SSM Health Cardinal Glennon Children’s Hospital, a leading pediatric medical center in St. Louis, Missouri, has tackled the state's severe shortage of behavioral health providers by embracing telemedicine. The hospital faced significant challenges as its emergency departments became overwhelmed with patients needing psychiatric evaluations and placements. Recognizing the universal impact of behavioral health issues across diverse demographics, the hospital sought innovative solutions to expand its psychiatric capacity. By partnering with Iris Telehealth, Cardinal Glennon implemented a telepsychiatry program that integrates seamlessly with its existing electronic health record system. This initiative has not only tripled psychiatric activity volume but also significantly reduced wait times and improved patient outcomes. The success of this program highlights the potential for telemedicine to address critical healthcare gaps.

The demand for behavioral health services is soaring nationwide, but Missouri faces an especially dire situation. With only 200 out of 1,000 licensed psychiatrists residing in the state to serve a population of approximately 6 million, the gap between supply and demand is vast. Even before the COVID-19 pandemic, this shortfall was intensifying, and the need for immediate intervention became apparent when Cardinal Glennon's emergency departments started seeing a surge in behavioral health cases. Patients often had to wait for weeks without proper beds or evaluations, creating a pressing need for alternative solutions. The hospital serves a wide geographic area, including Missouri, Illinois, Arkansas, and beyond, making the challenge even more complex. Families were forced to seek crisis care through the emergency department due to extended waitlists and appointment lead times, straining both behavioral health and acute care resources.

To address these challenges, Cardinal Glennon turned to telepsychiatry as a viable solution. Chris DiGiusto, Vice President of Ambulatory Services at SSM Health Cardinal Glennon, noted that behavioral health rarely requires physical examinations, making it an ideal candidate for telemedicine services. After evaluating several vendors, Iris Telehealth emerged as the top choice due to its proven track record and commitment to partnership. The proposal included starting with one full-time dedicated psychiatrist and expanding incrementally. This measured approach allowed the hospital to refine workflows before scaling up. The integration of tele-psychiatrists into the existing Epic EHR platform ensured continuity of care and streamlined documentation. The success of the program hinges on comprehensive wraparound services, which include pre-visit preparation, patient engagement, and ongoing therapeutic support from a multidisciplinary team.

The implementation of the telepsychiatry program has yielded remarkable results. Psychiatric activity volume has tripled, and the percentage of new patients scheduled within 14 days increased from 14% to over 60%. The no-show and same-day cancellation rate dropped from 21% to just 7%, maximizing the use of psychiatric resources. Perhaps most significantly, the average hold time for behavioral health patients in the emergency department has been cut by 50%, preventing many cases from escalating to emergency status. These improvements represent substantial progress in addressing the region's psychiatric care needs, although there is still work to be done. DiGiusto emphasized the importance of treating telemedicine as an integrated care program rather than just a technological implementation, highlighting the role of human elements like care coordinators and social workers in ensuring program success.

For organizations considering telemedicine for behavioral health, DiGiusto advises approaching it as a relationship-building opportunity. Success depends on finding vendors that understand specific needs and are willing to grow alongside the healthcare organization. A comprehensive approach that includes robust wraparound services supporting both providers and patients throughout the care journey is essential. Starting small and scaling incrementally allows for refining processes and building confidence in the program. While technology enables service delivery, it's the human touch—care coordinators, social workers, psychologists, and support staff—that truly makes these programs successful.