Due to the COVID-19 pandemic, many healthcare providers and facilities began offering telemedicine as a way to treat their patients while practicing social distancing guidelines. Though this technology has become more widely available in the past year, it has been around for some time and many patients find it a preferable way to receive medical care.
Dr. Irakli Mania, a psychiatrist and the Medical Director at Keystone Behavioral Health, has seen the benefits of using telemedicine for his patients and discusses the subject in today’s Take Care article.
What is telemedicine?
Telemedicine is the process of providing health care from a distance through technology, often using videoconferencing. It has become popular and has gained wide acceptance during the current COVID-19 pandemic. Telepsychiatry is a subset of telemedicine and can involve providing a range of services including psychiatric evaluations, medication management and therapy.
Telepsychiatry most commonly involves direct interaction between a provider and the patient when mental health care can be delivered through live, interactive communication. It can also include psychiatrists supporting primary care providers with mental health care consultation and expertise.
What is needed for a telemedicine appointment?
In order to hold a videoconferencing appointment, one needs to have access to internet and a device (phone, tablet or a computer) equipped with a camera and microphone. Most smartphones and tablets these days have these already installed and are ready to use.
There are different platforms through which telemedicine appointments are held. Some of the platforms that are popular include Doxy.me, Zoom and Skype for Business. Each provides unique features. They are very user-friendly and require minimal knowledge of using the software, like downloading an app or browsing the web. In addition, during this pandemic we have been allowed to have telemedicine appointments over the phone with just audio, if video is not available due to lack of access to such technology.
During the period of emergency declaration, it was allowed to even use video conferencing technology without HIPAA compliance certification. But in the usual course of telemedicine appointments, providers of these services choose systems that provide safe and secure conduction of these interactions between provider and patient in order to preserve confidentiality and protect health information.
What are the benefits of telemedicine?
Telepsychiatry can benefit patients in a number of ways. Traditionally it improves access to mental health specialty care that might not otherwise be available (e.g., in rural areas) and it reduces delays in care. It can also help integrate behavioral health care and primary care, leading to better outcomes with improved continuity of care. It has been shown to reduce the need for trips to the emergency room. Other more practical benefits include reduced need for time off work for travel, or finding childcare services. It is useful with certain barriers like lack of transportation which is quite common in our area. It can also reduce the old (but still present) barrier of stigma of going to a mental health facility.
Last but not least, the COVID-19 pandemic showed the importance of using this type of service. During current or future times when social distancing is needed, telemedicine provides a safe way for patients and providers to interact for treatment purposes.
Is it as effective as meeting in person?
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. Patient privacy and confidentiality are also equivalent to in-person care.
Research has also found that overall experiences among all age groups have been good. Moreover, there are 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. 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.
How have patients responded to having telemedicine appointments?
We have had overall a very positive experience both on the provider side as well as from the patient’s perspective. While some people may be reluctant or feel awkward talking to someone through a screen, experience shows that most people are comfortable with it. Some people may be more relaxed and willing to open up more from the comfort of their home or a convenient local facility. Also, this will likely be less of a problem as people become more familiar and comfortable with video communication in everyday life and I think that our society is ready for this.
Can this continue to be beneficial after the pandemic?
Absolutely. Telemedicine was not started during the pandemic; it was useful in practicing medicine before the pandemic as well. Therefore, it should and will continue to be used after the pandemic. Much depends on third party payers and their reimbursement policies, as well as state and federal regulations governing the practice of telemedicine. 50 states and Washington, D.C. reimburse for some form of live video telehealth in Medicaid fee-for-service. Currently, 43 states and the District of Columbia have laws that govern private payer reimbursement for telehealth.
That said, state Medicaid policies, rules and laws are continuing to evolve. We hope that policymakers will work with clinicians in order to continue offering this very important modality for healthcare delivery.
This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.
