While in graduate school for a doctorate in nursing, Brighid Gannon DNP, PMHNP-BC and Pritma Dhillon-Chattha, DNP, MHA, RN fantasized about one day starting a business together. The two met at Yale University’s doctorate of nursing program and went on to work in their respective fields and found their own businesses.
One day came a lot sooner than either expected.
Their in-person businesses were paused indefinitely when COVID hit, and they couldn’t see patients. For Gannon, that meant the clients she and her team served in nursing homes throughout New York State were left without psychiatric care visits. “The nursing homes weren’t allowing most practitioners in right when everyone needed mental health services.”
The two quickly pivoted and launched their telemental health practice, Lavender, from idea to implementation in just 45 days.
That first month, they had only one patient. They spent six months networking, listening and meeting with business and mental health practice owners. Eventually, the pace of client appointments started to pick up. “We were getting more patients every month, so we knew we had something there,” says Gannon.
Today, the team at Lavender books about 3,000 visits a month.
Changes in regulations pave the way for telemedicine
Like many mental health telemedicine practices launched during the pandemic, two regulatory factors opened the doors for Lavender:
- Reimbursement: Before COVID, insurance and Medicare reimbursements for telehealth visits were uncommon. Reimbursement opened up opportunities for practitioners to start new practices.
- Controlled medication laws: The Ryan Haight Act, requiring at least one in-person medical evaluation before prescribing a controlled substance over telehealth, was suspended in COVID and extended as of this writing.
Lifting these two barriers provides more comprehensive access to essential medical care, says Gannon. “COVID created a huge mental health crisis in America. Too many people need mental health support, and the demand is much greater than what we can provide.”
How mental health telemedicine transformed the way mental healthcare is delivered
COVID made patients more comfortable with telehealth and the licensed practitioners who provide it. “I don’t find myself having to explain to people what a psychiatric nurse practitioner is when I introduce myself anymore,” says Gannon.
It’s also led to more educated consumers. “What’s cool about technology is that people can take their blood pressure and check their pulse. That’s empowering to patients because they should be able to take their vitals and have some basic understanding of how to interpret them,” says Gannon.
Telehealth has also opened doors for clinicians, offering flexibility, convenience and opportunity. It’s opened up opportunities to start private practices on the side and work with more people. “Working from home is not for everyone, but you don’t lose time commuting, and when you have children, you can be in the same space as them,” says Gannon.
Gannon predicts the use of telehealth will only increase. “We’re going to be challenged regarding what we thought was limited.”
However, a critical consideration for providing mental health telemedicine is knowing how to activate emergency care. Gannon trains her psychiatric nurse practitioners to start every conversation by verifying where the patient is and if anybody is there with them. Calling 911 as a remote provider is not straightforward because emergency calls connect to local dispatchers.
Following are 4 additional ways mental health telemedicine has transformed healthcare:
- Increase in access to care: Clients and patients have more access to care, even in rural locations or too busy to make time for in-person visits. “The no-show rate at Lavender is much lower than industry standards. People can jump on a call, even if they’re running late, and don’t have to travel to an office physically,” says Gannon.
- More choice: Patients and clients can access care from a variety of providers in other states, thanks to interstate compacts.
- Better experience: Clients are starting to demand more of an effortless patient journey. “Why don’t we have more hospitality and kindness in a hospital? If there’s ever a place, it should be when people are sick,” says Gannon.
- Natural environment: Instead of seeking care in an office, clients and patients can relax more in their homes. There’s something nice about seeing a client on their turf,” says Gannon.
Expert advice for starting a new mental health telemedicine practice
After starting two successful businesses, Gannon has learned a thing or two about what’s key to starting a new private practice.
Following are five tips she offers to clinicians beginning a mental health telemedicine practice:
Find a good mentor
Know who you can reach out to, not only to discuss clinical cases but also to understand the business side of things. Being on your own is one of the main challenges of owning a private practice because it can feel isolating.
Be financially prepared
It takes time to build up your patient caseload. You have to be prepared not to make money in the first 6-9 months, so you need a cushion in place.
Learn from everyone who’s started a mental health practice
Gannon and her co-founder spent the first few months meeting with anyone who would agree to talk. They spoke to business owners and mental health practice owners. They even spoke to patients and their families to assess their needs. “We met with and listened to anybody who would give us time,” says Gannon.
Treat telehealth as seriously as you would in an in-person office
It’s important to keep care formal and private in telehealth. This means having a quiet space to see patients with a professional background. Use headphones if others are home when you’re in sessions. It also means staying focused and not getting distracted by other computer tasks or household chores.
Done is better than perfect
From the start at Lavender, they chose progress over perfection, and that hasn’t changed. They had a logo designed on Fiverr for $20 and built a website on Squarespace. “It was quick and dirty because we just wanted to throw spaghetti on the wall to see if it’s stuck,” says Gannon.
The Lavender team combined a good idea, hard work and some luck to design a business that has stuck. In the end, says Gannon, building a mental health telemedicine practice is all about moving forward.
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Brighid Gannon is co-founder of Lavender and owner of Ivy Psychiatry, leading a team of psychiatric nurse practitioners who serve 5,000 patients in nursing homes throughout New York State.
