Inside Disruption Blog

Transition to telemedicine

George L. Vergolias
May 31, 2017

We live in an age of rapid acceleration of technology, dissemination of communication, methods by which that communication can be disseminated, and the requirement for us to keep up. We are raising a cohort of children who will be challenged to think in non-linear, digital, expansive, and algorithmic ways to understand and solve the problems they face.


The video games and smartphones of today lay the groundwork for that future. It usually takes just one observation of a two-year-old first navigating a smartphone or tablet to see how quickly they will surpass us. Thus, it’s easy for those of us over 30 to see these changes over the past 10 years as revolutionary. We in the helping professions are particularly at risk to view these changes in like manner.


I was recently at a state mental health conference where many “well-learned” folks from several government offices talked about the exciting changes in mental health care reform, economies of scale, MCOs, ACOs, EMRs, EBPs and so on. It was certainly exciting talk, but there was a sense that all the talk was focused on our excitement. It failed to drive down to how we are going to help the individual – to help that patient with chronic schizophrenia gain access to care despite his paranoia; how that mother of four working three jobs with a special-needs child can gather additional support without traveling to three different clinics and taking excessive time off work or away from her children; or the Iraqi war veteran who struggles to adjust upon return home, as he and his wife try patching back together a marriage tested by distance and trauma.


These are the realities our patients live in, they really don’t care about our PowerPoint presentations.


Transition to telemedicine is revolutionary for health care practitioners, but merely evolutionary for patients. We need to be careful not to assume the patient understands the complexities faced by providers. They don’t care beyond how it impacts their care, the ease with which they can obtain it, and the positive life outcomes it can deliver.


Revolutions are revolutionary to those running them and effecting change, but to the poor farmer who just wants better crop yields, a fair price at the market, and consistent food for his family it is simply a welcome change. They have crops to tend to at sunrise. We have to be careful not to get too caught up in the revolution and lose focus on the main goal – cost-effective service delivery that improves clinical outcomes, and mostly improves patients’ lives.

George Vergolias

VP, Medical Director

About the Author: George Vergolias, PsyD, LP is a forensic psychologist and threat management expert serving as Vice President and Medical Director for the R3 Continuum. As part of his role of Vice President and Medical Director of R3 Continuum, he leads their Threat of violence and workplace violence programs. Dr. Vergolias is also the founder and President of TelePsych Supports, a tele-mental health company providing involuntary commitment and crisis risk evaluations for hospitals and emergency departments. He has over 20 years of forensic experience with expertise in the following areas: violence risk and threat management, psychological dynamics of stalking, sexual offending, emotional trauma, civil and involuntary commitment, suicide and self-harm, occupational disability, law enforcement consultation, expert witness testimony, and tele-mental health. Dr. Vergolias has directly assessed or managed over one thousand cases related to elevated risk for violence or self-harm, sexual assault, stalking, and communicated threats. He has consulted with regional, state, and federal law enforcement agencies, including the FBI, Secret Service, and Bureau of Prisons. He has worked for and consulted with Fortune 500 companies, major insurance carriers, government agencies, and large healthcare systems on issues related to work absence management, workplace violence, medical necessity reviews, and expert witness consultation.