The health system launched ExpressCare in the fall of 2020, when the need to reduce in-person visits was dire. Erfan Karim, the executive director of ExpressCare, said in an interview that the telehealth platform operates on a “convenience care model designed to keep patients away from the ED.” More than 80,000 visits have been conducted on the platform to date.
With the support of Helmsley’s grant, NYC Health + Hospitals is now incorporating mental health services to be available 24/7 on ExpressCare, including treatment for psychiatric conditions and substance abuse.
“We recognize that there’s a silent pandemic going on and there’s a huge need for behavioral health services,” Karim said. “We want to bring ExpressCare’s model of easy, equitable access to patients for their behavioral health needs.”
Through ExpressCare, patients receive on-demand access to behavioral health professionals, including psychiatrists, social workers, addiction counselors and mental health nurse practitioners. For example, someone with acute anxiety can utilize the platform if they feel like they need to urgently talk to a mental health professional. Or someone who ran out of their medication and doesn’t have an appointment with their psychiatrist for a few days can log onto ExpressCare to obtain a prescription that can bridge that adherence gap.
NYC Health + Hospitals is also working with the New York City’s homeless services department to launch a version of its new tele-behavioral health services that is tailored to the city’s homeless residents. The health system is planning to roll out this version at 25 homeless shelters and six mobile street outreach clinics during the first year of Helmsely’s three-year grant.
The program will also test the efficacy of four strategies to engage vulnerable patients in behavioral healthcare. The first strategy seeks to educate the homeless population about ExpressCare by ensuring shelter system workers, who are credible messengers, spread awareness about the services. NYC Health + Hospitals will also collaborate with these community liaison workers to learn more about what the homeless population’s day-to-day activities look like and how its tele-behavioral health services can be better tailored to meet these patients’ needs.
For the second strategy it’s testing, NYC Health + Hospitals is seeking to improve access to tele-behavioral health services by taking on the cost-sharing portion of this care. The health system is also testing the efficacy of interventions to help patients to keep up with their clinical treatment regimens, such as sending medications directly to the shelter in which a patient is staying. The last strategy the health system is testing is street-based behavioral healthcare. Karim said this is intended to reach the city’s homeless population that does not stay in shelters, as they are often forgotten by the U.S. healthcare system.
Over the next three years, Karim and his team plan for ExpressCare to reach between 10,000 and 15,000 homeless individuals. They also want to create a model for virtual urgent mental healthcare that is sustainable, so that other health systems can eventually use it to roll out similar programs in their communities.
Photo: Alisa Zahoruiko, Getty Images