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Polycom RealPresence Video Solutions Enable NARBHA to Remove the Distance Separating Patients from the Care they need While Saving Millions of Dollars
Posted on Monday, March 4, 2013
Northern Arizona Regional Behavioral Health Authority (NARBHA) Operates a Polycom-Powered Telemedicine Network to Bring Specialized Care to Half the State via Video
SAN JOSE, Calif. – Mar. 4, 2013 – Polycom, Inc. (Nasdaq: PLCM), the global leader in open standards-based unified communications and collaboration (UC&C), is enabling an Arizona managed care organization to bring community-based, patient-centered care to remote and rural areas using an  innovative video collaboration network, while saving millions of dollars.
Northern Arizona Regional Behavioral Health Authority (NARBHA), a private, not-for-profit corporation designated by the state to manage publicly funded behavioral health services, contracts with more than 80 providers to manage care for 700,000 Arizonans across a sprawling, arid region that spans half the state but is home to just 11 percent of its residents.  NARBHA’s network also provides behavioral healthcare services to 10 American Indian tribes. In the midst of these vast distances, NARBHA relies on a Polycom® RealPresence® video collaboration network to provide patients with personalized, face-to-face care from psychiatrists and other behavioral health professionals often in higher demand in remote and rural areas.
“Many small towns in northern Arizona are hours from the closest psychiatrist, and that effectively puts working people, children, and others beyond the reach of traditional care,” said Nancy Rowe, director of telemedicine at NARBHA. “That’s why our telemedicine network is so crucial to how we deliver services. Doctors love it because they get to live where they want, and patients love it because they can get care right in their own hometowns and not have to miss work or school to travel to get care. And the state loves it because it’s efficient – we’re not paying doctors for the hours they’d have to spend traveling, we’re paying them to provide patient services instead.”
Community-Based Care: 4 out of 5 Patients Prefer or Are Satisfied with Telemedicine
With the support of telemedicine, patients typically visit their community health center, where they participate in a video call with their remote doctor by using a Polycom RealPresence video solution. On-site clinicians assist the patient, while NARBHA telemedicine staff make the connection to a remote physician who engages via video from NARBHA’s Flagstaff headquarters, which is equipped with Polycom® HDX® series room systems, from another clinic in the region equipped with a Polycom room system, or from a home office using Polycom HDX series room systems or Polycom® RealPresence® Desktop 2.0 software on PCs.
“We have psychiatrists who remotely see patients from Texas, Florida, New York, and Kentucky,” said Rowe. “This system works because it allows these small community clinics to deliver the same level of care that a clinic in Flagstaff or Phoenix does. Doctors and patients report that, after the initial session, they forget the technology is between them. The doctor is about life-size on the TV, creating a natural experience for the patient.”  The quality of Polycom audio and video helps create that experience.
In fact, in a recent NARBHA patient survey, just 20 percent prefer in-person consults, with four of five patients saying they either prefer telemedicine care or don’t have a preference.
Patient Centered Care: Facilitating Team Treatment and Coaching Models
The Polycom network also supports NARBHA’s team treatment model of care by making it easier for multiple professionals to participate in a single patient session. “In a typical scenario, the patient and therapist are together at the clinic, and the psychiatrist is on video; this helps the patient see that they have a team caring for them and helps the clinicians communicate,” Rowe said. “In another model, NARBHA clinical care coordinators will form a team to help with, for example, a child’s anger management treatment. The team might include a teacher, pastor, family friend, parent, therapist, and professionals from other organizations such as Child Protective Services. The Polycom video network lets us bring that big group together into a single session. And if everyone can’t join on video, they can participate on audio. It just makes it easy to create that team and then keep it together.”
NARBHA serves a diverse client base, as shown by the fact that patient materials are published in English, Spanish, Navajo, and Hopi. This makes the lifelike quality of Polycom video and the fidelity of Polycom audio that much more important for doctors providing care to many ethnicities, cultures, languages, and accents throughout each day. “The quality of Polycom audio and video makes communicating so much easier, especially since so much of what we communicate is visual,” said Rowe. “Doctors need to see patients clearly, to pick up on their expressions and body language.” NARBHA’s network is also used to provide American Sign Language interpretation services to counseling sessions in remote towns that don’t have access to ASL interpreters.
Reducing Inpatient Stays: Saving Millions
As one of the first behavioral healthcare agencies to implement telemedicine in the U.S., NARBHA began offering video consults in 1996 and switched to Polycom solutions in 2001. At first, the purchases were funded with grants, but as different clinics and providers saw how the telemedicine network helped them hold down costs, they began to funnel their own budgets toward video solutions. “We all get a set amount of money every year,” said Rowe. “Telemedicine helps us make the most of it.”
The cost savings helps explain the state’s growing reliance on video to reach rural patients.  In 2011, NARBHA administered 10,500 patient sessions over video, along with 3,826 administrative and training meetings. The state saves more than just the $475,000 a year in transportation costs and time lost to travel. In 1996, prior to implementing its collaborative video network, Arizona’s Apache County averaged 11.22 inpatient days per month per 1,000 patients. One year and hundreds of video consults later, Apache County’s average inpatient days dropped to 7.73 per thousand – a reduction of 31 percent that represents a real-world average savings of $4,070 for every 1,000 patients.*
Collaboration Across State Agencies
NARBHA’s network is powered by the Polycom® RealPresence® Platform – the most interoperable and comprehensive software infrastructure for universal video collaboration – in Flagstaff with redundant Polycom infrastructure in a backup data center in Phoenix. The RealPresence Platform offers support for open industry standards, which simplifies NARBHA’s regular video meetings with state agencies and other healthcare administration organizations. “They’re supposed to be failovers for one another, but we get such a high volume of calls that we often have to use both,” Rowe said.
Even when traffic is at its peak, Rowe said NARBHA knows it can count on its Polycom network to deliver: “We’ve been running the same Polycom bridge every day for eight years to connect all video and voice calls. It just works.”