Executive Mental Health LA

Penelope Gallegos, Regional Nurse Consultant and Community Liaison

Back in March, Executive Mental Health’s partner facilities started closing off access to reduce the spread of COVID-19. Our psychologists and neuropsychologists couldn’t visit their patients, and neither could the patient’s families. Unable to offer mental health care when most needed, EMH worked fast to devise a new system, and TeleHealth was born.

To be honest, it was not easy, but we did learn a lot along the way. Here is the backstory on bringing TeleHealth to life.

Step 1: Tap into technology… and intuition. As a community liaison, I get pulled into great conversations with the executive team. When faced collectively with a problem, we have to think out of the box and conjure up ways to fix things we’ve never encountered. In this instance, I was tasked with figuring out how to get a tablet from room to room, while limiting physical contact. Did we need a rolling stand? Who would move the stand? How do we get the notes back to the SNF facility? There were so many questions, just keeping track of them was a job itself. After looking at various scenarios, we landed on a HIPAA-compliant solution that would work for residents, the SNF facility, and our doctors.

Step 2: Get the word out. If you’ve ever been in a SNF facility, you know the teams are always working on a number of shifting priorities, but even more so in a pandemic. The last thing on facility director’s mind would be entertaining yet another ‘marketing’ call. Prior to the pandemic, we could walk into a facility, get to know the staff, their needs, culture, and population. But not now. Faced with rejection, my motto during this time was “just do it.” We prepared special materials, made calls and wrote many mails knowing what we were offering was going to make a difference in people’s lives. It worked. Rejection got easier, the discouragement turned into encouragement, and insecurity to confidence. We were helping people and it felt good.

Step 3: Partner for progress. Truthfully, EMH TeleHealth would not have been possible without the help of our partners, who gave us essential feedback early on to craft a product and an operating protocol that worked. We made the switch to TeleHealth in late March, and started to see what worked, and what didn’t. Seeing some residents were not as open and receptive over a computer, we ensured the doctors explained the intent and process, and gradually were able to gain the patient’s trust.

Step 4: Be open to reinvention. While our clinicians wouldn’t be in the room speaking to the residents, we did need to find someone to take the tablet from room to room. This prompted the creation of a new team member at EMH: The Device Technician (DT). We built a completely new profile for this professional who offered essential logistical support including scheduling, moving the tablet to each patient, and gathering the necessary documentation for the clinicians.

Step 5: Come prepared. It took a lot to make TeleHealth work. Apart from the tablet and a team of highly trained clinicians, we needed our own PPE and an abundance of patience. Some days were easier – like when the residents literally lined up in the hall in eager expectation for their visit with the doctor. But other days were more challenging. There were new CDC guidelines to read and apply, new device technicians to train, as well as anxiety to deal with. While trying to be a superhero, I was prepared to focus on what was most important so our doctors could help patients, one day at a time.

Step 6: Follow through. This is perhaps the most important part. The devil is always in the details, and for EMH that meant scheduling time with facilities remotely, collecting documents in between sessions, gathering medication lists, psychiatry notes, lab results, and more. Akin to walking through your own home blindfolded, we had to employ our deep understanding of the workings of a facility to preempt issues and offer solutions.

There are so many stories about working and living in a time of COVID-19, fortunately this is one of the good ones where everyone wins.