When it came to figuring out a way to treat psychiatric patients safely during the coronavirus pandemic, there wasn't a whole lot of time to spare for the KU Wichita Psychiatry & Behavioral Sciences clinics.

"Our patient population tends to be stable because they're in treatment," Rachel Brown, MBBS, chair of KU School of Medicine-Wichita Department of Psychiatry & Behavioral Sciences, said. "If people go out of treatment, they risk relapse."

On a Tuesday in April, KU Wichita decided telehealth was the appropriate response to the coronavirus pandemic. The first test visit was conducted the next Wednesday, and the first actual patient was seen - virtually - the Monday after that.

"It was really very impressive," Brown said of the transition, stressing that there were "a lot of people more heavily involved than me" in making it happen.

Telehealth has been around for years, but for it to become the accepted option during the pandemic, changes in federal regulations were needed to allow providers to be reimbursed at the same rate as if they were seeing patients in person. That happened and for the past six weeks, about 95% of the clinics' patients have been seen via video. Usually clients are stationed in their homes, but a few have connected from their cars and one even did so from a beach.

Patients and practitioners alike think telehealth works as well, or nearly as well as, a traditional visit. The sessions last anywhere from 20 minutes to an hour.

"There are things you can't do - nuances and social interaction, conversation with multiple family members at the same time," Brown said. "Those are much more difficult to do. But it's been a great thing to sustain care over time to people. I mean, all of us are stressed out about what's happening."

Dan Lilligren, M.D., chief resident, agreed and added that for a small segment of patients, the new arrangement might actually be a plus.

"For some patients that might have a harder time making their (in-person) appointments, it was actually pretty convenient for that patient population," Lilligren said.

The clinics have continued to see a small number of patients in person, either because their conditions demanded it or because they were unable or unwilling to access the technology - basically a computer with a camera - required. For those patients, practitioners wear masks and maintain social distancing, and measures such as installing plexiglass screens and removing touchable objects like magazines and toys from the waiting room have been taken. A few patients have also been treated by telephone.

In addition to reimbursement regulations, the clinic and its practitioners had to figure out how to comply with HIPAA rules for telehealth and familiarize themselves with the technical aspects of hosting a visit on Zoom, the video conferencing service that is being used.

"There's a little bit of work you have to do about video etiquette, making sure you're big enough (on the video screen) and not too big," Brown said.

Lilligren cited two colleagues - Shannon Loeck, M.D., then a fourth-year resident and now an assistant professor, and Kristin Jones, MSN, APRN, BC, an advanced registered nurse practitioner - for their work making sure the transition ran smoothly.

"They came in very early and worked very late in the day," he said.

Clinic personnel who've practiced via telehealth include Jana Lincoln, M.D., Connie Marsh, M.D., Cheryl Wehler, M.D., Susanna Ciccolari-Micaldi, M.D., Brown and Sheldon Preskorn, M.D.; psychologists Nicole Klaus, Ph.D., ABPP, Kirsten Engel, Ph.D., LP, Kelli Netson, Ph.D., ABPP, CN, Ryan Schroeder, Psy.D., ABPP, CN, and Philip Martin, Ph.D., ABPP, CN; Jones and all of the third- and fourth-year residents and psychology trainees.

Brown hopes routine in-person visits to the clinics can resume by mid-July but expects telehealth to play a bigger role than before going forward.

"In the future, I think we could combine televisits with in-person visits as necessary," Brown said. "Life changed for all of us back in March and our clinic changed with it. Good clinical practice means adapting to the needs of our patients and their families. That's what we did, and what we'll continue to do."