The professional use of technology offers important opportunities for psychiatrists and patients. Which technologies to use and how they are used depends largely on the size of the practice and the manpower available. Online therapies can significantly improve access to care for hard-to-reach patients, such as adolescents or patients living in communities with few psychiatric resources. Interactive, computer-based programs, such as “Coping Cat” for treating anxiety in children or the online CATCH-IT program for preventing depression, may improve care.12,13
Technology provides an inexpensive means for rapidly disseminating important information to patients. Blogs and Web sites that provide accurate, up-to-date information for patients can provide important alternatives to the wealth of inaccurate content available online. Information directed toward groups of patients may be appropriate for social media. For example, using social media for advisories about a new FDA black box warning, the need for patients taking neuroleptics to use sun protection, or depot injection dates for a cohort of VA patients seem feasible and appropriate.
Technology can also enhance the logistics of running a practice. Findings from a recent study indicate that texting patients’ appointment reminders reduces the no-show rate.14 Protected portals for patients to e-mail medication refill requests or ask clinical questions of their psychiatrist can be efficient and helpful as well.
Some psychiatric treatments may improve with “bridging”—the use of patient networking sites for persons with chronic illness. Such patients may benefit from the support and resources these sites provide. Similar electronic “bridges” between psychiatrist and patient may be useful between sessions. Yager15 reports on improvement in the therapeutic alliance when e-mail was used to correspond with patients who had eating disorders. In working with children who have developmental disorders and their families, for which teams of multiple professionals are the norm, e-mail can significantly improve team communication.
Finally, online technology provides a means for professionals to network. While Facebook and YouTube are used by physicians for this purpose, professional social networking sites such as LinkedIn or Doximity (for physicians only) may be more appropriate for this purpose.
Recommendations for practice
In general, psychiatrists need to appreciate that technology is here to stay and represents a critical change to the framework of practicing psychiatry. By spurning technology, psychiatrists may risk failing to understand its importance in the lives of patients as well as its inevitable role in clinical practice. By embracing technology without caution, they risk violating professional roles and boundaries. By keeping in mind some caveats, psychiatrists can successfully employ technology in their practice:
• Be ever-vigilant about the impact of technology on the physician-patient relationship
• If you are using a specific technology, use it competently (Table 2); be wary about being unable to keep up with incoming information
• Know current professional guidelines and standards of practice regarding technology, including your institution’s policies (see Additional Resources box); violations can result in loss of licensure, job, and professional status16
• When you are in doubt about certain aspects of technology, ask an expert (eg, IT, risk management, legal, clinical, ethical)
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2. DeJong S, Benjamin S, Anzia J, et al. AADPRT Curriculum on Professionalism and the Internet in Psychiatry. 2011. http://aadprt.org/vtodocs/professionalism_and_the_internet/AADPRT_Profes.... Accessed October 30, 2012.
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