Client satisfaction in a feasibility study comparing face-to-face interviews with telepsychiatry

Abstract

We carried out a pilot study comparing satisfaction levels between psychiatric patients seen face to face (FTF) and those seen via videoconference. Patients who consented were randomly assigned to one of two groups. One group received services in person (FTF from the visiting psychiatrist) while the other was seen using videoconferencing at 128 kbit/s. One psychiatrist provided all the FTF and videoconferencing assessment and follow-up visits. A total of 24 subjects were recruited. Three of the subjects (13%) did not attend their appointments and two subjects in each group were lost to follow-up. Thus there were nine in the FTF group and eight in the videoconferencing group. The two groups were similar in most respects. Patient satisfaction with the services was assessed using the Client Satisfaction Questionnaire (CSQ-8), completed four months after the initial consultation. The mean scores were 25.3 in the FTF group and 21.6 in the videoconferencing group. Although there was a trend in favour of the FTF service, the difference was not significant. Patient satisfaction is only one component of evaluation. The efficacy of telepsychiatry must also be measured relative to that of conventional, FTF care before policy makers can decide how extensively telepsychiatry should be implemented.

Developing Rapport and Therapeutic Alliance During Telemental Health Sessions with Children and Adolescents

“…Building rapport and establishing a therapeutic alliance in TMH has additional nuance given the potentially negative impact of technology on clinical work, especially when the distant patient community differs culturally and demographically from the clinician's own community. Nonetheless, experienced teleclinicians and preliminary research suggest that clinicians and patients can, and do, establish a therapeutic alliance during TMH treatment that closely approximates, even equals, face-to-face treatment (Ghosh et al 1997;Bishop et al 2002;Cook and Doyle 2002;Bouchard et al 2004;De Las Cuevas et al 2006;Himle et al 2006;Knaevelsrud and Maercker 2006;Modai et al 2006;Morgan et al 2008;Ertelt et al 2010). Only occasionally do patients rate alliance, or rapport, as significantly lower for TMH versus the faceto-face modality (e.g., Morland et al 2010) Overall, the number of studies and enrolled subjects in these studies is not large, methodologies have differed across studies, and most studies have focused on patient ratings.…”

“…Similar to therapeutic alliance, most studies with adults, both large and small, have not found major differences in patient satisfaction when comparing care that is delivered through TMH with care provided face to face (Ghosh et al 1997;Bishop et al 2002;Cook and Doyle 2002;Bouchard et al 2004;De Las Cuevas et al 2006;Himle et al 2006;Knaevelsrud and Maercker 2006;Modai et al 2006;O'Reilly et al 2007;Morgan et al 2008;Ertelt et al 2010).…”

Feasibility of Conducting a Randomized Controlled Trial of Telemental Health with Children Diagnosed with Attention-Deficit/Hyperactivity Disorder in Underserved Communities

“…An evidence base establishing the efficacy of TMH is evolving. Comparability trials have shown that psychiatric treatment provided through VTC yields lengths of hospitalization (Graham 1996;De Las Cuevas et al 2006;O'Reilly et al 2007), medication use (Fortney et al 2007;O'Reilly et al 2007), symptom reduction (Graham 1996;De Las Cuevas et al 2006;Fortney et al 2007;O' Reilly et al 2007;Saeed et al 2011) and patient satisfaction (Bishop et al 2002) that are comparable to care rendered in person. A foundation has been laid for teletherapy.…”

Human Factors in Telemedicine

“…This makes discussion of the role of innovation in successful telemedicine somewhat problematic as what is 'successful' in one context may be regarded differently in another. Telepsychiatry in Canada (Bishop et al, 2002) is regarded by patients as highly successful for a variety of reasons. It would likely be reasonably easy to find plenty of studies in telepsychiatry which could be used to provide evidence that 'telepsychiatry is good', and that given these success stories healthcare organisations around the world should put into place such a service as soon as they can.…”