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Telepsychiatry 75387
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 75387
Telepsychiatry may involve direct interaction between the psychiatrist and 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 75387
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 75387
- Access to mental health specialist care in rural areas can be improved.
- Take care of the patient at their 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. to access appointments far away
- 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 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 75387
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 75387
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 75387
Evidence for 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 75387
Research has also found that overall experiences among all age groups have been good. There is evidence for children, adolescents, and adults regarding assessment and treatment (medication 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 75387
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 75387
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 75387
Patients can schedule appointments individually with a psychiatrist or therapist for a live video appointment. 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. Be prepared with all relevant information, including prescriptions and a list of questions. Telepsychiatry 75387
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 75387
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 75387
Insurance and Cost
43 states and District of Columbia currently have laws that govern private payer reimbursement for Telehealth Telepsychiatry 75387
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 75387
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. During a public health emergency, Medicare beneficiaries, regardless of geographic location, may be seen in the home (Medicare Telemedicine Health Care Fact Sheet). Telepsychiatry 75387
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: 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: 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 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. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote health care that does not always involve 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 between multiple locations.
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