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Telepsychiatry 75034
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 75034
Telepsychiatry may involve direct interaction between the psychiatrist and 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. You can also record medical information (images and videos, etc.). and sending this to a distant site for later review. Telepsychiatry 75034
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 75034
- Improve access to mental health specialty care that might not otherwise be available (e.g., in rural areas)
- 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 transportation barriers such as transportation inaccessibility or long driving distances.
- Eliminate stigmatization
While some people may be reluctant or feel awkward talking to a person on a screen, experience shows most people are comfortable with it. 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 75034
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. State licensing boards and legislatures view the location of the patient as the place where "the practice of medicine" occurs. Telepsychiatry 75034
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 75034
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 75034
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 75034
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. You can find more information on the evidence for telepsychiatry. Telepsychiatry 75034
Used in a Variety of Settings
Telepsychiatry is used in a variety of different settings, including private practice, outpatient clinics, hospitals, correctional facilities, schools, nursing homes, and military treatment facilities. Telepsychiatry 75034
Patients can schedule appointments individually with a psychiatrist or therapist for a live video appointment. 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 75034
Telepsychiatry is helping bring more timely psychiatric care 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. A 2016 poll of emergency room physicians found only 17 percent reported having a psychiatrist on call to respond to psychiatric emergencies. Telepsychiatry 75034
Telepsychiatry is being used in nursing homes to provide both ongoing psychiatric evaluation and care and emergency crisis intervention when it may be difficult to find a local psychiatrist to assist. Many states use telepsychiatry in corrections facilities where inmates frequently require ongoing mental health care. Telepsychiatry 75034
Cost and Insurance
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75034
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 75034
That said, state Medicaid policies, rules, and laws are continuing to evolve. 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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75034
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: Health care practice supported by electronic processes and communication.
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 is a way for qualified health care professionals to send prescriptions and renewals to local 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: Location of the patient at the time the service is provided via a telecommunications system.
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 and Telemedicine: Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. 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 an independent 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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