A Literature Review of Videophone Use in Mental Health
A Tool That Can Enhance Patient Convenience, Safety, and Satisfaction
By J. Edwin Nieves, MD, Gregory Briscoe, MD, Lucinda Edwards, MLS, and Aidith Flores-Carrera, DO |
June 8, 2011
Dr Nieves is associate chief of staff for education and associate professor of psychiatry and behavioral sciences at the Eastern Virginia Medical School in Norfolk. Dr Briscoe is professor of psychiatry and behavioral sciences at the Eastern Virginia Medical School and staff psychiatrist at the Veterans Administration Hospital in Hampton, Va. Ms Edwards is medical librarian in the department of education at the Veterans Administration Hospital. Dr Flores-Carrera is a psychiatry resident at the Naval Medical Center in Portsmouth, Va. The authors report no conflicts of interest concerning the subject matter of this article.
Disclaimer—The contents of this article do not represent the views of the Department of Veterans Affairs, the Department of the Navy, or of the government of the United States.
In our survey, we found videophones a surprisingly understudied and underutilized tool in spite of the fact that they are easy to use and do not require any technical support. One reason may be that most clinicians prefer higher-bandwidth technologies, such as videoconferencing, and are not familiar with videophones as a potential adjunct treatment alternative in patients whose functional mobility limitations maybe an issue. Another reason may be that most clinicians tend to think about “nonimage” technologies, such as home messaging, when they think about telehealth services delivered to the home. Videophones may be an ideal tool to bridge these 2 technical levels of care; videophones provide both imaging and in-home access to clinical care, albeit with some limitations.
Videophones are an ideal telehealth alternative for delivering “patient-centric” care. They are well accepted by patients, caregivers, and staff for their simplicity of use. They are affordable, portable, and durable and can be used to provide an array of adjunct care services to patients with barriers to treatment—whether geographical, functional, or otherwise. Videoconferencing equipment, on the other hand, is more expensive, requires dedicated space, and is not mobile; also, it requires technical support and incurs infrastructure expenses.
The second generation of videophones (ie, smartphones, super phones) will allow even more patient access and have the potential to be the ultimate patient-centric telehealth alternative. Software in these affordable phones allows for the exchange of high-resolution image and nonimage exchange modalities (such as electronic mail), ideal for appointment confirmation, laboratory results notification, etc. These devices have about the same screen size as the first-generation videophone, but their portability is greatly improved. On the other hand, patient privacy and the expectation of unlimited real-time access to care are items to be considered in the future clinical deployment of these devices.
Most of the studies of telemedicine have been small. Larger, more systematic investigations of telemental health via videophones, particularly in the areas of patient and caregiver satisfaction and treatment response, are needed. Areas of utilization listed in our review (special populations and/or caregiver support) are understudied and underserved telemental health populations. The ability of videophones to provide increased access to higher levels of care, such as hospital-based resources, at minimal cost is apparent, especially in cases in which mobility to “spoke” locations served by videoconferencing may be impractical because of illness or geographical barriers. Videophones enable clinicians and caregivers to maximize patient convenience, safety, and satisfaction.
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