Are All Psychiatry Services Created Equal?

A look at telepsychiatry and face-to-face psychiatry services

Do psychiatrists need to be in the same room with a patient in order to correctly diagnose and counsel the patient? According to a study involving 495 subjects — about half had face-to-face sessions with a psychiatrist, while the other half were treated via telepsychiatry — both delivery systems exhibited equivalent outcomes. In other words, telepsychiatry and face-to-face psychiatry showed equal clinical improvements, hospitalization rates and patient satisfaction with inpatient psychiatric treatment and telepsychiatry services. However, the cost of providing telepsychiatry was much lower than the cost of face-to-face sessions.

Telemedicine originally developed as a tool primarily used in the field of psychiatry. With the rise of high-speed Internet, telepsychiatry has emerged as an effective and promising method of providing psychiatric services to patients with little or no access to mental health services.

One reason behind the rapid expansion of telepsychiatry services is the 21st century’s shortage of psychiatrists. A survey conducted six years ago found that nearly 80 percent of U.S. state counties did not have enough psychiatrists to adequately address the mental health needs of people suffering serious mental illnesses.

The far-reaching effects of telepsychiatry services have fortunately alleviated this supply and demand imbalance. They have also improved the efficacy of psychiatric care by making it much easier for one psychiatrist to treat people in multiple venues without being burdened with transportation difficulties.

Why Psychiatrists Do Not Need Face-to-Face Sessions with Patients

Research on the reliability of telepsychiatry has produced good results supporting positive interrater reliability for a wide variety of psychiatric disorders.

Since the majority of psychiatric patients have been referred by primary care physicians, telepsychiatrists are not “cold” meeting a patient. Through clinical notes provided by the patient’s medical doctor, telepsychiatrists are already equipped with information that facilitates their ability to competently evaluate a patient’s mental health.

Telepsychiatry providers have also found that patients tend to open up more freely to them when using videoconferencing technology. Iris Telehealth uses software similar to Skype or Facetime, that has additional security built in to ensure patient confidentiality is protected. This type of technology can lead to self-disclosure, social exchange and meaningful relationships — many theorists believe these components are just as important as physical contact. Telepsychiatry providers working for educational institutions have also reported that students more readily disclose clinical information via videoconferencing rather than face-to-face contact.

Patient Satisfaction Naturally Leads to Better Outcomes

With the majority of patients satisfied with their telepsychiatry services, the likelihood that patients using telepsychiatry services will adhere to treatment procedures and medication regimens is significantly increased.

Better yet, telepsychiatry is now reaching disadvantaged populations — rural residents, the elderly and the disabled — who would otherwise be hard-pressed to access face-to-face sessions with a psychiatrist.

In fact, telepsychiatry in rural areas is one of the fastest-growing areas of mental health care today. One doctor in Greenville, NC, even closed his traditional practice to conduct evaluations and sessions via videoconferencing when he discovered patients wholeheartedly preferred telepsychiatric services over face-to-face meetings.

With research revealing a high percentage of satisfied patients and effectiveness rates supporting telepsychiatry services, the time has come for telepsychiatry providers to begin embracing the advantages of telehealth technology.

Cost, Access, and Quality of Telemedicine

Cost, Access, and Quality of Telemedicine

With research results finding telemedicine has the potential to increase the accuracy of diagnoses while improving access to health care for disadvantaged individuals, telemedicine/telehealth service activists are working to overcome barriers existing between patients and telemedicine providers. Additionally, study-based evidence further champions the need to improve access to telemedicine by revealing that socioeconomic benefits for families, patients and healthcare professionals are indeed significant. In fact, the significantly reduced cost of telemedicine, combined with the high quality of telemedicine, is rapidly becoming a primary subject of interest for global health providers and researchers.

Quality of Telemedicine Is Equal to or Exceeds Traditional Medicine

Several studies have found that the satisfaction rate among surgeons using telemedicine or teleconferencing was nearly 90 percent. The quality of telemedicine services rated by patients also either equaled or exceeded the same ratings for traditional medical treatment. Results of another study found evidence that telemedicine improved quality of life. Further, hypertension patients being monitored via telemedicine video conferencing experienced better blood pressure control than patients receiving traditional care.

Another interesting study focused on the impact telemedicine had on younger emergency room patients. It found that quality of care was higher for those requiring telemedicine consultations than for patients who were evaluated or diagnosed via phone consultations or no consultations.

Currently, some states are even investing in telemedicine technologies for use by home health providers as a way to reduce travel time for providers and therefore increase their ability to assist more patients in one day.

Cost of Telemedicine and Telemedicine Reimbursement

Since healthcare spending comprises a large portion of any community’s economy (especially rural communities), telemedicine services can give medical assistance to local people so they do not need to travel outside the community. Telemedicine would not only keep money within the community but would promote business retention and recruitment. In fact, access to locally available healthcare is an important factor in the successful recruitment of new businesses and improving local economies.

Telehealth advocates also assert that telemedicine has the ability to significantly reduce overall costs of health services. With a potential for restructuring and transforming the way healthcare is provided, telemedicine contributes to reducing costs by redistributing resources from clinical environments to primary care.

One of the most troublesome obstacles to completely integrating telemedicine services into standard healthcare methods is the lack of consistent reimbursement policies provided by private and public health insurance providers. Although the Balanced Budget Act of 1997 authorized partial reimbursement for telemedicine and telehealth services, factors like eligibility guidelines or geographic location still restrict reimbursement.

Currently, 48 state Medicaid programs contain reimbursement clauses to pay for telemedicine services. Behavioral health, psychiatry, and mental health counseling are seeing the most rapid expansions in reimbursement. Budget constraints are preventing other state Medicaid agencies from establishing telemedicine reimbursement policies.

In addition, over half of the states have telemedicine parity, a legal term that means these states require private insurers to reimburse telemedicine services equivalently to in-person care. Implementation of parity allows financially responsible services to be given in that state via telemedicine and increases access to care, particularly in rural areas.

On the other hand, Medicare reimburses recipients in all 50 states if they meet certain requirements. To learn more about telehealth reimbursement issues, please contact Iris Telehealth today.