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Telepsychiatry 75446
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 75446
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. Mental health care can be delivered 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 75446
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 75446
- 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
- 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 transportation barriers such as transportation inaccessibility or long driving distances.
- Reduce the barrier of stigma
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. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life. Telepsychiatry 75446
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. Legislative bodies and state licensing boards consider the location of the patient to be the place "where the practice of medicine takes place." Telepsychiatry 75446
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 75446
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 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 75446
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 75446
Telepsychiatry is particularly effective in treating PTSD, depression and ADHD. See more on the evidence base for telepsychiatry. Telepsychiatry 75446
Use 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 75446
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. Be prepared with all relevant information, including prescriptions and a list of questions. Telepsychiatry 75446
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 75446
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. Many states use telepsychiatry in corrections facilities where inmates frequently require ongoing mental health care. Telepsychiatry 75446
Cost and Insurance
Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth Telepsychiatry 75446
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 75446
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 75446
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 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 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 which transmit information in both directions at the same time.
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. 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. Telemedicine and telehealth include videoconferencing, still image transmission, e-health, remote monitoring of vitals and nursing call centers, as well as telemedicine and/or 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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