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April 27, 2020

Healing from home: UW-Madison engineers support telehealth providers

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Before mental health or addiction treatment providers launch telehealth services, researchers in the Center for Health Enhancement Systems Studies (CHESS) at the University of Wisconsin-Madison can offer training and preparation guided by detailed, proven healthcare systems engineering models.

The COVID-19 pandemic has afforded little time for such gradual, deliberate planning. Outside of residential treatment centers, the vast majority of providers have quickly shifted to telehealth.

 Todd Molfenter
Todd Molfenter

Nonetheless, as the home of U.S. Substance Abuse and Mental Health Services Administration-funded technology transfer centers for mental health, addiction and prevention services across the Great Lakes region, CHESS is helping providers navigate this abrupt transition. The center, based in the Department of Industrial and Systems Engineering at UW-Madison, is sharing best practices and resources, hosting webinars featuring clinicians with previous telehealth experience, and bringing together state leaders in the fields to share approaches and discuss policy changes.

Todd Molfenter, director of all three regional technology transfer centers, says the pandemic-enforced shift will likely usher in long-term changes to treatment approaches.

Among the early anecdotal feedback from a variety of treatment providers: They’re actually seeing an increase in interaction with patients through video and phone appointments, compared to the traditional in-person service model.

Molfenter also points to a recent conversation with a group of Wisconsin mental healthcare providers about in-home case assessments after a patient is released from the hospital. Rather than the standard two-hour commitment, one organization reported effectively completing assessments in 15 to 20 minutes over Zoom while also eliminating travel time.

Molfenter says there are dozens of such examples where changes necessitated by the pandemic are in turn unearthing new efficiencies.

“How healthcare is provided will never be the same again,” he says. “I think there’s been enough learned already and I think people are seeing unexpected benefits to the point that it’s going to change how we provide healthcare and other services.”

If such a scenario had occurred even five years ago, Molfenter says, the transition to telehealth would have been considerably bumpier.

“At that point, telehealth was more through set systems, where you had to buy a telehealth system and you’d have a monitor somewhere and the patient had to be at another similar monitor,” he says. “What’s happened with video platforms has really revolutionized the ability to reach people in their homes.”

That evolution is particularly significant in the current context, given existing evidence that social isolation increases the risk of mental health conditions and substance-abuse disorders. Alcohol sales have soared since stay-at-home orders have covered most of the country. And while there hasn’t been another comparable pandemic in recent history, Molfenter says other disasters such as 9/11 and Hurricane Katrina have prompted rises in addiction rates and the incidence of mental health conditions.

CHESS plans to examine whether the more widespread adoption of telehealth services helps blunt those trends. The center has already submitted a grant to study participation and retention rates in behavioral health services before and after the pandemic.

“It’s a large natural experiment happening,” says Molfenter, “and it would be really good to be able to document it, so people can use that as evidence to guide how they design their services in the future.”