Our 6th post in the doxy.me "Voice of Telemedicine" blog series brings you insights from North Pine Counseling Center owner, Ken Scroggs.
This is an opportunity for telemedicine professionals to share their experience with telemedicine.
About the author, In 1987, Ken founded the North Pines Counseling Center. Ken received a BA from LaGrange College with a double major in Psychology and Social Work. He received his Masters in Social Work from the University of Georgia. He's earned three licenses to practice in Georgia: Clinical Social Work, Professional Counseling and Marriage and Family Therapy. He's also a Certified Employee Assistance Professional.
Tell our readers about yourself and why you decided to get involved in the telemedicine space.
Utilizing technology to make mental health services available to more people was a natural progression for me and my colleagues. Over the years my Employee Assistance Programs have made the transition from only providing face to face counseling services to telephone counseling (especially via our Crisis Hotline), and then to video conferencing.
We're not attempting to replace face to face counseling, but to augment it with support in between sessions. The need for mental health services is greater than ever and corporations are seeing how this can impact their bottom line.
What's your background and specialty? How long have you been in telemedicine? Where is your primary focus? My background goes back to the early days of civil rights when I was a juvenile probation officer working out of the Office of Economic Opportunity in a small town in Georgia. After completing an undergraduate degree with a double major in Psychology and Social Work, I attended the University of Georgia obtaining a Masters in Social Work. During the Vietnam War I was a Social Work Officer providing services in a variety of capacities including an Army Hospital, Mental Hygiene Clinic, Army Community Services and eventually working under General Robert Shoemaker, FORSCOM Commander at Ft. Hood Tx. He assigned me to launch the Leadership Development Program and to be the General Secretary to the Human Services Counsel coordinating all human services on post. After leaving the military 30 years ago I have been the CEO of a private psychotherapy practice, North Pines Center, Inc. as well as the CEO of EAP Works. My involvement in TeleMental Health became more significant about 8 years as the technology became more advanced with a focus on providing emergency mental health services.
What motivated you to start get into telemedicine? My goal has always been to help as many people as possible by providing mental health services. Over the years I’ve met many healthcare professionals and this is one thing we all have in common, helping others. Technology greatly expands our ability to reach so many people many of which would be without the care they need.
How has telemedicine changed in the last year? One significant change in the use of technology occurred last year when the State of Georgia Composite Board, which governs three professional groups, Social Workers, Professional Counselors and Marriage and Family Therapist passed a regulation (Ga. Reg. 135.11.01) requiring all these licensed professionals to complete six hours of training in TeleMental Health. This makes TeleMental Health (TMH) mainstream within the mental health profession. I was involved in the design of the requirements within the course content. A significant portion of the course focuses on how to protect PHI, and it addresses the fact that most health care professionals use cell phones (which we refer to as Handheld Computers requiring HIPAA protection) and emails. The course also includes best practices in the use of synchronous and asynchronous delivery methods.
Where do you see the telemedicine market 1 year from now? Mental health services are a perfect fit for using technology. I believe the use of technology within mental health will grow at an enormous rate. Additionally, the greatest change we’ll see over the next year and years to come is the need for making services convenient. This reduces time lost away from work and school for millions of adults and children.
From your POV, how do patients like meeting with doctors by telemedicine? For those people where TeleMental Health is a good fit for their therapy, they love it! Also, people greatly appreciate being connected to their therapist, especially in times of crisis. When there is an accident, overdose or relapse, death of a loved one, divorce or your teenager runs away from home the client wants help and they need it immediately. Some of these issues need to be directed to a medical facility, but most do not. Even when they need medical attention, support via the use of technology can be vital.
What do doctors find most valuable about telemedicine? Perhaps the most valuable service therapists enjoy is the expansion of their service area. We often think of the fact that there is a tremendous need for healthcare in rural areas, and we all know that it's true across the country. For example, the Georgia Partnership for TeleHealth has been connecting doctors and nurses with patients in rural areas for about seven years and have helped thousands at hospitals, clinics and in schools. At there recent annual conference, I couldn’t help but appreciate several speaker's mention of the need for more behavioral health services to augment their existing healthcare delivery system. Additionally, what we’re realizing with our traffic problems in Atlanta, is there are times your therapist is only 20 miles away, but the time it takes to get through traffic might be well over an hour.
Do you have any insightful, interesting, funny, or notable experiences from your tenure in the telemedicine space? Perhaps one of the most interesting and helpful uses of telemedicine is with couples in marriage counseling who are separated by their jobs being in different parts of the country. The separation of a couple can create issues or complicate existing problems. Having the husband, wife and therapist meet weekly via telemedicine can greatly help support and even save marriages. Often there are humorous exchanges within these distance counseling sessions to uplift what can be some “heavy” situations. Once I had a husband show up in a clown suit on a video counseling session. His wife was greatly impressed by his efforts and we all got a big laugh! Of course, he would never have dressed up like a clown to come to a face to face session. It worked to get our session off on a good start that day and his wife frequently made mention of it after that. Underlying the humor is the fact that it showed how much thought and energy he was putting into the marriage as well as that one funny gesture.
What challenges have you seen doctor’s experience with telemedicine? How did they overcome them? I believe the main challenge is our technology infrastructure with bandwidth as well as the frustration with upgrades that are required from time to time. Of course, it’s frustrating for everyone when there's a technology glitch, but technology issues that create problems of connectivity and disruption can have exacerbating effects on a person experiencing anxiety, major depression and so forth. For some clients, such technology issues make the use of video conferencing unacceptable. For clients that have the technical skills and equipment as well as the temperament, I recommend that the first counseling session be face to face in the therapists office, if at all possible. The client can bring their laptop and during an extended session the therapist can conduct an assessment of the prospective client’s emotional concerns as well as connect over doxy.me or the platform most comfortable for the client. Of course, it must be HIPAA compliant and the therapist should have a BAA in place with the provider platform.
What advice would you give to other healthcare providers interested in starting telemedicine? I strongly encourage my mental health colleagues and participants in my TeleMental Health courses to experience a “mock session” with a colleague to see the ease and effectiveness that TMH offers. In my advanced courses we offer “hands on” training to help therapists set up their equipment, learn best practices and answer all their questions. We also examine the importance of client selection so they are comfortable working with clients where successes have the greatest potential. My main advice is to simply try it because I think most therapists will like it.