AcuteCare Telemedicine Blog

Technology is Advancing the Practice of Telepsychiatry

Telepsychiatry and other long-distance options for providing mental health care can help overcome problems related to location and distribution of specialty mental health services but should not be seen as a panacea for delivering care to rural areas in the United States, reported a research and policy brief from the Maine Rural Health Research Center. “Telemental health” (yet another new term) once depended on heavy-duty audio and video technology based in fixed studios to initiate care. Despite this coarse beginning, advances in computer technology and its near-universal adoption have resulted in improved delivery of Telepsychiatry and made it more cost effective and available to a wider audience, however, some non-technical hurdles remain to be cleared.

Until recently, “Telemental health” services were most commonly provided by psychiatrists, clinical psychologists, clinical social workers, and psychiatric nurse practitioners, but now a pilot project begun at one critical-access hospital in collaboration with a psychiatrist and specialty mental health staff at a community mental health center has expanded to five additional hospitals. This system provides round-the-clock crisis evaluation and support at the hospital emergency departments and some say that “Telemental health” enabled them to provide services to rural persons that otherwise would not be available, but some nontechnical barriers such as poor Medicaid and commercial reimbursement rates, recruitment and retention difficulties, high numbers of patients without insurance, and high no-show rates serve as a drag on expansion of current programs.

The barriers experienced with “Telemental health” expansion is shared by other medical service disciplines seeking to enter or expand the utilization of telecommunication technologies that promise to revolutionize the delivery of medical care in the United States and across the world.  While progress is being made to overcome many of the most significant structural road blocks to expansion and adoption of these new technologies, much remains to be done to clear the path to a new medical care delivery model.

Maintaining a consistent push to encourage state and congressional representatives and health insurance industry leaders to move forward and embrace the revolution in healthcare must continue until each barrier is removed or neutralized.  The promise of delivering better, less expensive and more available medical care to millions of patients across the country depends on these continued efforts progressing and succeeding.

Leading Providers of Telemedicine Technology Present at Summit

The Alabama Rural Health Association (ARHA) and the Alabama Partnership for Telehealth (APT) held the 2nd Annual Alabama Rural Health & Telehealth Summit on October 16th thru the 17th in Prattville, Alabama.  The conference provided an excellent opportunity to learn about the current uses and capabilities of telehealth and telemedicine and included updated information on the Affordable Care Act (ACA) and more specific information on the Health Insurance Exchange program, Navigator program, and Accountable Care Organization program.

Cecilia Land, Director of Rehab Services, presented a session titled, “Reaching Out to Alabama with Telestroke Services.”  Land discussed the stroke mortality rates in Alabama, and more specifically stroke mortality in the counties that fall inside the Southeastern Alabama Medical Center (SAMC) footprint and its desire to help bring down those rates in the counties surrounding the SAMC Telestroke Hub and their partner spokes in southeastern Alabama.

Levonne Outlaw, SAMC Stroke Network Coordinator, discussed education and training of the individual hospital staffs at the spokes. Initial training proved to be very successful and adoption of the telemedicine and telestroke platforms was well received by the staffs. The initial concern for a potentially long learning curve on implementation was not realized.

Dr. Matt Gwynn, Acute Care Telemedicine, the leading practice-based provider of Telemedicine services in the southeast, discussed the national statistics on stroke and their dramatic impact on quality of life of survivors.  His discussion centered on the unique nature of stroke and how telemedicine can best be implemented to treat this disease. “Stroke is a perfect fit for demonstrating the life saving and life enhancing benefits of telemedicine, given that telemedicine can reduce the time to treat patients in the narrow, 3-hour window, which is so critical to stroke victims”, said Dr. Gwynn.  He went on to share a specific case of a 46-year old female stroke patient at Dale Medical Center and how she had benefited from SAMC’s new telemedicine presence.  Dale Med Center had been live with telestroke not more than a week, and the patient presented into the ER with stroke symptoms, was treated with the clot-busting drug tPA and discharged within 48 hours with minimal long-term neurological damage.

Other key topics were presented by: Gary Capistrant, Senior Director of Public Policy for the American Telemedicine Association and panelists from Auburn University, University of Alabama and Alabama College of Osteopathic Medicine.  Updates were presented on the Affordable Care Act and its effects on telemedicine throughout the United States.