Question 1

What is Telepsychiatry?

Accepted Answer

Telepsychiatry refers to mental health care provided via Videoconferencing Technology.  
 
The patient and the psychiatrist are not physically located in the same place.  Instead of seeing the psychiatrist in an office or clinic, the patient logs into a Videoconferencing website.  The website can be accessed from any computer, tablet, or smartphone that is connected to the internet.
 
The patient and the psychiatrist see, hear, and speak directly with one another throughout the Telepsychiatry session.  Psychiatry is particularly well-suited for Telemedicine because Psychiatrists typically do not need to conduct physical examinations.  Mental health care provided during a Telepsychiatry appointments is essentially the same as it would be during a traditional office-based outpatient appointment.
 
In order to protect patient confidentiality, Videoconferencing platforms used for Telepsychiatry are more secure than social video chat services (like FaceTime, Skype, or WhatsApp).  Telepsychiatry sessions with Dr. Rambo are fully HIPAA compliant.  It is not necessary to download anything onto your device for the Telepsychiatry session.

Question 2

Why do People like Telepsychiatry?

Accepted Answer

1.  Effectiveness:
Studies demonstrate that treatment via Telepsychiatry is equally as effective as more traditional, office-based treatment.  
 
2.  Convenience:
Appointments can be "attended" from any quiet, safe, private location.
New parents don't have to tote newborns (or lug car seats & diaper bags,...) to appointments.
Transportation problems don't prevent access to mental health care.
Being homebound due to a physical or mental health condition doesn't prevent access to mental health care.
 
3.  Simplicity:
The only requirements are:
- An interest in improving one's mental health.
- A computer that has a built-in camera, microphone, and speaker.  
- A strong internet connection with Chrome, Firefox, or Safari web browser.
 
4.  Cost Savings:
No need to spend money on gasoline, parking fees, bus / taxi / Uber fares,...
 
5.  Time Savings:
No more time spent getting to a doctor's office, waiting in line at reception desks, waiting in a waiting room,...

Question 3

Are there any Potential Drawbacks?

Accepted Answer

As with any medical procedure, there are potential risks associated with the use of Telepsychiatry.  These risks include, but may not be limited to:
 
1.  Transmission of information may be adversely affected by poor video resolution, poor audio quality, technical difficulties, or equipment failure.  Such issues may lead to delays in medical evaluation and treatment.  
 
2.  While every precaution is taken to secure patient data and maintain confidentiality, Telepsychiatry and the associated electronic procedures (for ordering prescriptions, ordering labwork, and patient-doctor communications) can result in additional risk of a breach of confidentiality.
 
3.  Outside of a traditional doctor's office, the patient has the responsibility of finding a safe and private space to use during the appointment time.  It may be important to consider who else is at home.  Is there a lock on the door?  How would you handle it if a family member or roommate unexpectedly walked into the room during a session?  Could someone overhear the session even through a closed door?  Privacy during treatment sessions is essential for success.
 
4.  In rare cases, a lack of access to all of the information available in a face-to-face appointment may result in clinical errors.
 
5.  Due to the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, controlled substances cannot be prescribed through treatment that is provided exclusively by Telemedicine.  Controlled substances include some medications that may be dangerous because they their use may lead to psychological or physical dependence.  At times, controlled substances are prescribed for the treatment of some mental health conditions (such as ADD, anxiety, and insomnia).  Safer and lawful alternatives that are also known to be effective for treatment of these mental health conditions may be considered.  If Dr. Rambo believes a controlled substance would be an important part of a patient's treatment, collaboration of care with a Primary Care Doctor who may prescribe the medication or, possibly, referral to a different psychiatrist would be recommended.