A new telemedicine program is making life easier for patients, families and clinicians in the Johns Hopkins Child Mobile Treatment Program, which treats young patients who have serious, persistent mental health issues.

Now, Johns Hopkins psychiatrists can see and assess patients with an iPad, so patients don’t have to travel to the program’s offices at Johns Hopkins Bayview Medical Center.

The Child Mobile Treatment Program serves about 90 patients, ages 4 to 24, at a time. They have conditions such as schizophrenia or bipolar disorder, and did not have success with outpatient or school-based treatments. To be eligible for the Child Mobile Treatment Program, children must be at risk for multiple hospitalizations or out-of-home placement, and a special authorization is required.

“This is a great program,” says Hal Kronsberg, psychiatrist for the mobile psychiatry service. “It supports the kids, but also the families. Some kids may go in and out of foster care or experience homelessness, and we continue to see them despite these disruptions. They’re having a tough time with emotional and psychosocial needs, and other treatments have not worked out.”

The program operates under a single fee for all services, with a minimum requirement that patients must be seen by a clinician at least four times per month. To achieve that goal, the program’s four therapists and two case managers travel by car to meet patients in their schools, homes, places of work or other locations.

The patients also need to meet several times per year with psychiatrists who can prescribe and adjust medications, as well as provide other medical assessments and treatments.

But bringing a child with mental health issues to a psychiatrist’s office is a hassle under the best of circumstances. It’s even more difficult for families that rely on public transportation, that have to tote along siblings because they can’t afford child care, and that risk losing a day’s pay.

One family simply grew too large to fit into the therapist’s car when a fifth sibling was born. Another moved from Baltimore to Aberdeen, says Kronsberg. “A therapist goes out to see her, but for the therapist to bring her to the clinic and then drive her back is not really feasible,” says Kronsberg.

Before the telemedicine program launched in October 2018, patients had three ways to connect with Kronsberg: They could travel to the Bayview offices on their own, a therapist could pick them up and drive them there and back, or Kronsberg could travel to the patient — an option that limits the number of patients he can see.   

Telemedicine adds a fourth way to reach patients, says Tawny Epperson, clinical supervisor for child mobile treatment services. “Our families love it,” she says. “It’s extremely easy for them.”

Here’s how it works: Kronsberg and the patient set the appointment time. When therapists visit patients in the community, they bring a tablet with the Polycom app, which provides a secure connection. The digital visit is recorded as one of the four required for the month.

Anthony Artista, project lead for Johns Hopkins Telemedicine, says Kronsberg asked him in mid-2018 to create a telemedicine program. He chose a tablet-based solution because it is “simple and effective,” he says.

Epperson says the office now uses telemedicine about once a week, and patients who try it typically want to stick with it. “Children and teenagers are very comfortable talking through the iPad,” she says.

“The use of telemedicine has facilitated psychiatric visits for patients who had previously gone months before they could coordinate a way to come to the clinic,” says Kronsberg. “The ability to see my patients more often is always a good thing.”