Benefits of a Telepsychiatry Consultation Service for Rural Nursing Home Residents

Abstract

Psychiatric care for nursing home residents is difficult to obtain, especially in rural areas, and this deficiency may lead to significant morbidity or death. Providing this service by videoconference may be a helpful, cost-effective, and acceptable alternative to face-to-face treatment. We analyzed data for 278 telepsychiatry encounters for 106 nursing home residents to estimate potential cost and time savings associated with this modality compared to in-person care. A total of 843.5 hours (105.4 8-hour work days) of travel time was saved compared to in-person consultation for each of the 278 encounters if they had occurred separately. If four resident visits were possible for each trip, the time saved would decrease to 26.4 workdays. Travel distance saved was 43,000 miles; 10,750 miles if four visits per trip occurred. More than $3,700 would be spent on gasoline for 278 separate encounters; decreased to $925 for four visits per roundtrip. Personnel cost savings estimates ranged from $33,739 to $67,477. Physician costs associated with additional travel time ranged from $84,347 to $253,040 for 278 encounters, or from $21,087 to $63,260 for four encounters per visit. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. Providing psychiatric care to rural nursing home residents by videoconference is cost effective and appears to be a medically acceptable alternative to face-to-face care. In addition, this approach will allow many nursing homes to provide essential care that would not otherwise be available.

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

“…Examples include psychiatry 133 (including depression [134][135][136] and dementia 137 ), dermatology, [138][139][140][141][142][143][144] sleep apnea, 145 The following analysis is based on 14 cost studies ( Table 4) dealing with one or more of the target chronic diseases in this article and is organized on the basis of the particular cost method used in the study.…”

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

“…1 The ability to provide remote consultations though telepsychiatry, has been suggested as a potential solution to the problem of addressing the mental health needs of mental health care users living in remote and rural areas in resource constrained environments such as South Africa. 2 There appears to be widespread implementation of telepsychiatry across countries [3][4] , across different treatment modalities 5 and across different service settings [6][7][8][9] from Child and Adolescent services (CAMHS) [10][11][12][13][14][15][16][17] to Geriatric services. [18][19][20][21] Telepsychiatry has been used for assessment and diagnosis, ongoing management, medication review, development of clinical care plans, psychotherapy, neuropsychological testing, forensic evaluations and certain psychiatric emergencies.…”

Telepsychiatry “Coverage” to a Rural Inpatient Psychiatric Unit

“…5,6 There is more literature addressing the use of telepsychiatry with nursing home residents. [7][8][9][10] Peninsula Regional Medical Center (PRMC) is a regional hospital located in the central eastern shore of Maryland and maintains a 13-bed inpatient mental health unit. Like several other general hospitals in the Maryland region, PRMC subcontracts its unit manager and psychiatrists.…”