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Telepsychiatry 75053
What is Telepsychiatry?
Telemedicine is the process of providing health care from a distance through technology, often using videoconferencing. Telepsychiatry is a subset that of telemedicine. It can include psychiatric evaluations and therapy (individual therapy or group therapy), patient education and medication management. Telepsychiatry 75053
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. Mental health care can be delivered 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 75053
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 75053
- Access to mental health specialist care in rural areas can be improved.
- Bring care to the patient's 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
- Enhance 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 75053
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 75053
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 75053
Evidence for Effectiveness
Telepsychiatry is proven to be effective. Research has shown that patients, psychiatrists, as well as other professionals, are satisfied with it. Telepsychiatry can be compared to in-person care in terms of diagnostic accuracy, treatment effectiveness and quality of care. In-person care is equivalent in terms of confidentiality and patient privacy. Telepsychiatry 75053
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). 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 75053
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75053
Use 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 75053
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. Patients should plan ahead and prepare the just as for an in-person appointment. Be prepared with all relevant information, including prescriptions and a list of questions. Telepsychiatry 75053
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 75053
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. Many states use telepsychiatry in corrections facilities where inmates frequently require ongoing mental health care. Telepsychiatry 75053
Insurance and Cost
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75053
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 75053
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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75053
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: 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 is Acronym to Health Information Portability and Accountability Act. HIPAA is an acronym for Health Information Portability and Accountability Act.
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, Telemedicine: Telemedicine refers to the exchange of medical information via electronic communications between two sites in order to improve patients' health. 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. Videoconferencing, the transmission of still images, e-health including patient portals, remote monitoring of vital signs, and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not an independent medical specialty. Telemedicine encompasses different types of programs and services provided for the patient.
Videoconferencing: Real-time transmission of digital video images between multiple locations.
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