We’ve invited Dr. Tom Milam, the Chief Medical Officer for Iris Telehealth, to discuss approaches to addressing behavioral wait times. Dr. Milam has been a psychiatrist for over 25 years, and throughout his career, he’s seen many changes in the field and different approaches to care. He notes that there’s always been a shortage of providers for various reasons.

People needing psychiatric and mental health services will often wait for weeks or even months to see a provider. Iris Telehealth seeks to lessen such waiting times by providing telehealth services to people nationwide. Iris Telehealth employs psychiatrists, licensed social workers, and nurse practitioners. They partner with various agencies and institutions to provide psychiatric and behavioral health services. One of the services they provide is matching services so that people have a provider to meet their needs for the long term.  

Telehealth service providers may sometimes struggle to provide adequate care coordination and follow-up with clients. Iris Telehealth manages this by collaborating with inpatient units and other healthcare providers. When they partner with other organizations, they use a collaborative care model, including working directly with facility employees, their billing process, and their EMR. He notes that this is good for both systems and patients, as they only have to work with one organization. 

Iris Telehealth’s Bridge Care services program helps bridge the gap between referrals and services. Dr. Milam shares that when people get referred, for example, from inpatient or emergency care, they may sit on a waiting list for weeks or even months. For patients discharged from the hospital, this has been difficult to have people seen promptly. Bridge Care offers care as patients transition from one care site to another, such as acute care to outpatient care. The goal is to see patients within a week to do an initial psychiatric assessment and then triage them within a few days to see a medication prescriber and a therapist. At the same time, the program will collaborate with other facilities to ensure the patient eventually sees a long-term provider. Usually, this service is 90 days, but sometimes it is longer. Dr. Milam states that focusing on local providers is vital as many people benefit from community-based services, and Iris Telehealth wants to support the valuable work done by community service organizations. He notes that the goal is not to pull patients out of local care to a virtual environment but to supplement services to fill in the gaps in services. 

In conclusion, Iris Telehealth continues to work towards providing needed services in a timely manner while also supporting local providers, as they will have more understanding of community resources and needs. This type of bridging service will be needed until systemic changes occur to address the ongoing challenge of the shortage of psychiatric and behavioral health providers. 

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Dr. Tom Milam is the Chief Medical Officer of Iris Telehealth, where he manages the team of clinicians and guides them in telemedicine and industry best practices. He received his undergraduate degree from WVU in Anthropology, graduated summa cum laude, and received his M.D. from the University of Virginia. His residency training in psychiatry took place at Duke and UVA. Dr. Milam has served in a leadership role throughout his psychiatric career and spearheaded the telepsychiatry initiative at his previous hospital. Dr. Milam is also an ordained Episcopalian priest and got his Master of Divinity Degree from Yale. He is a fan of various sports and traveling with his wife and four children. In his free time, he enjoys DIY projects, “honey-do” lists, and driving his convertible sports car.

By: Megan O'Laughlin