Bringing Specialty Telebehavioral Medicine Home: Feasibility of a Quality Improvement Pilot for Medically Complex Patients

Abstract

Objectives: The aims of this quality improvement project were twofold: Phase 1: conduct a needs assessment study for home-based telebehavioral medicine (H-TBM) among medically complex patients living in rural areas seeking care at an academic medical center (AMC) in a Behavioral Medicine Clinic, and Phase 2: evaluate the feasibility of a pilot implementation of H-TBM to improve therapy access for these underserved patients.

Results: The needs assessment study supported patient interest and need for H-TBM services. In the pilot, patients and providers were “satisfied to completely satisfied” using H-TBM. Patients engaging in H-TBM (Phase 2) reported significantly lower acute distress after H-TBM sessions than they experienced prior to sessions (t(29)=4.26; p<.001).

Conclusion: Results demonstrated preliminary acceptance by and feasibility for Behavioral Medicine Clinic patients with complex medical conditions to receive psychotherapy via H-TBM (in their homes), reducing their travel burden. H-TBM services offer the following benefits to chronically ill patients: they help to manage psychosocial complications associated with chronic disease and to prepare for intensive medical interventions.