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Telepsychiatry 75228
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 75228
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. You can also record medical information (images and videos, etc.). Sending this information to a remote site for review later. Telepsychiatry 75228
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 75228
- 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.
- Reduce the need for trips to the emergency room
Reduce delays in care
- Improve continuity of care and follow-up
- Reduce the need for time off work, childcare services, etc. Access appointments from faraway locations
- Reduce potential transportation barriers, such as lack of transportation or the need for long drives
- Reduce the barrier of stigma
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. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life. Telepsychiatry 75228
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. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75228
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 75228
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 can be compared to in-person care in terms of diagnostic accuracy, treatment effectiveness and quality of care. Patient privacy and confidentiality are equivalent to in-person care. Telepsychiatry 75228
Research also shows that all age groups experience positive overall. 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 75228
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 75228
Use 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 75228
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. 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 75228
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 75228
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 75228
Insurance and Cost
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75228
Fifty states and Washington, D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service. Comparatively, only 16 state Medicaid programs reimburse for store-and-forward services ("asynchronous telemedicine"). Telepsychiatry 75228
That said, state Medicaid policies, rules, and laws are continuing to evolve. 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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75228
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: 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 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 allows qualified health care personnel to send new prescriptions or renewals to community or mail-order pharmacies.
HIPAA: Acronym for 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 which transmit information in both directions at the same time.
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. 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 encompasses different types of programs and services provided for the patient.
Videoconferencing Real time transmission of digital video images among multiple locations.
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