May 2024

Psychiatry eConsults strengthen primary care, save lives

With behavioral and mental health needs rising across all patient populations, psychiatric eConsults are a valuable resource for patients and primary care providers.

The primary care provider at Finger Lakes Community Health Center was alarmed. Her patient—a person in remission from opioid use disorder, with a history of traumatic brain injury—suddenly became paranoid, their mental status altered. The patient’s MRI showed abnormal results.

Gorgeous lakes and historic sites are plentiful in this Upstate New York region. Specialty care appointments, not so much. The provider issued urgent referrals to a psychiatrist and neurologist. Neither was able to provide an appointment to rapidly see or evaluate the patient. The patient went to the ER, where an ER physician recommended psychiatric medications. 

At the health center however, the patient’s provider was not comfortable with the diagnosis or the proposed treatment. She turned to ConferMED.

How It Works

EConsults, secure electronic exchanges of information between primary care practitioners and specialists, are powerful tools, especially where specialty care is not readily available and primary care providers must fill in the gaps. Using ConferMED’s  efficient process, the Finger Lakes provider ordered a psychiatry eConsult from her EHR. Within one day, she received an in-depth consult note from a board-certified psychiatrist with detailed treatment and follow-up recommendations.

Behavioral health needs continue to grow in an America where people are increasingly troubled by stress, anxiety, depression, trauma, and substance use disorder. The burden of these problems falls disproportionately on poor people and people of color, groups who often face limited access to health care. Navigating the behavioral health “system” can be challenging for anyone. But when individuals and families face barriers to treatment because they lack insurance or are “underinsured” through state Medicaid programs, their difficulties are compounded.

How psychiatric eConsults strengthen primary care

Primary care providers are routinely managing patients with common behavioral health conditions. Studies suggest that approximately 40% of all office visits related to behavioral health occur in primary care settings, and primary care physicians write nearly half of all behavioral health prescriptions.

Still, primary care physicians are not psychiatrists. A family practice doctor who prescribes basic psychiatric medications to some of his patients, Dr. Dan Wilensky, ConferMED’s Medical Director, uses psychiatry eConsults for additional treatment advice and guidance. He says many primary care providers like himself turn to ConferMED for assistance with their more complex patients, including those with extensive clinical histories, co-morbidities, histories of trauma, recent hospitalizations, and multiple prescriptions.

“I find psychiatric eConsults very helpful,” Dr. Wilensky explained. “Psychiatrists can help us know which approaches and diagnostic tools to use to sort out unipolar from bipolar depression, anxiety from hypomania, and PTSD from personality disorders. They help us with dual diagnosis cases. They may recognize incorrect assumptions we have made about our patients. They can help guide us when prescribing or continuing previously prescribed medications that we are less familiar with.”

More providers are taking advantage of psychiatric eConsults

Dr. Daren Anderson, President of ConferMED, says his company is increasingly seeing eConsults used to assist with patient behavioral health needs.

“We have a large and growing team of adult and child psychiatrists who provide detailed recommendations to help guide primary care providers often working in communities with very limited access to behavioral health treatment,” he said. “The psychiatrist’s guidance can help primary care providers make the right diagnosis, refine their treatment plans, and know when to refer to a higher level of care.”

Today at the Finger Lakes Community Health Center, the patient is receiving appropriate treatment. “Your team was able to assist with review,” recalled Ellen Hey, FNP, the Center’s Chief Clinical Officer. “The eConsult psychiatrist recommended further lab tests and initial treatment. The patient has since been seen by a psychiatrist and neurologist.”

For Dr. Anderson, the patient’s story illustrates the power of eConsults to support primary care providers in delivering the best results to their patients. Today, with suicide rates rising across the United States and many people unable to access any mental health treatment at all, it is no exaggeration to say that psychiatric eConsults may help save lives.

If you would like to learn more about psychiatric eConsults and ConferMED’s other services and benefits, click here to contact us or schedule a conversation with a member of our team.