Institutionally based videoconferencing

Abstract

The delivery of psychiatric care via video-teleconferencing (VTC) technology is thought to have reached a tipping point. As a medical speciality with relatively few material or technical requirements for service delivery, psychiatry has been one of the earliest to embrace the possibility of providing evaluations and treatment at a distance. Such technical infrastructure as is necessary can often be found in the institutions already in existence. It was natural therefore that institutionally based telepsychiatry would lay the foundation for the development of the field. In this article we review the history and development of institutional VTC in a wide variety of clinically supervised settings such as hospitals, outpatient clinics, and forensic settings. We cite evidence supporting institutionally sponsored use and expand on key takeaways for the development and expansion of videoconferencing in these settings. We also speculate on the future direction and development of psychiatric care provided by these arrangements.

Barriers to Use of Telepsychiatry: Clinicians as Gatekeepers

“…3 Telepsychiatry (ie, 2-way video) provides access to psychiatric care, enhanced quality of care, and reduced health care costs. [4][5][6] An increasing body of literature reports effectiveness and outcomes equivalent to in-person care across a broad range of mental health disorders and patient populations. [4][5][6] In some situations (such as working with children and teens), telepsychiatry may even be preferable to in-person care.…”

“…[4][5][6] An increasing body of literature reports effectiveness and outcomes equivalent to in-person care across a broad range of mental health disorders and patient populations. [4][5][6] In some situations (such as working with children and teens), telepsychiatry may even be preferable to in-person care. [7][8][9][10][11][12] Despite many studies reporting positive clinician and patient satisfaction with telepsychiatry, 8,9,11,13,14 implementation has not been rapid, easy, or widespread.…”

Improving care quality with prison telemedicine: The effects of context and multiplicity on successful implementation and use

“…The quantitative outcomes data reported varied from correlation between in-person/telemedicine assessment scores, 38 numbers of consultations, 39–42 patient satisfaction scores, 43 cost effectiveness, 34,44–50 and clinical outcome measures. 51–52 Very few studies reported outright failures of telemedicine, 53–54 with most finding it offered equivalent or improved care quality 5,42,43,51,52,55–70 at an acceptable cost. 8,9,25,31,34,38,43,47,50,53,56–59,62,64,69…”

Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study

“…There is a large body of evidence which demonstrates their effectiveness at improving the access and cost of healthcare provision in prisons 13. The more limited data on patient experience suggests it also offers improved care quality for prisoners 14–17…”