Economic Grand Rounds: Rural Telepsychiatry Is Economically Unsupportable: The Concorde Crashes in a Cornfield

Werner, Arnold; Anderson, Lance E.

doi:10.1176/ps.49.10.1287

Cited by 30 publications

(20 citation statements)

References 12 publications

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“…Historically, a significant concern with the feasibility of VC has been cost [45]. Although this paper was not intended to address cost, it is worth noting that, as with other areas of technology, the cost of VC equipment and connectivity, once prohibitively expensive, continues to decline.…”

Section: Discussionmentioning

confidence: 99%

The use of videoconferencing with patients with psychosis: a review of the literature

Sharp¹,

Kobak

Osman³

2011

Ann Gen Psychiatry

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Videoconferencing has become an increasingly viable tool in psychiatry, with a growing body of literature on its use with a range of patient populations. A number of factors make it particularly well suited for patients with psychosis. For example, patients living in remote or underserved areas can be seen by a specialist without need for travel. However, the hallmark symptoms of psychotic disorders might lead one to question the feasibility of videoconferencing with these patients. For example, does videoconferencing exacerbate delusions, such as paranoia or delusions of reference? Are acutely psychotic patients willing to be interviewed remotely by videoconferencing? To address these and other issues, we conducted an extensive review of Medline, PsychINFO, and the Telemedicine Information Exchange databases for literature on videoconferencing and psychosis. Findings generally indicated that assessment and treatment via videoconferencing is equivalent to in person and is tolerated and well accepted. There is little evidence that patients with psychosis have difficulty with videoconferencing or experience any exacerbation of symptoms; in fact, there is some evidence to suggest that the distance afforded can be a positive factor. The results of two large clinical trials support the reliability and effectiveness of centralized remote assessment of patients with schizophrenia.

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Section: Discussionmentioning

confidence: 99%

The use of videoconferencing with patients with psychosis: a review of the literature

Sharp¹,

Kobak

Osman³

2011

Ann Gen Psychiatry

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“…In addition, preexistence of ISDN lines at the sites involved reduces the cost. [78] E-mail and telephony appear as relatively cheaper alternatives as these do not require any additional technical support. Rahman et al .…”

Section: Challenges Of Telepsychiatrymentioning

confidence: 99%

Telepsychiatry: Promise, potential, and challenges

Malhotra

Chakrabarti

Shah

2013

Indian J Psychiatry

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Despite the high prevalence and potentially disabling consequences of mental disorders, specialized mental health services are extremely deficient, leading to the so-called ‘Mental Health Gap’. Moreover, the services are concentrated in the urban areas, further worsening the rural-urban and tertiary primary care divide. Strengthening of and expanding the existing human resources and infrastructure, and integrating mental health into primary care appear to be the two major solutions. However, both the strategies are riddled with logistic difficulties and have a long gestation period. In such a scenario, telepsychiatry or e-mental health, defined as the use of information and communication technology to provide or support psychiatric services across distances, appears to be a promising answer. Due to its enormous potential, a review of the existing literature becomes imperative. An extensive search of literature was carried out and has been presented to delineate the modes of communication, acceptability and satisfaction, reliability, outcomes, cost-effectiveness, and legal and ethical challenges related to telepsychiatry. Telepsychiatry has been applied for direct patient care (diagnosis and management), consultation, and training, education, and research purposes. Both real-time, live interaction (synchronous) and store–forward (asynchronous) types of technologies have been used for these purposes. A growing amount of literature shows that training, supervision, and consultation by specialists to primary care physicians through telepsychiatry has several advantages. In this background, we have further focused on the models of telepsychiatry best suited for India, considering that mental health care can be integrated into primary care and taken to the doorstep of patients in the community.

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“…Hardware and connection time with these systems can be very expensive and may be economically unfeasible (Werner and Anderson, 1998). However, if end-user sites can be found that already have access to the hardware and connectivity, then this option should be pursued.…”

Section: Downloaded By [University Of Maryland] At 09:35 19 October 2014mentioning

confidence: 99%

Considerations in the Use of Telecommunications as a Primary Treatment Medium: The Application of Behavioral Telehealth to Marriage and Family Therapy

Bischoff

2004

The American Journal of Family Therapy

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Economic Grand Rounds: Rural Telepsychiatry Is Economically Unsupportable: The Concorde Crashes in a Cornfield

Cited by 30 publications

References 12 publications

The use of videoconferencing with patients with psychosis: a review of the literature

The use of videoconferencing with patients with psychosis: a review of the literature

Telepsychiatry: Promise, potential, and challenges

Considerations in the Use of Telecommunications as a Primary Treatment Medium: The Application of Behavioral Telehealth to Marriage and Family Therapy

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