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A Leader’s Perspective: How to Grow Virtual Programs

An Addictions Leader’s Perspective: Shane Saltzman on How to Launch and Scale Successful Virtual Outpatient Programs with Telehealth

By Shane Saltzman, CEO of Trafalgar Addiction Treatment Centers

Shane Saltzman, CEO of Trafalgar Addiction Treatment Centers, speaks to OnCall about Trafalgar’s experience scaling their virtual outpatient programs with OnCall’s solution. Shane’s leadership and experience showcases his expertise and unique perspective on healthcare accessibility and equity, and how virtual outpatient programs are essential for the future of mental healthcare. He also reveals why behavioural healthcare and addictions organizations require more than just video conferencing tools to manage telehealth operations at scale, and why these tools are not enough to launch virtual outpatient programs. 

Discover actionable insights that can help any behavioural healthcare organization and leader learn what it takes to launch and scale virtual outpatient programs. 

1. What are some challenges you see when healthcare leaders attempt to launch VIOPs (virtual outpatient programs) with disconnected solutions like Teams or Zoom? 

When utilizing disconnected solutions– like video conferencing tools that don’t connect to other platforms– there tends to be a lack of privacy compliance and controls, client and clinical team confusion managing appointments, various calendars, and attempting to create consistency between platforms. Simply put, video conferencing tools do not have the features that enable organizations to scale virtual outpatient programs. There is no patient-facing app, no digital booking experience and content sharing tools, and it’s impossible to measure the impact of telehealth on your organization and clients. Video conferencing solutions only enable video interactions, and nothing else. Virtual outpatient programs require much more than a video appointment to succeed, to enable better outcomes for patients, and to help leaders build their telehealth operations. 

2. How can healthcare leaders leverage complete telehealth solutions, like OnCall, to launch VIOPs? How did Trafalgar leverage OnCall to do this?

Complete telehealth solutions such as OnCall are completely scalable, reliable, and cost effective. Because we’re using a single solution, it is very easy for clinical teams and clients to schedule appointments, provide asynchronous care, or instant message without trying to manage different web solutions, passwords, and portals. I recommend leaders find a solution that is a one-stop-shop experience for both the client and the clinician– and which offers a much simpler experience for both.  

At the height of Ontario’s lockdown during the pandemic, OnCall enabled Trafalgar to pivot and transform a small, local physical Intensive Outpatient model into a growing national Virtual Intensive Outpatient (VIOP) model supporting hundreds of clients across the country. Our VIOP clinical team grew from 3 professionals to a team of 22, and continues to grow to support clients in multiple time zones. 

We also knew we could augment the program with more service options for our various patient groups and individual patient needs. This includes instant messaging, secure document sharing, as well as utilizing custom forms and other synchronous and asynchronous tools such as videos and learning exercises. Asynchronous care tools are essential for VIOPs, as they enable providers to engage with clients before, during, and after video appointments. These tools engage clients differently than a video call, and when we continue to engage a client, we continue to see enrolment in new programs, interest in therapy, and better health outcomes overall. I suggest that leaders ensure their solution provides asynchronous care tools like OnCall does for Trafalgar and its other clients. These tools will help you scale your programs beyond just video conferences. 

3. Why is a telehealth vendor’s support team so important when launching VIOPs? Are there specific support features you looked for in OnCall when considering our solution? 

Not only do clinicians have a professional responsibility to be respectful of clients’ time and emotions, but they are managing multiple clients a day and need to be efficient with their time. These professionals simply do not have the time to troubleshoot internet speed or technical issues, and cannot provide this tech support service to clients. This is where a strong support team from a telehealth vendor can help. OnCall’s support team ensures that Trafalgar’s clinicians and clients are onboarded to the platform immediately after booking the first appointment. They complete internet speed tests, video infrastructure tests, and troubleshoot any final technical questions. Without this support, clients and clinicians would be dealing with these challenges during an appointment, which is a time for therapy, not technical support. It’s important to examine whether your telehealth vendor offers this level of support and training, especially as organizations like Trafalgar continue scaling virtual services. 

4. What types of asynchronous tools does Trafalgar use for its VIOPs? Why are these tools important for these types of accessible programs? 

Trafalgar has spent this year building our Virtually Integrated Programming Library– also known as asynchronous therapy tools. The library consists of a variety of brief self-help, skill-building, and self-awareness videos, and sound-bites and exercises that our clients access at any time. We, just like many organizations, understand that our care should not just consist of the face-to-face support we provide during regular hours. With our library, we now have the ability to augment our care structure with these resources for our clients to access outside of normal hours, perhaps during heightened anxiety or times of stress. OnCall’s content tools have allowed Trafalgar to establish a 24/7 care model that has translated to a more engaging client experience with longer lasting client results.

5. Talk about ways that an end-to-end telehealth solution has helped Trafalgar grow from one VIOP to multiple?

Trafalgar always believed that virtual care would contribute to our organization’s overall growth; however, we thought it would take time for it to be widely accepted by our clients. Trafalgar’s successful pivot to virtual addictions programming through OnCall has created new opportunities for accessibility to intensive mental health and addictions support throughout Canada. By offering care that fits into client lifestyles, including self-led programming, Trafalgar has been able to offer new programming to clients we were unable to target previously. This includes clients in remote areas, clients who are unable to take time off work, or clients who need support but feel more comfortable receiving it from home. 

Although the pandemic forces us to implement virtual care, it made virtual group therapy acceptable and even more engaging than we imagined. Confidentiality and privacy assurances were completed during OnCall’s implementation and our clinician team was trained immediately, giving us the confidence we needed to initially launch virtual care successfully and encourage clients to partake in therapy in new and innovative ways. The results were, and still are, overwhelmingly positive. Not only are the therapeutic benefits clear, but Trafalgar has gone from one virtual program to multiple programs for different types of mental health and addictions needs in just one year. 

6. Why do you think it’s important to measure the impact that telehealth is having on your organization? 

The biggest question Trafalgar hears from other healthcare leaders is, “Does virtual care really work?”, and, “Is it truly effective?” We need to be able to communicate the impact that virtual programs are having on our business and our clients. Trafalgar has been able to measure the impact on accessibility that virtual programming has allowed. We’ve acquired clients from all over Canada, which is something we were completely unable to do prior to launching these programs. This measurement shows growth. As a result, we’re completing more appointments, billing more, and growing our bottom line. Additionally, we’ve been able to see the impact that virtual programs have on client health outcomes. Trafalgar has received multiple requests for special interest programming from clients because their initial results with Trafalgar are so positive. This shows that Trafalgar is not only acquiring new clients, but those clients are completing more than one program. Program completion rates now sit at 95%, which shows just how successful virtual programming is. 

7. Why is telehealth and its ability to create accessible healthcare so important for behavioural healthcare?

Mental health and addiction does not discriminate. It impacts us all, across all communities, no matter where we live, no matter our social status, or our cultural background.  For many healthcare leaders in this space, residential programming is often believed to be the only way to treat clients. Trafalgar offered residential programs for 8 years prior to launching virtual care. 

The reality is that not every client needs to be in inpatient treatment. Many do, and there will always be a need for safety, security, and retreat. However, many clients are higher-functioning but recognize they are struggling. They may not be able to afford the high cost of residential programs or take time away from work or family. Virtual outpatient programs offer an early intervention model where clients receive intensive help before they may need to enter inpatient treatment. 

This is key; our system has typically dealt with only low-functioning emergency client cases. Now, we have an affordable and accessible program for higher-functioning individuals looking for care from the comfort of their own homes. 

Whether you are in Vancouver, Calgary, Winnipeg, Saskatchewan, Collingwood, Toronto, or the Maritimes, you can access a Trafalgar Addiction Treatment Centre Virtual Addiction Rehab Program.  Accessibility means greater health equity and better health outcomes across society as a whole. The need for better mental healthcare has never been more apparent, and virtual care allows us to do this and so much more. 

Learn how your behavioural healthcare organization can manage virtual outpatient programs at scale with OnCall. Book a demo today.