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Telepsychiatry 75002
What is Telepsychiatry?
Telemedicine is the process of providing health care from a distance through technology, often using videoconferencing. Telepsychiatry, a subset of telemedicine, can involve providing a range of services including psychiatric evaluations, therapy (individual therapy, group therapy, family therapy), patient education, and medication management. Telepsychiatry 75002
Telepsychiatry may involve direct interaction between the psychiatrist and patient. This includes psychiatrists who provide mental health care consultation and expertise to primary care providers. You can deliver mental health care in live, interactive communication. You can also record medical information (images and videos, etc.). and sending this to a distant site for later review. Telepsychiatry 75002
Benefits
Telepsychiatry via video helps patients access affordable and convenient mental health services. It can benefit patients in a number of ways, such as: Telepsychiatry 75002
- Improve access to mental health specialty care that might not otherwise be available (e.g., in rural areas)
- Bring care to the patient's location
- Help integrate behavioral health care and primary care, leading to better outcomes
- Reduce the need for trips to the emergency room
Reduce delays in care
- Enhance continuity of care and follow up
- You can save time and use childcare services to reduce the amount of time you spend at work. Access appointments from faraway locations
- Reduce potential transportation barriers, such as lack of transportation or the need for long drives
- Eliminate stigmatization
Although some people might be hesitant or uncomfortable talking to someone on a screen with them, most people seem to be comfortable doing so. Some people may be more relaxed and willing to open up from the comfort of their home or a convenient local facility. This will likely to be less of an issue as people become more comfortable using video communication in their daily lives. Telepsychiatry 75002
Telepsychiatry allows psychiatrists the ability to see more patients from distant locations. Psychiatrists, as well as other clinicians, must be licensed in the state where they work. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75002
Although telepsychiatry has the disadvantage of the patient and psychiatrist not being in the same room, it can create enhanced feelings of safety, security, and privacy for many patients. Telepsychiatry 75002
Evidence of Effectiveness
Telepsychiatry is proven to be effective. Research has shown that patients, psychiatrists, as well as other professionals, are satisfied with it. Telepsychiatry is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. In-person care is equivalent in terms of confidentiality and patient privacy. Telepsychiatry 75002
Research also shows that all age groups experience positive overall. There is evidence for children, adolescents, and adults regarding assessment and treatment (medication and therapy). There are even people for which telemedicine may be preferable to in-person care, for example, people with autism or severe anxiety disorders and patients with physical limitations may find the remote treatment particularly useful. Telepsychiatry 75002
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75002
Used in a Variety of Settings
Telepsychiatry can be used in many settings including outpatient clinics and hospitals, private practice, schools, nursing homes, military treatment facilities, and correctional facilities. Telepsychiatry 75002
For a live video session, patients can make appointments with their psychiatrists or therapists individually. If the provider offers this service, it can be done with them or one of many companies that offer access to mental health professionals for video appointments. As with an in-person appointment, patients should prepare ahead. Have any relevant records and information, including prescriptions, and have a list of questions to address. Telepsychiatry 75002
Telepsychiatry helps bring quicker psychiatric treatment to emergency rooms. According to the Agency for Healthcare Research and Quality, one in eight emergency rooms visits is related to a mental or substance use condition. Many emergency rooms are not equipped to handle people with serious mental health issues and do not have psychiatrists or other mental health clinicians on staff to assess and treat mental health problems. Only 17 percent of emergency room doctors reported that they had a psychiatrist available to treat psychiatric emergencies. Telepsychiatry 75002
Telepsychiatry can be used in nursing homes for both ongoing psychiatric evaluations and care as well as emergency intervention. This is done when it might not be possible to find a local psychiatrist. Telepsychiatry is used in many states in corrections facilities that have inmates who need ongoing mental health care. Telepsychiatry 75002
Cost and Insurance
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75002
Fifty states and Washington, D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service. Only 16 states have Medicaid programs that reimburse for store-and forward services ("asynchronous Telemedicine"), in contrast. Telepsychiatry 75002
That said, state Medicaid policies, rules, and laws are continuing to evolve. If the community is rural, Medicare will pay for telepsychiatry services. Otherwise, the patient must report to an "Originating site" unless the patient has a substance abuse disorder. (Medicare will also cover any coexisting diagnosis under the SUPPORT Act. Medicare Telemedicine and Health Care Fact Sheet. Telepsychiatry 75002
Definition of Terms
Asynchronous, or "Store and Forward": Capture data and then transfer it to another site using a camera or other similar device. The image is stored in a camera (or similar device) and sent to another site via telecommunication for consultation.
Distant site: Website at which the doctor or licensed practitioner who is providing the service is located at time that the service is being provided by a telecommunications network. eHealth: Electronic communication and support for health care practices.
Electronic Health Record (EHR): A systematic collection of electronic health information about individual patients or populations that is recorded in digital format and capable of being shared across health care settings via information networks or exchanges. EHRs typically include information about patients, such as their medical history, medications, allergies, immunization status and laboratory test results.
e-Prescribing: The electronic generation, transmission, and filling of medical prescriptions, as opposed to traditional paper and faxed prescriptions. E-prescribing allows qualified health care personnel to send new prescriptions or renewals to community or mail-order pharmacies.
HIPAA: Acronym for Health Information Portability and Accountability Act. HIPAA protects the privacy of individually identifiable health information, sets national standards for the security of electronically protected health information, and protects identifiable information being used to analyze patient safety events and improve patient safety. More about HIPAA.
Originating site: The location of the patient when the service is rendered via a telecommunications network.
Synchronous: Interactive video connections that transmit information in both directions during the same time period.
Teleconferencing: Interactive electronic communication (voice, video, and/or data transmission) between multiple users at two or more sites.
Teleconsultation: Consultation between a provider and specialist located at a distance using either store and forward telemedicine or real-time videoconferencing.
Telehealth, Telemedicine: Telemedicine refers to the exchange of medical information via electronic communications between two sites in order to improve patients' health. Telemedicine is closely associated with the term "telehealth", which is used to describe a wider definition of remote healthcare that does not always include clinical services. Telemedicine and telehealth include videoconferencing, still image transmission, e-health, remote monitoring of vitals and nursing call centers, as well as telemedicine and/or telehealth. Telemedicine is not a separate medical specialty. Telemedicine can include a variety of services and programs that are offered to the patient.
Videoconferencing: Real-time transmission of digital video images between multiple locations.
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