Models of Telepsychiatric Consultation–Liaison Service to Rural Primary Care

Hilty, Donald M.; Yellowlees, Peter Mackinlay; Cobb, Hattie C.; Bourgeois, James A.; Neufeld, Jonathan; Nesbitt, Thomas S.

doi:10.1176/appi.psy.47.2.152

Cited by 91 publications

(60 citation statements)

References 26 publications

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“…In addition, a lack of medical expertise in-country and stigma surrounding mental health made this an area of particular need for health workers in this study. Tele-psychiatry has seen success in improving access to mental health in rural and remote communities in high-income countries [49,50], even for treatment of post-traumatic stress disorder such as: [51], and in creating a platform for transcultural psychiatry between UK and Somali medical students [52]. However, more research is needed to determine the feasibility and effects of e-health interventions in post-conflict populations [53].…”

Section: Discussionmentioning

confidence: 99%

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

et al. 2014

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BackgroundTechnological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging ‘post-conflict’ contexts. However, analyses on the adoption of technology for health (that is, ‘e-health’) and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations.MethodsThis study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger’s diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis.ResultsAll health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination.ConclusionsResults from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more widespread and sustainable. Increased awareness is necessary among health professionals, even among current e-health users, and physical and financial access barriers need to be addressed. Future e-health initiatives are likely to increase their impact if based on perceived health information needs of intended users.

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Section: Discussionmentioning

confidence: 99%

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

et al. 2014

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“…Hilty et al [97] demonstrated successful uptake of skills among PCPs treating anxiety and depression following consultations with telepsychiatrists. In this study, PCPs' ability to appropriately dose medications for depression and anxiety improved from 47% to 64% (P < 0.001).…”

Section: %mentioning

confidence: 99%

Review of key telepsychiatry outcomes

Hubley¹,

Lynch²,

Schneck³

et al. 2016

WJP

425

400

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“…Synchronous TP (STP) or TMH: E-MH models of clinical care and education have pros and cons [17,100,101], including their level of overall intensity, cost, feasibility and depth of the relationship between the TmH provider, the PCP and patient. Low intensity models include tele-education, formal case review and in-person, telephone or email doctor-to-doctor "curbside" consultations.…”

Section: Innovations or Additions To Regular Traditional Treatmentsmentioning

confidence: 99%

New Frontiers in Healthcare and Technology: Internet-and Web-Based Mental Options Emerge to Complement In-Person and Telepsychiatric Care Options

Hilty¹,

Chan²,

Torous³

et al. 2015

J Health Med Informat

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Background: Web and Internet-based resources are remarkably popular with the public, patients and others as a way to access mental health information, tools for self-care, advice/consultation from a professional, and providerdirected treatments.Objective: This paper provides a framework of a spectrum that includes person-centered health education options (conceptual endpoint), patient and caregiver-centered mental health care interventions (evidence-based literature review), and more formal provider-directed treatments (conceptual endpoint). Methods:The evidence-based literature review was focused on treatment studies, using a minimum of three key words and the 1996-2015 period, resulting in 13,612 articles. This was reduced to 388 (title words used), to 125 (abstracts for methods, design, and outcomes) and 40 (evidence-based criteria of guidelines). Results:Technology is frequently used, is readily accessible and satisfies persons, patients, and caregivers. Its impact on openness to engage with others and begin self-care appears very positive; its ability to help people change behaviors and engage additional clinical services appears modest, though this is inadequately evaluated. Formal treatments over the Internet, asynchronous care models, or traditional video-based synchronous services are as good as or better than in-person services, though an incomplete range of services has been evaluated. Relatively few treatment studies assess outcomes, compare in-person and e-MentalHealth care, and or compare technology-based care options to one another; hybrid models of care have emerged, but have rarely been studied. Conclusions:For persons or patients not in care, use of the internet for common, non-acute problems appears to work, though a one-time clinical evaluation may help them place options in context. Clinicians and patients should specifically plan how to use technology and exercise sound judgment, based on guidelines when available. More research is needed on the application of new technologies to clinical care, with randomized trials and health services studies for effectiveness suggested. Internet-based mental health (MH) education and services are on the rise, as more patients, caregivers, and MH providers are using the Internet. This is driven by consumers or persons at-large, before they become patients in traditional services, and transitions our thinking from clinic-based care past patient-centered care to person-centered care known as participatory medicine [19][20][21]. MH-related, technology-based services exist on a continuum: self-help/support groups -well-prepared materials for patient psychoeducation and provider professional education -tips for assessment and selfcare (e.g., depression) -informal provider consultation online -asynchronous communication with providers -MH services with professionals like teleMH ((TMH) care or; Internet-based cognitive behavioral treatment (CBT) [22][23][24][25][26][27][28][29][30]. New Frontiers in Healthcare andConsumers, patients, caregivers and provi...

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Models of Telepsychiatric Consultation–Liaison Service to Rural Primary Care

Cited by 91 publications

References 26 publications

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

Review of key telepsychiatry outcomes

New Frontiers in Healthcare and Technology: Internet-and Web-Based Mental Options Emerge to Complement In-Person and Telepsychiatric Care Options

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