Northern Arizona Regional Behavioral Health Authority

At a Glance

  • 80% prefer telemedicine care
  • Arizona saves $475,000/year
  • Saves $4,070 for every 1,000 patients

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NARBHA’s Polycom Telemedicine Network Brings Cost-Saving Care to Rural Arizonans


Northern Arizona Regional Behavioral Health Authority (NARBHA), a private, not-for-profit agency designated by the state to manage publicly funded behavioral health services, contracts with more than 80 providers to manage care for 700,000 Arizonans–and 10 American Indian tribes–across a sprawling, arid region that spans half the state but is home to just 11 percent of its residents. To provide patients with care from psychiatrists and other behavioral health professionals, NARBHA relies on a telemedicine network powered by Polycom RealPresence video collaboration solutions.

“Many small towns in northern Arizona are hours from the closest psychiatrist, and that puts working people, children, and others beyond the reach of traditional care,” says 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 spent traveling, we’re paying them to provide patient services instead.”

The Polycom-powered network supports NARBHA’s coordination with state and federal agencies, and enables a multi-disciplinary team approach to care coordination–an efficient and effective model that has helped reduce average inpatient days. “The state’s regional behavioral health authorities each get a set amount of money every year,” says Rowe. “Telemedicine helps us make the most of it.”

Delivering coordinated, community-based care

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. With help from on-site clinicians and NARBHA telemedicine staff they connect face-to-face with physicians working from several locations:

  • From NARBHA’s Flagstaff headquarters, equipped with Polycom HDX series room systems
  • From other area clinics equipped with Polycom room systems
  • From a home office using Polycom HDX series room systems or Polycom RealPresence Desktop 2.0 PC software

“This system allows small community clinics to deliver the same level of care that a clinic in Flagstaff or Phoenix does,” says Rowe. “Doctors and patients forget the technology is between them.” In fact, in a recent NARBHA survey of telemedicine patients in Apache County, just 20 percent prefer in-person consults; 80 percent either prefer telemedicine care or don’t have a preference.

The Polycom network also supports NARBHA’s multi-disciplinary team approach to care coordination 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,” Rowe says. “This helps the patient see that they have a team caring for them and helps the clinicians communicate.”

NARBHA’s diverse client base–patient materials are available in English, Spanish, Navajo, and Hopi–presents daily communication challenges. “Doctors need to see patients clearly, to pick up on their expressions and body language,” says Rowe. “The quality of Polycom audio and video makes communicating more effective.”

Reducing inpatient stays and 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. Before long, clinics and providers saw how the telemedicine network helped them hold down costs and investments in video grew.

The 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 with state agencies made easy

NARBHA’s network is powered by the Polycom RealPresence Platform in Flagstaff with redundant Polycom infrastructure in a backup data center in Phoenix. The RealPresence Platform supports open industry standards, which simplifies NARBHA’s regular video meetings with state agencies and other healthcare administration organizations.

Better still, says Rowe, it’s reliable: “We’ve been running the same Polycom bridge every day for eight years to connect all video and voice calls. It just works.”

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