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Telepsychiatry 75244
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 75244
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. You can also record medical information (images and videos, etc.). and sending this to a distant site for later review. Telepsychiatry 75244
Benefits
Video-based telepsychiatry helps meet patients' needs for convenient, affordable, and readily accessible mental health services. It can benefit patients in a number of ways, such as: Telepsychiatry 75244
- 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 potential transportation barriers, such as lack of transportation or the need for long drives
- Eliminate stigmatization
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 may be more relaxed and willing to open up from the comfort of their home or a convenient local facility. This will likely to be less of an issue as people become more comfortable using video communication in their daily lives. Telepsychiatry 75244
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 75244
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 75244
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. In-person care is equivalent in terms of confidentiality and patient privacy. Telepsychiatry 75244
Research also shows that all age groups experience positive overall. 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 75244
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. You can find more information on the evidence for telepsychiatry. Telepsychiatry 75244
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 75244
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 75244
Telepsychiatry helps bring quicker psychiatric treatment 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 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 75244
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. Telepsychiatry is used in many states in corrections facilities that have inmates who need ongoing mental health care. Telepsychiatry 75244
Cost and Insurance
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75244
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 75244
That said, state Medicaid policies, rules, and laws are continuing to evolve. 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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75244
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: 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 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 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 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 between multiple locations.
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