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Telepsychiatry 75394
What is Telepsychiatry?
Telemedicine is the process of providing health care from a distance through technology, often using 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 75394
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. Mental health care can be delivered 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 75394
Benefits
Telepsychiatry via video helps patients access affordable and convenient mental health services. Patients can reap the benefits of it in many ways. Telepsychiatry 75394
- Access to mental health specialist care in rural areas can be improved.
- Bring care to the patient's 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
- 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.
- Eliminate stigmatization
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. This will likely to be less of an issue as people become more comfortable using video communication in their daily lives. Telepsychiatry 75394
Telepsychiatry allows psychiatrists to treat more patients in 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 75394
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 75394
Evidence of 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 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 75394
Research also shows that all age groups experience positive overall. 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 75394
Telepsychiatry has been found especially effective with respect to the treatment of PTSD, depression, and ADHD. You can find more information on the evidence for telepsychiatry. Telepsychiatry 75394
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 75394
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 75394
Telepsychiatry is helping bring more timely psychiatric care 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. Only 17 percent of emergency room doctors reported that they had a psychiatrist available to treat psychiatric emergencies. Telepsychiatry 75394
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 75394
Cost and Insurance
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75394
Washington, D.C. and fifty states reimburse live video telehealth services in Medicaid fee for service. Only 16 states have Medicaid programs that reimburse for store-and forward services ("asynchronous Telemedicine"), in contrast. Telepsychiatry 75394
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 75394
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 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: 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 is an acronym for Health Information Portability and Accountability Act.
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. 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 can include a variety of services and programs that are offered to the patient.
Videoconferencing Real time transmission of digital video images among multiple locations.
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