Implementing Videoconferencing Groups: A Timeline
Video-based group therapy in rural communities
Telehealth is a tool that can increase access to opioid use disorder treatment in rural communities, where the limited number of providers, geographic distance, lack of anonymity, and stigma can make it difficult to receive care.1 Group therapy is one of the important elements of treatment that can become more widely available in rural areas through telehealth.
To achieve this expanded access, technology and internet barriers need to be addressed. Internet hotspots can help patients get connected. Communities and providers can also look to offer a space with technology that patients can use.
Resources to help rural providers and patients include:
- Health Resources and Services Administration telehealth website
- Rural Health Information Hub Rural Telehealth Toolkit
- For broadband/internet, Universal Service Administrative Co.’s Lifeline program (individuals) or Rural Health Care program (providers and facilities)
- Center for Connected Health Policy, which includes information about policy changes due to COVID at the federal and state levels
- Flexibilities around telehealth during COVID-19 (Providers should remain current on federal and state policies and third-party billing considerations as they may change during and after the pandemic.)
Timeline
The following timeline outlines steps involved in shifting in-person group therapy for substance use disorder online. It charts the course that Strong Recovery took after they halted in-person group therapy the week of March 16, 2020, due to the COVID-19 pandemic. The program was able to reestablish groups—through videoconferencing—on April 27.
During COVID, patients at Strong Recovery have joined video calls from home. Rural communities looking to expand access may wish to explore the possibility of providing a space equipped with technology that patients can use as an alternative.
Timeframe | Activities |
Week 1 (March 16-20) | Groups placed on hold |
Focus on social distancing & medication dispensing procedures | |
Communicating changes to patients & staff | |
Week 2 (March 23-27) | Therapists move to telehealth (phone) for some individual sessions |
Point person to lead on video-based therapy identified | |
Staff shift to partly remote schedule | |
Planning for video cameras/laptops | |
Week 3 | Patients & therapists ask for groups to return |
Ongoing research (confidentiality, billing, electronic health record, etc.) | |
Week 4 | Point person trains in telehealth & consults with experienced program |
Some individual therapy sessions shifted to videoconferencing | |
Integration of video platform with electronic health record | |
Week 5 | Therapists surveyed on group topics & days/times |
Weekly schedule developed | |
Laptop cameras distributed | |
Staff kickoff meeting | |
Week 6 | Point person provides one-on-one & group training to staff |
Administrative staff distribute schedule & coach patients on platform | |
Meetings scheduled & invitations sent | |
Week 7 | Launch of videoconferencing groups |
Troubleshooting (e.g., helping patients sign on) | |
First post-launch huddle on Friday (held weekly moving forward) | |
10 weeks out (mid-May) | Number of groups & hosts has grown |
Feedback & ongoing assessment | |
Point person has ongoing individual check-ins with staff | |
5 months out (late August) | Several in-person groups have been reestablished |
Operating under hybrid model | |
State certification process completed to obtain permanent approval for tele-practice |
For an end-to-end description of this practice and how Strong Recovery made it happen, see our main article.
[1] Blanco, C., Ali, M.M., Beswick, A., Drexler, K. Hoffman, C., Jones, C.M., Wiley, T.R.A., & Coukell, A. (2020). The American opioid epidemic in special populations: Five examples. NAM Perspectives. Discussion Paper, National Academy of Medicine, pp. 5-8.
March 2021