A story published in the July 8th 2008 issue of “Images” a State of South Carolina publication, describes the road to success and the time and effort it took to develop a relationship with a source for possible funding. In 2006, the need to address mental health issues in South Carolina was creating critical problems for the state. According to John H. Magill, the South Carolina Director for Mental Health (DMH), people with behavioral health problems were crowding into hospital emergency rooms for treatment because of a scarcity of local resources.
The Duke Endowment a private foundation established to serve the people of North and South Carolina has a program that supports healthcare. In the fall of 2006, Duke Endowment sent some representatives to pay a courtesy call to meet with Mr. Magill to discuss the Duke Endowment’s growing interest in mental health issues in the state.
Mr. Magill was very interested in talking to the representatives from Duke Endowment about the possibility of easing problems in the state and being able to provide adequate mental health care without crowding the emergency rooms. DMH already had a successful record of using telemedicine to serve clients with mental illness that were deaf. The representatives liked what they heard about using telemedicine and were interested in pursuing the matter to help in the emergency rooms.
As Duke Endowment was learning more about the possibility of the DMH proposal, Mr. Magill expanded his team to find others with a stake in finding an effective solution that could bring assets to the table. He approached the South Carolina Hospital Association, South Carolina Office of Research and Statistics, and the South Carolina Department of Health and Human Services to get on board with the project. Discussions were also held with the heads of the Departments of Psychiatry at the University of South Carolina, School of Medicine, the Medical University of South Carolina, and the Medical College of Georgia.
In June 2007, DMH submitted an application to Duke Endowment, and in November 2007, received a letter saying that the agency had been awarded a $3.7 million grant to develop and implement the telepsychiatry consultation network in all emergency rooms around South Carolina.
By using telemedicine in the emergency rooms, psychiatrists can now provide better mental health care to smaller rural communities by using state-of-the-art video and voice equipment placed in all participating emergency rooms. The equipment is capable of providing direct links to DMH where psychiatrists can be available 24/7 to conduct face-to-face behavioral health consultations with the patient, the family, and the ER staff. Participating hospitals can also contact each other for other medical consultations.
Also, Mr. Magill formed the Connectivity Committee, a group comprised of DMH’s business partners, leadership from other state agencies and universities, and other principals to serve in an advisory capacity. The idea is for the group to review the status of DMH’s telemedicine project in light of other advanced technological initiatives taking place in and around South Carolina.
That was not all that was accomplished. In addition to the use of telemedicine in the emergency rooms, electronic medical records were installed in mental health centers in the state. Since, the South Carolina Office of Research and Statistics was developing a multi-agency electronic health record, the South Carolina Department of Health and Human Services awarded South Carolina DMH a $1 million grant to design and implement an electronic health record system.
In 2007, the Electronic Medical Record was ready to move beyond the pilot stage, so the system was installed it in three mental health centers and now has expanded to all of the satellite offices. The system includes client and individual treatment plans and progress summaries, plus the scheduler has all of the client’s appointments.
Most clinical documentation placed in the clinical notes section includes psychiatric medical assessments, medication monitoring plans, and clinical service notes. The initial clinical assessment section is in development and will be added later this year, followed closely by the psycho-social rehabilitative service notes. New documentation will be added in the order of what is most widely used.