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Telepsychiatry 75368
What is Telepsychiatry?
Telemedicine is the process of providing health care from a distance through technology, often using 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 75368
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. You can deliver mental health care 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 75368
Benefits
Telepsychiatry via video helps patients access affordable and convenient mental health services. Patients can reap the benefits of it in many ways. Telepsychiatry 75368
- 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
- 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
- Improve 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 75368
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. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75368
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 75368
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 75368
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 75368
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 75368
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 75368
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. Patients should plan ahead and prepare the just as for an in-person appointment. Have any relevant records and information, including prescriptions, and have a list of questions to address. Telepsychiatry 75368
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. Only 17 percent of emergency room doctors reported that they had a psychiatrist available to treat psychiatric emergencies. Telepsychiatry 75368
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 75368
Insurance and Cost
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75368
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 75368
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 75368
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 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 is Acronym to Health Information Portability and Accountability Act. HIPAA is an acronym for Health Information Portability and Accountability Act.
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 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 an independent 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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