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Telepsychiatry 75165
What is Telepsychiatry?
Telemedicine refers to the provision of health care remotely using technology. Most often, this is done via 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 75165
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. Mental health care can be delivered 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 75165
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 75165
- Access to mental health specialist care in rural areas can be improved.
- Bring care to the patient's location
- Help integrate behavioral health care and primary care, leading to better 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. Access appointments from faraway locations
- Reduce transportation barriers such as transportation inaccessibility or long driving distances.
- 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. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life. Telepsychiatry 75165
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 75165
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 75165
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. Patient privacy and confidentiality are equivalent to in-person care. Telepsychiatry 75165
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). 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 75165
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75165
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 75165
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 75165
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. A 2016 poll of emergency room physicians found only 17 percent reported having a psychiatrist on call to respond to psychiatric emergencies. Telepsychiatry 75165
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 75165
Cost and Insurance
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75165
Washington, D.C. and fifty states reimburse live video telehealth services in Medicaid fee for service. Only 16 states have Medicaid programs that reimburse for store-and forward services ("asynchronous Telemedicine"), in contrast. Telepsychiatry 75165
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 75165
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: 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: 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: 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 is Acronym to 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 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 between multiple locations.
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