Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care

Looi, Jeffrey; Bastiampillai, Tarun; Pring, William; Reay, Rebecca; Kisely, S.; Allison, Stephen

doi:10.17061/phrp3242238

Cited by 4 publications

(9 citation statements)

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“…A factor significantly influencing the accelerated development of telemedicine services was the COVID-19 pandemic, which limited access to all medical services, not just psychiatric ones. Closure of facilities, and reduction of interpersonal contacts due to the risk of virus transmission forced people to look for new forms of service delivery to maintain the continuity of treatment [14][15][16][17].…”

Section: Equal Access To Health Care Servicesmentioning

confidence: 99%

“…Czynnikiem istotnie wpływającym na przyspieszony rozwój usług telemedycyny była pandemia COVID19, która ograniczyła dostęp do wszystkich usług medycznych, nie tylko psychiatrycznych. Zamknięcie placówek, ograniczenie kontaktów interpersonalnych ze względu na ryzyko transmisji wirusa zmusiło ludzi do poszukiwania nowych form świadczenia usług w celu utrzymania ciągłości terapii [14][15][16][17].…”

Section: Korzyści Wynikające Ze Stosowania Telepsychiatrii 1równomier...unclassified

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Are we ready for Telepsychiatry? Benefits and challenges of digital psychotherapy

KISTER

Jakub

Dybała

et al. 2023

Curr Probl Psychiatry

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Background: Telemedicine is one of the most modern and fastest-growing branches of medicine. The most common form is video consultation. We distinguish between synchronous and asynchronous telepsychiatry. This study aims to show the benefits of using telepsychiatry services, the challenges it poses to users, and to evaluate its use against traditional therapy. Materials and methods: A review of literature from 1956-2023 in EMBASE, OpenKnowledge and PubMed databases was conducted. Keywords used were: telepsychiatry, teletherapy, and digital psychiatry. Ninety-eight articles were included. Discussion: Telepsychiatry is an opportunity for regions affected by medical staff shortages. It bypasses cultural barriers, the problem of traveling and reduces the cost of medical point-of-service. Telepsychiatry is an opportunity for patients who do not use psychiatrists due to discrimination in a conservative society. Groups that may find it challenging include the elderly, the blind, and the deaf. Creating a healthy therapeutic alliance through a screen can be impossible, making it difficult to achieve successful therapy. A barrier to developing telepsychiatry is the need for more guidelines for dealing with medical errors. Conclusions: Telemedicine can help in accessing specialized care regardless of location. Telepsychiatry provides a safe and anonymous environment for patients reluctant to receive inpatient therapy. The effectiveness of online therapy is primarily debated. Telepsychiatry should be limited to follow-up consultations and well-known patients - it is a form of complementing the diagnosis and treatment process. The authors point to the need for developing specific guidelines for conducting teletherapy with particular attention to the problem of suicide. Keywords: telepsychiatry, teletherapy, digital psychiatry.

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Section: Equal Access To Health Care Servicesmentioning

confidence: 99%

Section: Korzyści Wynikające Ze Stosowania Telepsychiatrii 1równomier...unclassified

Are we ready for Telepsychiatry? Benefits and challenges of digital psychotherapy

KISTER

Jakub

Dybała

et al. 2023

Curr Probl Psychiatry

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“…6 The role of telepsychiatry and videoconferencing became prominent in private psychiatry during the COVID-19 pandemic, with the Australian government providing reimbursement for patients and/or psychiatrists to access telehealth either as an inpatient (in time-limited circumstances) or outpatient. 7 Perhaps, there are opportunities for the provision of local psychiatric cover via telehealth in busy understaffed metropolitan services, and in specific circumstances when travel for face-to-face interaction is impracticable, such as during a pandemic lockdown, fires, and floods, as has recently happened in Australia.…”

Section: Future Directionsmentioning

confidence: 99%

Practical psychiatry: Providing temporary psychiatric cover

Looi

Allison

Woon

2023

Australas Psychiatry

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Objective Psychiatric cover for healthcare staffing shortfalls is increasingly common post-pandemic. We aim to provide comprehensive practical advice on providing temporary inpatient or outpatient cover as a psychiatrist, based on the authors’ clinical experience and the existing research literature. Conclusions There is limited peer-reviewed advice available on providing safe and effective temporary psychiatric consultant cover for patient care. We suggest a framework for reviewing the potential hazards and benefits of a temporary post, and planning for the role, guided by consideration of the following: caring for patients, supporting staff, working with peers, and understanding local healthcare systems and the local regulatory environment. Application of this reflective framework is informed by the psychiatrist’s assessment of the temporary role, and consideration of the local service conditions.

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“…5 Accordingly, patients potentially lacking the financial means to access private practice telepsychiatry due to OOP costs remains a substantive concern. 6 To date, there have been no peer-reviewed cost analyses of MBS telepsychiatry consultation items, and specifically, examination of consultation OOP costs. We describe and compare patient OOP payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the OOP cost burden for patients across different modalities of outpatient psychiatric services.…”

mentioning

confidence: 99%

“… 5 Accordingly, patients potentially lacking the financial means to access private practice telepsychiatry due to OOP costs remains a substantive concern. 6 …”

mentioning

confidence: 99%

Comparison of the out-of-pocket costs of Medicare-funded telepsychiatry and face-to-face consultations: A descriptive study

Woon,

Allison,

Bastiampillai

et al. 2024

Australas Psychiatry

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Objective Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities. Methods out-of-pocket cost information was obtained from the Medical Costs Finder website, which extracted data from Services Australia’s Medicare claims data in 2021–2022. Cost information for corresponding face-to-face, video, and telephone MBS items for outpatient psychiatric services was compared, including (1) Median specialist fees; (2) Median out-of-pocket payments; (3) Medicare reimbursement amounts; and (4) Proportions of patients subject to out-of-pocket fees. Results Medicare reimbursements are identical for all comparable face-to-face and telepsychiatry items. Specialist fees for comparable items varied across face-to-face to telehealth options, with resulting differences in out-of-pocket costs. For video items, higher proportions of patients were not bulk-billed, with greater out-of-pocket costs than face-to-face items. However, the opposite was true for telephone items compared with face-to-face items. Conclusions Initial cost analyses of MBS telepsychiatry items indicate that telephone consultations incur the lowest out-of-pocket costs, followed by face-to-face and video consultations.

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Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care

Cited by 4 publications

References 0 publications

Are we ready for Telepsychiatry? Benefits and challenges of digital psychotherapy

Are we ready for Telepsychiatry? Benefits and challenges of digital psychotherapy

Practical psychiatry: Providing temporary psychiatric cover

Comparison of the out-of-pocket costs of Medicare-funded telepsychiatry and face-to-face consultations: A descriptive study

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