Magazine article Behavioral Healthcare Executive

Using Telehealth Technology to Better Treat TBI: Rural Providers Gain Expertise to Help This Growing Patient Population

Magazine article Behavioral Healthcare Executive

Using Telehealth Technology to Better Treat TBI: Rural Providers Gain Expertise to Help This Growing Patient Population

Article excerpt

According to the U.Sand Human Services' Department of Health Human Services' Health Resources and Services Administration (HRSA), 5.3 million Americans have a traumatic brain injury (TBI). With military personnel returning from the wars in Iraq and Afghanistan with head injuries (see sidebar), the prevalence of TBI continues to rise.

While primary treatment for TBI typically occurs at urban or suburban rehabilitation centers or, in the case of returning soldiers, Veterans Administration (VA) facilities, many patients return home to rural areas with scarce resources to continue their TBI treatment. The federal government recognizes the difficulty of treating TBI in rural areas and through HRSA has established the Traumatic Brain Injury Program, which through planning and implementation grants helps states to establish TBI networks for treatment and information dissemination.

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One of the difficulties state officials have faced in these planning efforts is the training of local behavioral healthcare providers to treat TBI. The complex and often chronic health condition has not routinely fallen within the purview of mental healthcare providers because treatment usually is initiated in rehabilitation or VA centers. For patients returning home to rural areas, however, rehab and VA centers typically are not feasible options for continuing care.

"It's not a service system that serves the needs of rural, especially rural and impover ished, patients," says Laura H. Schopp, PhD, of the Department of Health Psychology at the University of Missouri-Columbia.

States increasingly are turning to tele-health technology to train providers in rural communities on how to treat patients with TBI. Dr. Schopp and two colleagues at the University of Missouri-Columbia began a project in 1998 that used telehealth technol ogy to train and consult with psychologists and other mental health clinicians in rural areas on the finer aspects of treating patients with TBI. That project constructed a telehealth network that continues to grow.

In 16 rural communities throughout Missouri, Dr. Schopp's project matched TBI patients being transferred from acute rehab settings with providers her team trained in individual videoconference sessions. "The telehealth training is great because it enables you to reach out to a single clinician, talking about the needs of a single patient and his family, so it's a really nice opportunity to transfer a case to a rural clinician and have him feel very well briefed in the particular needs of the patient," says Dr. Schopp.

while Dr. Schopp and her colleagues trained rural providers on treating TBI, it's the knowledge of local resources that makes the role of the rural clinician critical. "I draw on their great knowledge of local resources, and that's the thing that no specialist from the city can ever replace," says Dr. Schopp, noting that local providers know about other supports that TBI patients often require, such as vocational training and employment, housing assistance, and transportation.

Dr. Schopp believes that community mental health centers (CMHCs) in rural areas would be ideal settings for people with TBI to receive services because of their connection to their area's wider service array. "If they're given the appropriate financial and training resources, I think the system of care that CMHCs provide for underserved and rural communities is in some ways an ideal network for people with brain injuries," says Dr. …

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