In Arizona, Polycom® RealPresence® Video Solutions Enable NARBHA to Remove the Distance Separating Patients from the Care they Need, While Saving Millions of Dollars
Polycom,
Inc. (Nasdaq:PLCM), the global leader in open standards-based
unified communications and collaboration (UC&C), is enabling an
Arizona managed care organization to bring community-based,
patient-centered care to remote and rural areas using an innovative
video collaboration network, while saving millions of dollars.
Northern
Arizona Regional Behavioral Health Authority (NARBHA), a private,
not-for-profit corporation designated by the state to manage publicly
funded behavioral health services, contracts with more than 80 providers
to manage care for 700,000 Arizonans across a sprawling, arid region
that spans half the state but is home to just 11 percent of its
residents. NARBHA’s network also provides behavioral healthcare services
to 10 American Indian tribes. In the midst of these vast distances,
NARBHA relies on a Polycom®
RealPresence® video collaboration network to provide patients with
personalized, face-to-face care from psychiatrists and other behavioral
health professionals often in higher demand in remote and rural areas.
“Many small towns in northern Arizona are hours from the closest
psychiatrist, and that effectively puts working people, children, and
others beyond the reach of traditional care,” said Nancy Rowe, director
of telemedicine at NARBHA. “That’s why our telemedicine network is so
crucial to how we deliver services. Doctors love it because they get to
live where they want, and patients love it because they can get care
right in their own hometowns and not have to miss work or school to
travel to get care. And the state loves it because it’s efficient –
we’re not paying doctors for the hours they’d have to spend traveling,
we’re paying them to provide patient services instead.”
Community-Based Care: 4 out of 5 Patients Prefer or Are Satisfied
with Telemedicine
With the support of telemedicine, patients typically visit their
community health center, where they participate in a video call with
their remote doctor by using a Polycom RealPresence video solution.
On-site clinicians assist the patient, while NARBHA telemedicine staff
make the connection to a remote physician who engages via video from
NARBHA’s Flagstaff headquarters, which is equipped with Polycom®
HDX® series room systems, from another clinic in the region equipped
with a Polycom room system, or from a home office using Polycom HDX
series room systems or Polycom®
RealPresence® Desktop 2.0 software on PCs.
“We have psychiatrists who remotely see patients from Texas, Florida,
New York, and Kentucky,” said Rowe. “This system works because it allows
these small community clinics to deliver the same level of care that a
clinic in Flagstaff or Phoenix does. Doctors and patients report that,
after the initial session, they forget the technology is between them.
The doctor is about life-size on the TV, creating a natural experience
for the patient.” The quality of Polycom audio and video helps create
that experience.
In fact, in a recent NARBHA patient survey, just 20 percent prefer
in-person consults, with four of five patients saying they either prefer
telemedicine care or don’t have a preference.
Patient Centered Care: Facilitating Team Treatment and Coaching Models
The Polycom network also supports NARBHA’s team treatment model of care
by making it easier for multiple professionals to participate in a
single patient session. “In a typical scenario, the patient and
therapist are together at the clinic, and the psychiatrist is on video;
this helps the patient see that they have a team caring for them and
helps the clinicians communicate,” Rowe said. “In another model, NARBHA
clinical care coordinators will form a team to help with, for example, a
child’s anger management treatment. The team might include a teacher,
pastor, family friend, parent, therapist, and professionals from other
organizations such as Child Protective Services. The Polycom video
network lets us bring that big group together into a single session. And
if everyone can’t join on video, they can participate on audio. It just
makes it easy to create that team and then keep it together.”
NARBHA serves a diverse client base, as shown by the fact that patient
materials are published in English, Spanish, Navajo, and Hopi. This
makes the lifelike quality of Polycom video and the fidelity of Polycom
audio that much more important for doctors providing care to many
ethnicities, cultures, languages, and accents throughout each day. “The
quality of Polycom audio and video makes communicating so much easier,
especially since so much of what we communicate is visual,” said Rowe.
“Doctors need to see patients clearly, to pick up on their expressions
and body language.” NARBHA’s network is also used to provide American
Sign Language interpretation services to counseling sessions in remote
towns that don’t have access to ASL interpreters.
Reducing Inpatient Stays: Saving Millions
As one of the first behavioral healthcare agencies to implement
telemedicine in the U.S., NARBHA began offering video consults in 1996
and switched to Polycom solutions in 2001. At first, the purchases were
funded with grants, but as different clinics and providers saw how the
telemedicine network helped them hold down costs, they began to funnel
their own budgets toward video solutions. “We all get a set amount of
money every year,” said Rowe. “Telemedicine helps us make the most of
it.”
The cost savings helps explain the state’s growing reliance on video to
reach rural patients. In 2011, NARBHA administered 10,500 patient
sessions over video, along with 3,826 administrative and training
meetings. The state saves more than just the $475,000 a year in
transportation costs and time lost to travel. In 1996, prior to
implementing its collaborative video network, Arizona’s Apache County
averaged 11.22 inpatient days per month per 1,000 patients. One year and
hundreds of video consults later, Apache County’s average inpatient days
dropped to 7.73 per thousand – a reduction of 31 percent that represents
a real-world average savings of $4,070 for every 1,000 patients.*
Collaboration Across State Agencies
NARBHA’s network is powered by the Polycom®
RealPresence® Platform – the most interoperable and comprehensive
software infrastructure for universal video collaboration – in Flagstaff
with redundant Polycom infrastructure in a backup data center in
Phoenix. The RealPresence Platform offers support for open industry
standards, which simplifies NARBHA’s regular video meetings with state
agencies and other healthcare administration organizations. “They’re
supposed to be failovers for one another, but we get such a high volume
of calls that we often have to use both,” Rowe said.
Even when traffic is at its peak, Rowe said NARBHA knows it can count on
its Polycom network to deliver: “We’ve been running the same Polycom
bridge every day for eight years to connect all video and voice calls.
It just works.”
About Polycom
Polycom is the global leader in open standards-based unified
communications and collaboration (UC&C) solutions for voice and video
collaboration, trusted by more than 415,000 customers around the world.
Polycom solutions are powered by the Polycom® RealPresence®
Platform, comprehensive software infrastructure and rich APIs that
interoperate with the broadest set of communication, business, mobile
and cloud applications and devices to deliver secure face-to-face video
collaboration in any environment. Polycom and its ecosystem of over
7,000 partners provide truly unified communications solutions that
deliver the best user experience, highest multi-vendor interoperability,
and lowest TCO. Visit www.polycom.com
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About NARBHA
Northern Arizona Regional Behavioral Health Authority (NARBHA) is a
non-profit managed care organization advancing integrated primary care
and behavioral health services in Mohave, Yavapai, Coconino, Navajo and
Apache Counties for people with behavioral health disorders. Established
in 1967, NARBHA serves a 62,000-square-mile region through a network of
more than 75 agencies delivering inpatient, outpatient and recovery
services. Through its community reinvestment grants, NARBHA promotes its
innovative incentive model that commits integrated primary care services
throughout its network. Behavioral health and substance abuse services
are funded through a contract with the Arizona Department of Health
Services/Division of Behavioral Health Services and AHCCCS.
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*Kaiser
Health State Facts, average cost of inpatient day in Arizona
state/local government hospital: $1,163 (2010 figures)