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Thursday, Mar 28, 2024

On-Screen Psychiatrists

Aligned TeleHealth Inc., a Calabasas company that provides psychiatric counseling on a computer screen, has received $12 million in venture capital to keep up with the rising demand of mental health services in hospitals and nursing homes. “There’s a national shortage of psychiatrists — close to about 40,000 at this time,” said Dr. Nitin Nanda, chief executive of Aligned. “At any given time, 30 percent of consumers in the emergency room have some type of psychiatric or behavioral health issue, so they are occupying almost 30 percent of beds with wait times anywhere from eight to 12 hours.” Many hospitals don’t employ enough psychiatrists, but Aligned’s service could help solve this problem. The company provides behavioral health doctors via a robot with a monitor on top. Therefore, the psychiatrist doesn’t have to physically be available but can still see patients virtually, greatly reducing wait times — often as low as 30 minutes to an hour — as well as costs associated with increasing staff. When doctors remotely diagnose and treat patients through telecommunications technology, it is known as telemedicine or telehealth. In health care, this practice has become a growing trend that is beginning to receive higher reimbursement rates by insurance providers and further implementation by health care providers. “(A) significant change has been the expansion of insurance coverage for telemedicine services,” said Craig Hankins, vice president of digital products at health insurer UnitedHealthcare Inc. “By the end of 2017, we expect more than 2 million UnitedHealthcare members in California with employer-sponsored health plans to have coverage for virtual care provider visits.” Interested investors Nanda identified the need for telemedicine in psychiatry early on and started Aligned TeleHealth in 2013. Initial investors include Deepak Chopra, the founder and chief executive of telecommunications service provider OSI Systems Inc. of Hawthorne (but not the famed author of the same name), as well as Hector Sulaiman, chief executive of Controles Gráficos, a Mexico City-based medical imaging company. More recently, private equity firm SV Life Sciences of Boston purchased $12 million worth of newly issued Series A preferred stock in a deal that includes two board seats. “We expect the company to experience explosive growth over the next few years.” said Michael Balmuth, partner at SV and Aligned board member. Prior to the investment, Aligned was already generating more than $20 million in revenue. The company has also nearly tripled the number of patient-doctor virtual visits over the past two and a half years. Nanda is no stranger to startups. In 2012, his first company Asana Integrated Medical Group, which provides hospitalist staffing services, was acquired by IPC Healthcare Inc. in North Hollywood. IPC is now a part of TeamHealth Holdings Inc. of Knoxville, Tenn. Much like Asana, Aligned also provides doctors to hospitals and nursing homes in behavioral health, but the company’s main line of business is psychiatric telemedicine. Altogether, the company employs approximately 90 psychiatrists, doctors and nurses, who are either full-time employees or independent contractors, providing services to patients in close to 100 facilities nationally. In the Valley, Aligned contracts with close to 35 nursing homes and hospitals, including Providence Health & Services, which operates Providence Holy Cross Medical Center in Mission Hills, Providence St. Joseph Medical Center in Burbank and Providence Tarzana Medical Center. “Doctors are able to use their laptops and iPads to see patients, and that’s what makes it more scalable,” said Nanda. “I am sitting here in Calabasas but can see patients all around the country.” The $12 million investment will go toward expansion of doctor recruitment as well as the hiring of key executives, improving technology infrastructure and marketing. One major challenge for Aligned is the doctor credentialing process, which can take up to three months. For a doctor to practice telemedicine at hospitals A, B and C, he or she must be independently verified at each facility. Thus, sometimes a doctor may be hired in January but won’t be able to start work until May. Nanda said this has resulted in losing doctors while waiting for credentialing. In response, Aligned is working on implementing what Nanda calls credentialing by proxy, which essentially means if a doctor is credentialed at a major hub hospital in a system, then he or she is automatically credentialed at other hospitals within the system. Growth trajectory Another issue is state-specific licensure, so on top of having to be credentialed at each hospital, each doctor must be licensed in each state he or she practices in. Dr. Bill Bithoney, chief physician executive at consulting firm BDO Center for Healthcare Excellence and Innovation, said there are efforts afoot that may help Aligned down the road. “There is a movement for standardized medicine licensure,” he said. “Twenty-three states are trying to put together a conjoined licensure program. I can tell you pneumonia and cardiac arrest are the same state by state. It (standardized licensure) makes all the sense in the world, technically and medically.” As for the future of Aligned, Nanda, SV Life Sciences and team have big plans. Eventually, the company hopes to move beyond telepsychiatry into other specialties. Currently, the company works through hospitals and nursing homes, but wants to move into serving the consumer directly. The company’s psychiatrists and patients would connect directly for an appointment on the internet. Furthermore, once it solidifies its national business model, Aligned wants to take its services to the international market. “Telemedicine is a very nascent industry at this time, but over the next five years, it is absolutely going to explode,” said Nanda. “I think they are projecting it to be a $10 billion industry (by then).”

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