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Telepsychiatry 75238
What is Telepsychiatry?
Telemedicine refers to the provision of health care remotely using technology. Most often, this is done via 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 75238
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 75238
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 75238
- 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. Access appointments from faraway locations
- Reduce transportation barriers such as transportation inaccessibility or long driving distances.
- 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 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 75238
Telepsychiatry allows psychiatrists the ability to see more patients from distant locations. Psychiatrists, as well as other clinicians, must be licensed in the state where they work. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75238
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 75238
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. In-person care is equivalent in terms of confidentiality and patient privacy. Telepsychiatry 75238
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 75238
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 75238
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 75238
For a live video session, patients can make appointments with their psychiatrists or therapists individually. 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. Have any relevant records and information, including prescriptions, and have a list of questions to address. Telepsychiatry 75238
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 are not equipped to handle people with serious mental health issues and do not have psychiatrists or other mental health clinicians on staff to assess and treat mental health problems. A 2016 poll of emergency room physicians found only 17 percent reported having a psychiatrist on call to respond to psychiatric emergencies. Telepsychiatry 75238
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 75238
Insurance and Cost
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75238
Washington, D.C. and fifty states reimburse live video telehealth services in Medicaid fee for service. Comparatively, only 16 state Medicaid programs reimburse for store-and-forward services ("asynchronous telemedicine"). Telepsychiatry 75238
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 75238
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: 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 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 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 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 which transmit information in both directions at the same time.
Teleconferencing - Interactive electronic communication between multiple users at different sites (voice, video and/or data transmission).
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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