Telepsychiatry: Case Study

November 12, 2014

The chronic shortage of primary care and specialty physicians in the US is well documented, and continues to represent a serious barrier to timely, qualitative healthcare for millions of Americans. Most noteworthy has been the widespread shortage of psychiatrists. Today, 1000�s of clinics and hospitals report the difficulty in attracting qualified behavioral health providers to their facilities results in ED treatment delays, longer lengths of inpatient stays, difficulties in discharge planning and chronic recidivism. As a result, during the past 3-5 years, the use of telepsychiatry as a viable alternative to on-site behavioral healthcare has evidenced a sharp rise in popularity. The present review documents the rise in popularity of telepsychiatry and the advantages of telepsychiatry for US healthcare facilities and patients.

A Brief History of Telepsychiatry

Telepsychiatry got its start in the 1960�s on black and white television screens broadcasted between two sites. Early efforts at telepsychiatry met with technological, regulatory and professional barriers that prevented broader acceptance. Fast forward to the late 90�s and early 2000's when the public�s use of the internet was still limited. In particular, internet connection speeds and picture quality were unacceptably poor by current standards, While more expensive videoconferencing hardware was available to overcome many of these barriers � the exorbitant cost of this hardware prevented wide acceptance. By contrast, during the past 5 years, the behavioral health industry has reached a point where both the hardware and software to conduct telepsychiatry has become readily available at low cost to health care providers and consumers. The accessibility and affordability of present day televideo has made it a truly viable alternative to on-site behavioral health services for millions of Americans. The advent of telepsychiatry has given facilities greater access and choice with regard to the experience and sub-specialties of the psychiatrists they work with. Not only has this given facilities the ability to hire psychiatrists quickly but it has also given them greater choice over the selection of available psychiatrists and their specialization. Telepsychiatry is also rapidly becoming the delivery system choice for many psychiatrists and psychologists who prefer the comfort and security of delivering behavioral health services from their home or private office.

Psychiatry Recruitment Specialists

The widespread shortage of psychiatrists and the boom in telepsychiatry has made the use of recruitment and staffing specialists to attract behavioral health talent commonplace. The limited number of psychiatric recruitment specialty companies has rendered these companies in high demand by facilities engaged in a variety of frenzied efforts to attract the limited supply of available telepsychiatrists. Hospitals and clinics routinely employ or contract with recruitment firms that aggressively market their jobs to mental health providers. For many small, medium and large facilities these recruitment and staffing agencies have become their primary vehicles for attracting new psychiatric talent.

Legal Aspects of Telepsychiatry

The popularity and advantages of telepsychiatry to patients, facilities and payers has helped to advance state and federal regulation with regard to telepsychiatric services. Today, telepsychiatry is reimbursed by Medicare, Medicaid, the Veterans Administration, and many/most commercial carriers. As with on-site providers and facilities, the specific services for which different payers reimburse telepsychiatry varies from payer to payer. Still the small gaps that exist for some payers between the reimbursement schedules for on-site and telepsychiatry services are rapidly diminishing, and payer acceptance of telepsychiatry is clearly on the rise. Further, while most payers currently require that telepsychiatry services be delivered to patients who are in a clinic or other healthcare facility setting, some payers are already beginning to reimburse for telepsychiatric services that are delivered to patients in their homes. Finally, while most regulators and payers still require that telepsychiatrists be licensed in the same state in which they are providing treatment, several payers, including CMS, are currently considering allowing telepsychiatrists who maintain licensure in any US state, to deliver telepsychiatry services in all 50 states.

Despite the popularity and advantages of telepsychiatry, confusion about telepsychiatry is common. As a result, hospitals, facilities, long-term care facilities, correctional institutions routinely reach out to leading telepsychiatry corporations like e-Psychiatry for consultation and services to ensure that they are fully capitalizing on the opportunities presented by telepsychiatry. The future for telemedicine, and especially telepsychiatry, seems undeniable, and the possibility exists that telepsychiatry may someday replace on-site services as the preferred method of treatment for most patients. On balance, this represents a tectonic shift in the behavioral health profession for which the time has come.