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Published on: May 15, 2020
Telepsychiatry in Integrated Care Settings
1Dr. Adaji is a 2016-2017 fourth-year psychiatry resident at the Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota. Dr. Fortney is professor, Division of Population Health, Department of Psychiatry and Behavioral Sciences, University of Washington, and core investigator, Health Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle.
Abstract:
The objective of this article is to inform psychiatrists and other mental health professionals and primary care providers about the role of telepsychiatry in facilitating integrated care models, particularly in remote primary care practices. A narrative literature review was conducted to highlight the evidence and challenges of using telepsychiatry for integrated care. Telepsychiatry uses communication technologies to facilitate audiovisual interaction between patients and care teams to deliver services and expertise across distances and practice settings. It is particularly suited for integrated care settings, if business model innovations such as collaborative care models are implemented alongside to improve the access and delivery of care to patients. Telepsychiatry has been shown to be equivalent to face-to-face evaluations and, in certain instances, may lead to better outcomes in integrated care settings. Several challenges of adopting telepsychiatry in real practice are highlighted, including reimbursement and licensing across states, which continue to be an important barrier. It is critical to use an established framework to understand the potential users of telepsychiatry and develop and promote competency-based telepsychiatry training for novice, competent, and expert users. Psychiatrists who want to extend their expertise to distant sites, improve access to care, and partake in the new business models of collaborative care will need to consider these benefits and challenges.
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