Telepsychiatry 75008

Telepsychiatry 75008

What is Telepsychiatry?

Telemedicine refers to the provision of health care remotely using technology. Most often, this is done via 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 75008

Telepsychiatry can involve direct interaction between a psychiatrist and the patient. It also encompasses psychiatrists supporting primary care providers with mental health care consultation and expertise. You can deliver mental health care in live, interactive communication. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Telepsychiatry 75008

Benefits

Video-based telepsychiatry helps meet patients' needs for convenient, affordable, and readily accessible mental health services. Patients can reap the benefits of it in many ways. Telepsychiatry 75008

- Access to mental health specialist care in rural areas can be improved.

- Take care of the patient at their location

- Integrating primary and behavioral health care can lead to improved outcomes.

- Reducing the number of trips to the emergency department

Reduce delays in care

- Improve continuity of care and follow-up

- Reduce the need for time off work, childcare services, etc. to access appointments far away

- 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. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life. Telepsychiatry 75008

Telepsychiatry allows psychiatrists the ability to see more patients from distant locations. Psychiatrists and other clinicians need to be licensed in the state(s) where the patient they are working with is located. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75008

Telepsychiatry can have the drawback of not having the psychiatrist and patient in the same room. However, it can provide enhanced security and privacy for many patients. Telepsychiatry 75008

Evidence for Effectiveness

There is substantial evidence of the effectiveness of telepsychiatry and research has found satisfaction to be high among patients, psychiatrists, and other professionals. Telepsychiatry is equivalent to in-person care in diagnostic accuracy, treatment effectiveness, quality of care, and patient satisfaction. Patient privacy and confidentiality are equivalent to in-person care. Telepsychiatry 75008

Research has also found that overall experiences among all age groups have been good. Children, adolescents, as well as adults, have good experiences with assessment and treatment (medications and therapy). Telemedicine can be more effective than in-person care for some people, such as patients with severe anxiety disorders or autism, and those with physical limitations. Telepsychiatry 75008

Telepsychiatry has been found especially effective with respect to the treatment of PTSD, depression, and ADHD. You can find more information on the evidence for telepsychiatry. Telepsychiatry 75008

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 75008

For a live video session, patients can make appointments with their psychiatrists or therapists individually. This can be with a regular provider if they offer the service or through one of a number of companies offering access to mental health clinicians 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 75008

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 lack the ability to treat serious mental illnesses and don't have psychiatrists or other mental healthcare clinicians available to help. Only 17 percent of emergency room doctors reported that they had a psychiatrist available to treat psychiatric emergencies. Telepsychiatry 75008

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 75008

Cost and Insurance

43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75008

Fifty states and Washington, D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service. Comparatively, only 16 state Medicaid programs reimburse for store-and-forward services ("asynchronous telemedicine"). Telepsychiatry 75008

Despite this, laws, policies and rules governing state Medicaid are constantly changing. Medicare will reimburse for telepsychiatry services if the community is considered rural, and requires the patient to report to an "Originating Site," unless that patient has a substance use disorder (Medicare will also cover any co-occurring diagnosis), under the SUPPORT Act. Medicare Telemedicine and Health Care Fact Sheet. Telepsychiatry 75008

Definition of Terms

Asynchronous or "Store and Forward": Capture and then transfer data from one site to another through the use of a camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site 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: Health care practice supported by electronic processes and communication.

Electronic Health Record: A digitally recorded collection of electronic information about patients and populations. It can be shared via information networks or exchanges with other health care providers. EHRs generally include patient demographics, medical history, medication, allergies, immunization status, laboratory test results, radiology, and other medical images, vital signs, characteristics such as age and weight, and billing information.

E-Prescribing is Electronic generation, transmission and filling medical prescriptions. This is in contrast to traditional paper prescriptions and faxed ones. 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 between multiple users at different sites (voice, video and/or data transmission).

Teleconsultation: Consultation with a specialist and provider located far away using store-and-forward telemedicine or real time videoconferencing.

Telehealth and Telemedicine: Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote health care that does not always involve 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 among multiple locations.

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