PMC:7276834 / 23892-26305 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7276834","sourcedb":"PMC","sourceid":"7276834","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7276834","text":"5.2.1 Limited clinic capacity\nAs we made our rapid transition to telepsychology, we needed to adjust to the unique parameters of each site. Therefore, supervisors collaborated with key personnel at individual sites (e.g., medical directors, head nurses, head administrators) to identify site‐specific changes to our procedures. For example, some sites provided the administrative support to reach already scheduled patients to inform them of our move to telepsychology, whereas others preferred for our team to take the lead in contacting patients. Similarly, while all of our clinics had electronic medical records that could be accessed remotely, some sites did not have the capacity for us remotely to enter appointments into their scheduling system, and thus we had to create our own password‐protected and encrypted schedules. Those schedules were then shared with the medical staff so they could add a patient as needed and know which patients had attended telepsychology appointments.\nThe fundamental premise of primary care psychology is to provide brief services to as wide a cross‐section of patients as possible, aiming to improve the behavioral health of the entire clinic population. To achieve the promise of this population‐based approach to primary care, a steady flow of referrals from physicians and/or routine screenings are needed. However, nationally and within our primary care clinics as well, there was a dramatic cutback in primary care visits, especially visits aimed at chronic conditions, routine check‐ups, or prevention. Furthermore, our free clinic partners that rely on part‐time volunteers to provide a percentage of their care had to furlough many of those volunteers for safety reasons. Seeing fewer patients leads to fewer referrals. Additionally, with our primary care colleagues in medicine embarking on their own steep learning curve to shifting to telehealth, some of our clinicians lost bandwidth they usually have to discuss behavioral health issues with their patients. Lastly, without our physical presence in their workspace, our medical colleagues did not have the usual visual reminders or verbal prompts from our clinicians asking for referrals. This sudden drop‐off in referrals was experienced across the spectrum of integrated care providers nationally, who were weighing in daily on listservs about their challenges with similar transitions in integrated 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