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Telepsychiatry 75106
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 75106
Telepsychiatry can involve direct interaction between a psychiatrist and the 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. It can also involve recording medical information (images, videos, etc.) Sending this information to a remote site for review later. Telepsychiatry 75106
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 75106
- 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
- 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 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 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 75106
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. State licensing boards and legislatures view the location of the patient as the place where "the practice of medicine" occurs. Telepsychiatry 75106
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 75106
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. In-person care is equivalent in terms of confidentiality and patient privacy. Telepsychiatry 75106
Research has also found that overall experiences among all age groups have been good. 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 75106
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 75106
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 75106
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. Patients should plan ahead and prepare the just as for an in-person appointment. Have any relevant records and information, including prescriptions, and have a list of questions to address. Telepsychiatry 75106
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. Only 17 percent of emergency room doctors reported that they had a psychiatrist available to treat psychiatric emergencies. Telepsychiatry 75106
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 75106
Cost and Insurance
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75106
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 75106
Despite this, laws, policies and rules governing state Medicaid are constantly changing. 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 75106
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: Site at which the physician or other licensed practitioner delivering the service is located at the time the service is provided via a telecommunications system. 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 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 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 with a specialist and provider located far away using 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. 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 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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