Asynchronous Telepsychiatry: A Component of Stepped Integrated Care.

OBJECTIVE Integrated behavioral healthcare models typically involve a range of consultation options for mental healthcare. Asynchronous telepsychiatry (ATP) consults may be an additional potential choice, so we are conducting a 5-year clinical trial comparing ATP with synchronous telepsychiatry (STP) consultations. METHODS Patients referred by primary care providers are randomly assigned to one of the two treatment groups, ATP or STP. Clinical outcome, satisfaction, and economic data are being collected from patients for 2 years at 6-month intervals. RESULTS Baseline characteristics for the first 158 patients and case examples of ATP are presented. CONCLUSION Implementing ATP in existing integrated behavioral healthcare models could make mental healthcare more efficient.

[1]  C. Peek Integrated Behavioral Health and Primary Care: A Common Language , 2013 .

[2]  Varsha G. Vimalananda,et al.  Electronic consultations (e-consults) to improve access to specialty care: A systematic review and narrative synthesis , 2015, Journal of telemedicine and telecare.

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

[4]  William B Weeks,et al.  Improving efficiency and access to mental health care: combining integrated care and advanced access. , 2008, General hospital psychiatry.

[5]  Peter Yellowlees,et al.  PsychVACS: a system for asynchronous telepsychiatry. , 2011, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[6]  Jennifer McWilliams Integrating Telemental Healthcare with the Patient-Centered Medical Home Model. , 2016, Journal of child and adolescent psychopharmacology.

[7]  Charles R Doarn,et al.  The Empirical Foundations of Telemedicine Interventions in Primary Care. , 2016, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

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

[9]  Alberto Odor,et al.  A feasibility study of the use of asynchronous telepsychiatry for psychiatric consultations. , 2010, Psychiatric services.

[10]  B. Druss,et al.  Effects of electronic psychiatric consultations on primary care provider perceptions of mental health care: Survey results from a randomized evaluation. , 2017, Healthcare.

[11]  Mark T Hegel,et al.  Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. , 2002, JAMA.

[12]  Peter M Yellowlees,et al.  The Empirical Evidence for Telemedicine Interventions in Mental Disorders. , 2016, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[13]  Daniel Fischer,et al.  Availability of outpatient care from psychiatrists: a simulated-patient study in three U.S. cities. , 2015, Psychiatric services.

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

[15]  Peter Yellowlees,et al.  Cost analysis of store-and-forward telepsychiatry as a consultation model for primary care. , 2012, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[16]  Peter M Yellowlees,et al.  Cross-lingual asynchronous telepsychiatry: disruptive innovation? , 2012, Psychiatric services.

[17]  Donald M Hilty,et al.  The effectiveness of telemental health: a 2013 review. , 2013, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.