The Crossroads Partnership for Telehealth (Crossroads) is a collaborative agreement between the Indiana Rural Health Association, Union Hospital’s Richard G. Lugar Center for Rural Health, behavioral health service providers, critical access hospitals, and rural PPS hospitals that seeks to establish and maintain an Evidence-based Telehealth Network whose purpose is, “To use and maintain a telehealth network that will: increase access to behavioral healthcare services in rural communities as well as conduct evaluations of those efforts in an effort to both expand and strengthen the evidence base for assessing the effectiveness of tele-behavioral healthcare services for patients, providers, and payers”.
The need for quality data and a deeper pool of numbers is apparent in the field of tele-behavioral health, and this need is especially magnified in rural settings. Crossroads is a robust Independent Rural Hospital Network of telemedicine providers and recipients whose operations are directed by a Network Advisory Board composed of executives from each Network Partner site. They will replicate and expand previously developed research methods and implementation strategies to both establish and evaluate tele-behavioral health services in the emergency department of healthcare facilities in four, rural counties in Indiana: Cass County, Decatur County, Fayette County, and Rush County. The Indiana Rural Health Association has extensive experience in project management and network development; using this experience, by leveraging preexisting relationships with rural healthcare facilities around the state, Crossroads will be well equipped to carry out the implementation of tele-behavioral health services at all four member sites. Union Hospital’s Lugar Center has conducted primary research through its Wabash Valley Rural Telehealth Network (WVRTN), a HRSA-funded network through the Evidence-based Telehealth Network Grant Program, and will provide the necessary expertise to assist in data collection across disparate electronic medical records systems as well as multivariable analyses of an interdisciplinary factors, results, and trends. Union Hospital-Clinton, a current WVRTN member, will join Crossroads to share expertise and contribute data from an established tele-health spoke site. All findings will be collated and disseminated among various forums on the municipal, county, state, and national levels.
The Crossroads Partnership for Telehealth will utilize local tele-behavioral health providers to aid clinical personnel in rural emergency departments in the diagnosis, referral, and treatment of individuals who present with both acute and chronic behavioral health needs. To evaluate cost and impact, descriptive data on utilization, patient and provider satisfaction, and reductions in costs and specialist drive time will be collected. Inferential statistical analyses will occur on measures of patient progress and between group differences. Diagnosis-based outcomes data will comprise performance measures, with anticipated added value to healthcare found in state-wide replication. Throughout the grant period, the addition of Critical Access and Rural PPS hospitals will generate ample data, upward of 4,000 consults, to effectively contribute to and support the OAT-led program evaluation to match the rigor of studies found in peer-reviewed journals.
We expect positive outcomes in quality of care, reduced service provision costs, efficiency, accessibility, availability, and in overall patient improvement.