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Telepsychiatry 75091
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 75091
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. 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 75091
Benefits
Telepsychiatry via video helps patients access affordable and convenient mental health services. Patients can reap the benefits of it in many ways. Telepsychiatry 75091
- 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.
- Reduce the need for trips to the emergency room
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
- Reduce the barrier of stigma
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 might be more comfortable and open to sharing their thoughts from the comfort of home or at a nearby facility. This will likely to be less of an issue as people become more comfortable using video communication in their daily lives. Telepsychiatry 75091
Telepsychiatry allows psychiatrists to treat more patients in 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 75091
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 75091
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 75091
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 75091
Telepsychiatry has been found especially effective with respect to the treatment of PTSD, depression, and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75091
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 75091
Patients can schedule appointments individually with a psychiatrist or therapist for a live video appointment. 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. Be prepared with all relevant information, including prescriptions and a list of questions. Telepsychiatry 75091
Telepsychiatry is helping bring more timely psychiatric care to emergency rooms. An estimated one in eight emergency room visits involves a mental health and/or substance use condition, according to the Agency for Healthcare Research and Quality. 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 75091
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 75091
Insurance and Cost
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75091
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 75091
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 75091
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: 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 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: 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. 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 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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