Vidyo-based iPad Telepresence Study
Reduces RMHC’s Financial Losses From Patient Therapy No-Shows


Range Mental Health Center (RMHC) is a 250-employee agency that serves 7,000 patients annually across 6,800 square miles and five counties in rural Minnesota. Janis Allen, RMHC’s Chief Executive Officer, faced a challenge as big as the geographic area her business serves: Reducing the many no-shows and cancellations of mental health outpatient therapy appointments caused by transportation issues, from inclement weather to the patient being too tired to commute the long distance. Additionally, the severity of some patients’ chronic mental health conditions also often cause no-shows and cancellations. Together, these resulted in significant financial losses for RMHC.
“We’re talking about our crisis lines becoming part of the 9-1-1 system so that both parties can respond to a mental health-related call.”

Janis Allen, Chief Executive Officer


Allen found hope through Barriala B. Kpuinen, a nursing student at Metropolitan State University in St. Paul, MN. Kpuinen’s thesis asked the question: “Would giving patients an iPad in their homes for the purpose of virtual visits help maintain and improve their health?” Allen and Kpiunen brainstormed to determine which of RMHC many agencies – from its Adult Rehabilitative Mental Health Services (ARMHS) to its Outpatient Mental Health Clinic – the study could most benefit. The Outpatient Mental Health Clinic was chosen with the hypothesis that a virtual care program could help reduce no-shows and cancellations.

The three-month program was funded by Arrowhead Health Alliance (AHA), a regional mental health agency that serves the Arrowhead Region in Minnesota and provides mental health crisis services through U.S. Department of Human Services (DHS) grants. AHA gave RMHC 13 iPads – three with Wifi – and 12 patients were recruited for the program. Vidyo was chosen to be the video technology because the DHS is a longstanding Vidyo customer.

RMHC implemented the iPad program in September 2017. Vidyo was installed on computers in two outpatient offices as well as on the laptops of eight therapy providers, all of whom provided video-based virtual therapy to participating patients.


RMHC tracks patient iPad therapy progress with several tools, including a Patient Health Questionnaire (PHQ – 9) which measures depression, Generalized Anxiety Disorder Scale (GAD 7) which measures anxiety, and a brief psychiatric exam that measures overall patient progress. ​​Allen noted that the program results showed:
  • Some improvement in lowering patient depression scores
  • Reduced no-shows and cancellations. Before the study, patients met with therapists face-to-face approximately once every other month or two. During the study, they met twice a month.
  • The amount of time measured indicates promise that the consistent connection with a therapist is helpful.
That consistent connection is one of the top program benefits Allen cited, noting that a stable relationship with the same therapist positively impacts the patient. With video, if the therapist or patient moves away, they can easily maintain the relationship. Most therapists and patients responded favorably to the program. RMHC measured patients’ experience using Vidyo technology in such areas as quality of connection and overall communication. The results showed that 100% of users rated their experience as “Excellent” or “Good”. “Patients are really excited about having the option to connect virtually,” Allen continued. “One patient especially because, during one of her on-site appointments, she was so physically exhausted upon her arrival and so worried about how she was going to get home that she wasn’t able to engage effectively in any useful skill-building.”

Future Opportunities

Allen has plans for expanding the Vidyo solution, including installing it on more psychiatric providers’ laptops so that they can easily attend weekly clinic meetings which are held nationwide. She also plans to work with law enforcement and RMHC’s crisis team to have Vidyo  with police officers and in the emergency room (ER). “We’re talking about our crisis lines becoming part of the 9-1-1 system so that both parties can respond to a mental health-related call,” Allen explained. She believes that this would offer multiple benefits, including providing a coordinated assessment to determine whether or not a patient needs to go to the ER, reducing unnecessary visits to the ER where patients have to sometimes wait hours to be assessed, and reducing ER beds being filled with patients who are not being admitted for medical purposes.

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