A feasibility study of the use of asynchronous telepsychiatry for psychiatric consultations.

OBJECTIVE This study examined the feasibility of conducting psychiatric consultations using asynchronous, or store-and-forward, video-based telepsychiatry. METHODS Video-recorded 20- to 30-minute assessments of 60 nonemergency, English-speaking adult patients in a medically underserved county in California were uploaded along with other patient data to a Web-based record. Two psychiatrists then used the record to provide psychiatric consultations to the referring primary care providers. RESULTS Eighty-five percent of patients received diagnoses of mood disorders, 32% diagnoses of substance use disorders, 53% diagnoses of anxiety disorders, and 5% other axis I diagnoses. Psychiatrists recommended short-term medication changes for 95% of the patients and provided guidelines for possible future changes. CONCLUSIONS This study-the first study of asynchronous telepsychiatry to be published-demonstrated the feasibility of this approach. This type of assessment should not replace the face-to-face psychiatric interview, but it may be a very helpful additional process that improves access to care and expertise.

[1]  M. Ansseau,et al.  High prevalence of mental disorders in primary care. , 2004, Journal of affective disorders.

[2]  J. Neufeld,et al.  Use of secure e-mail and telephone: psychiatric consultations to accelerate rural health service delivery. , 2006, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[3]  C R Doarn,et al.  Use of the Internet for long-term clinical follow-up. , 1998, Telemedicine journal : the official journal of the American Telemedicine Association.

[4]  J. Neufeld,et al.  The e-Mental Health Consultation Service: providing enhanced primary-care mental health services through telemedicine. , 2007, Psychosomatics.

[5]  D. Sheehan,et al.  The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. , 1998, The Journal of clinical psychiatry.

[6]  E. Lindström,et al.  Axis V—Global Assessment of Functioning Scale , 1994, Acta psychiatrica Scandinavica.

[7]  P. Hauser,et al.  Treatment outcomes in depression: comparison of remote treatment through telepsychiatry to in-person treatment. , 2004, The American journal of psychiatry.

[8]  T. Stern,et al.  The Academy of Psychosomatic Medicine practice guidelines for psychiatric consultation in the general medical setting. The Academy of Psychosomatic Medicine. , 1998, Psychosomatics.

[9]  W. Katon,et al.  Stepped collaborative care for primary care patients with persistent symptoms of depression: a randomized trial. , 1999, Archives of general psychiatry.

[10]  P. Yellowlees Your Health in the Information Age: How You and Your Doctor Can Use the Internet to Work Together , 2008 .