Implementation Plan
The deployment of the proposed telehealth technology requires a consideration of various critical aspects that influence implementation and effectiveness in the long term. As previously identified, there is need for telehealth in the Murray County Central School District due to the insufficient presence of resources necessary for the dispensation of mental health services to high school students in the respective environment. Based on current evidence surrounding the potential for better mental health outcomes associated with telehealth, a synchronous videoconferencing intervention was proposed and supported. The respective technology aims to offer adequate counseling services to high school students. Hence, for the aim of proper implementation, the discourse will address the adequacy of the existing telehealth technology infrastructure, assign tasks and responsibilities for deploying the technology, develop an implementation schedule, determine staff training prerequisites and strategies, develop a strategy for collaboration, and establish a post-deployment telehealth technology evaluation and maintenance strategy.
Adequacy of Existing Telehealth Technology Infrastructure
The existing telehealth technology infrastructure at St. Anthony Medical Center (SAMC) is resourceful and sufficient in supporting the inclusion of videoconferencing technology for synchronous virtual counseling. However, the provision of a grant illustrates the facility’s need to revamp the existing system in order to facilitate the effective implementation of the proposed telehealth technology. Implementation of the respective service depends on the facility’s capacity. Accordingly, barriers to implementation comprise technological concerns, clinical workflows, staffing issues, and organizational cultures (Rutledge et al., 2017). In this context, the facility will technological factors including the existence of required mobile and hardware technology such as tablets, laptops, and desktops, as well as the internet capacity. Assessment will focus on addressing whether these devices are outfitted with audio systems and high-definition (HD) video cameras. There is a knowledge gap concerning whether the current internet capacity is capable of offering continuous video communication. If the respective resources are inadequate, changes will focus on equipping devices with HD cameras and increasing the bandwidth capacity.
Tasks and Responsibilities for Deployment
The implementation of telehealth technology requires a thorough consideration of several factors, ranging from the population of the organization to the location and number of offices. Foremost, the process begins with convening a team responsible for making critical decisions, including offering leadership during the implementation process (Rutledge et al., 2017). Some individuals with expertise to be considered comprise the organization’s leadership, quality assurance specialists, information technology specialists and marketing personnel. The program manager leverages the various skillsets to coordinate process reviews, provide project oversight and ensure adherence to policies, regulations and routines. The technology manager will work on security measure, such as user authentication. The team member is equally responsible for monitoring the system. Clinicians provide the necessary feedback regarding the system’s efficiency and effectiveness for continuous improvement. Quality assurance personnel ensure that system adjustments do not impede service delivery and contribute to improving patient outcomes.
Implementation Schedule
The implementation process will entail meetings running across a six-week schedule. The meetings will be conducted until there is consensus regarding process standardization. Subsequently, team session will be done bi-monthly. Intended is for each meeting to last a single hour. The purpose of the meetings is to review the current telehealth system, create plans for continuous communication and offer potential solutions to identified inefficiencies. The system upgrade will be done in three phases. Pre-implementation (six weeks) will cover the identification of team members. Implementation (another six weeks) will involve personal education and training on the use of telehealth technology. Post-implementation will take four weeks and will involve providing technical support.
Staff Training Requirements and Strategies
Effective implementation of the intervention also depends on the staff’s awareness and knowledge of synchronous videoconferencing. Since a significant aspect of the plan concerns the alleviation of technical issues, the telehealth coordinator will be responsible for implementing a training strategy. In this context, training will be provided to clinicians such as nurses to address concerns associated with the use of videoconferencing technology. The focus on use derives from the role experience assumes in facilitating the application of telehealth modalities (Muir et al., 2020). Accordingly, experience in the application of videoconferencing modalities influences the promotion and management of new services (Muir et al., 2020). Additionally, overcoming resistance to the application of telehealth requires the integration of experience-oriented activities such as simulation training (Rutledge et al., 2017). Training incorporating experience-based activities and didactic learning furthers understanding regarding the application of telehealth modalities (Rutledge et al., 2017). Hence, the provision of training aimed at the usage of the respective technology influences its application, as well as management.
Collaborative Strategy
The provision of training also creates opportunities for the development of a collaborative strategy aimed at patients and other healthcare providers. Training will facilitate the adequate exposure of the respective technology to end-users. For example, clinicians knowledgeable in the use of videoconferencing will help end-users understand the implications the respective intervention poses for mental health outcomes (Ignatowicz et al., 2019). Currently, the adoption of videoconferencing in the sector of mental health is attributed to its beneficial outcomes for common disorders including anxiety and depressive disorders, posttraumatic stress disorder (PTSD), and adjustment disorder (Varker et al., 2019; Reay et al., 2020). These findings clearly demonstrate end-users’ response to the implementation of the technology in question. Nevertheless, the introduction of new technology may be subject to resistance associated with the facility’s organizational culture. Accordingly, elements such as status quo often amplify resistance to changes, resulting in suboptimal change implementation (Fernandez-Alvarez & Fernandez-Alvarez, 2021). In this respect, participative and transactional leadership may address resistance by facilitating communication regarding the technology’s implementation between patients and clinicians with a focus on encouraging supplementary training and instruction.
Post-Deployment Telehealth Technology Evaluation and Maintenance
Following implementation, it will also be imperative to determine the adverse effects of the current plan on elements critical to the effective application of the proposed telehealth intervention. Accordingly, the introduction of new technology in this context implies the allocation of time and financial resources. In addition, the provision of ongoing support and training for clinicians and the consequent inclusion of on-site champions pose implications for workflows over the short and long term. With the focus underlying the provision of counseling for students in need of mental health services, implementation in one site will help enhance workflows associated with the treatment of mental conditions. Integration of videoconferencing within the current workflow will aid in aligning the site and facility’s responsibilities and processes with the objective of safe and quality patient care.
Identifying the impacts of the intervention will also determine its feasibility in the long term. In this respect, an evaluation plan will be developed to ascertain what is working. For instance, an approach aimed at outcome assessment will be used to determine elements that should be included or enhanced in the current implementation plan for long-term objectives. The evaluation will focus on assessing outcomes associated with patient satisfaction including the number of students who have dropped out from counseling visits, the number of appointments, as well as associated decreases or increases, the volume of counselor-patient visits, overall telehealth use, medication prescription rates, and feedback findings from patients who have utilized the respective service. Following the assessment, emphasis on the long-term application of videoconferencing will necessitate the deployment of an external support and maintenance team with good relations with vendors.
Conclusion
The integration of synchronous videoconferencing technology poses better implications for students in the Murray County Central School District. The emphasis on the respective intervention derives from evidence documenting the correlation between videoconferencing and beneficial outcomes for conditions including anxiety and depression, posttraumatic stress disorder (PTSD), and adjustment disorder. Since the implementation of this telehealth intervention depends on the facility’s current technology infrastructure, considering elements such as the internet capacity and the presence of internet-based audio and video devices is necessary. If these aspects are unsatisfactory, purchasing new devices and increasing the current internet capacity is necessary for implementation. Additionally, the appointment of a telehealth coordinator coupled with the use of on-site champions including clinicians will facilitate effective implementation and limit opportunities for resistance to change. Lastly, a post-deployment strategy aimed at evaluation and maintenance will involve an assessment of outcomes associated with patient satisfaction, as well as the employment of an external technical support staff with connections with suppliers.
References
Fernandez-Alvarez, J., & Fernandez-Alvarez, H. (2021). Videoconferencing psychotherapy during the pandemic: Exceptional times with enduring effects? Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.589536
Ignatowicz, A., Atherton, H., Bernstein, C. J., Bryce, C., Court, R., Sturt, J., Griffiths, F. (2019). Internet videoconferencing for patient-clinician consultations in long-term conditions: A review of reviews and applications in line with guidelines and recommendations. Digital Health, 5. https://doi.org/10.1177/2055207619845831
Muir, S. D., Boer, K. D., Nedeljkovic, M., & Meyer, D. (2020). Barriers and facilitators of videoconferencing psychotherapy implementation in veteran mental health care environments: A systematic review. BMC Health Services Research, 20(999). https://doi.org/10.1186/s12913-020-05858-3
Reay, R. E., Looi, J. C. L., & Keightley, P. (2020). Telehealth mental health services during COVID-19: Summary of evidence and clinical practice. Australasian Psychiatry, 28(5), 514-16. https://doi.org/10.1177/1039856220943032
Rutledge, C. M., Kott, K., Schweickert, P. A., Poston, R., Fowler, C., & Haney, T. S. (2017). Telehealth and eHealth in nurse practitioner training: Current perspectives. Advances in Medical Education and Practice, 8, 399-409. https://doi.org/10.2147/AMEP.S116071
Varker, T., Brand, R. M., Ward, J., Terhaag, S., & Phelps, A. (2019). Efficacy of synchronous telepsychology interventions for people with anxiety, depression, posttraumatic stress disorder, and adjustment disorder: A rapid evidence assessment. Psychological Services, 16(4), 621-35. https://doi.org/10.1037/ser0000239