by the Coronavirus pandemic.

American Medical Association found that 71.5% of COVID frontline healthcare workers experienced psychiatric symptoms, including depression, anxiety, insomnia, and distress. Ascellus is combating this alarming statistic by launching their COVID Rebound Program to provide evidence-based behavioral therapy to essential workers most impacted by the pandemic. Because COVID has impacted people in so many ways, we first focus on determining the exposure levels and general mental health, then put together a treatment protocol specific to that person’s experience and needs. By offering treatment without the patient ever having to leave home, we are able to meet the patient where they are and help them get back to work better than ever.

Are there things that you wish patients knew in order to make sure they are getting the best results even though they are not actually in the office?

I would like patients to know that their care can be very patient-centered. I like to describe the evidence and science behind this modality and the privacy and confidentiality behind it.

The technology is rapidly evolving and new tools like VR, AR, and Mixed Reality are being developed to help bring people together in a shared virtual space. Is there any technology coming down the pipeline that excites you?

VR for patients who require cognitive rehabilitation or treatment for PTSD is very promising. Momentary ecological assessment and remote patient monitoring as adjunctive to care by a clinician, can help our field to respond more timely and targeted ways. Predictive algorithm and decision support help to scale high quality care.

Is there a part of this future vision that concerns you? Can you explain?

I’m hopeful that we have and will continue to leverage the benefits of telehealth and digitally supporting care as a routine part of healthcare following the pandemic.

Ok wonderful. We are nearly done. Here is our last “meaty” question. You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

I think it is important to continue focusing on addressing and remedying inequities in healthcare, and to continue to leverage science in a biopsychosocial and culturally sensitive manner.

How can our readers further follow your work online?

Connect with me on LinkedIn, follow me on twitter, check out the Ascellus website to see what we are doing in telehealth.

Thank you so much for the time you spent doing this interview. This was very inspirational, and we wish you continued success.

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