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Telepsychiatry 75243
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 75243
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. You can deliver mental health care 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 75243
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 75243
- 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
- Help integrate behavioral health care and primary care, leading to better 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. 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. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life. Telepsychiatry 75243
Telepsychiatry allows psychiatrists to treat more patients in distant locations. Psychiatrists, as well as other clinicians, must be licensed in the state where they work. State licensing boards and legislatures view the location of the patient as the place where "the practice of medicine" occurs. Telepsychiatry 75243
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 75243
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 75243
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 75243
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75243
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 75243
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. Be prepared with all relevant information, including prescriptions and a list of questions. Telepsychiatry 75243
Telepsychiatry helps bring quicker psychiatric treatment 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. A 2016 poll of emergency room physicians found only 17 percent reported having a psychiatrist on call to respond to psychiatric emergencies. Telepsychiatry 75243
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 75243
Insurance and Cost
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75243
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 75243
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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75243
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 (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: 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 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. 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 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 between multiple locations.
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