Telepsychiatry holds the promise of providing a link between urban areas with a high concentration of psychiatrists and rural areas in dire need of specialists to provide consultations to clinicians and direct services to patients. Widespread adoption of telepsychiatry programs would allow specialists to consult on care to geriatric patients, children, prison populations, military veterans and others groups with access problems.
The technology continues to improve, and equipment costs have dropped dramatically in recent years. Video conferencing equipment that cost $30,000 three years ago now costs about $10,000. However, making the connection is not as easy as it might seem. The technology's potential remains largely untapped, in part, because payors are reluctant to embrace it. Consequently, many programs end when their grant funding ends.
The growth of telemedicine is very hard to follow, William Tucker, M.D., told Psychiatric Times. Tucker is director of the New York State Office of Mental Health (OMH) Telepsychiatry Project. Although the trend is clearly burgeoning, almost as many programs close as open. The problem is that almost all programs start on grants that include salaries. And when the grant runs out, so does the salary support, Tucker said.
The OMH Telepsychiatry Project, which is located at the New York State Psychiatric Institute in New York City, is unique in that all its staff and consultants are on salary with OMH or Columbia University's College of Physicians & Surgeons. In over three years, the program has provided about 200 consultations to 12 rural mental health clinics and 12 correctional facilities, drawing upon the expertise of about 94 psychiatrists. Each consultation takes about 90 minutes, Steven E. Hyler, M.D., project coordinator for the OMH program, told PT.
The consultant meets initially with the requesting clinicians. That is followed by a patient interview. Consultants then present their findings in a discussion with the requesting physicians.
For the last two years, members of the OMH project have offered a course in telepsychiatry at the American Psychiatric Association's annual conference. Both years it generated considerable interest and sold out, Tucker said. "People see very quickly the potential of the medium."