Magazine article Clinical Psychiatry News

Telepsychiatry Reliable for Some Rural Patients

Magazine article Clinical Psychiatry News

Telepsychiatry Reliable for Some Rural Patients

Article excerpt

BOCA RATON, FLA. -- Telepsychiatry is a valid and reliable way to extend depression treatment to rural settings, according to a study from researchers at the University of California, Davis.

"Telepsychiatry has been hot and cold, hot and cold, and right now it's hot," Dr. Donald M. Hilty said at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health.

Attention-deficit hyperactivity disorder, depression, developmental disorders, eating disorders, posttraumatic stress, and schizophrenia are among the disorders being treated via telemedicine.

"The bottom line is that telepsychiatry is reliable and valid. There is no question that telepsychiatry can be used for these diagnoses," said Dr. Hilty, who is with the university.

Early surveys of physicians and patients regarding telepsychiatry yielded less than satisfactory results, perhaps partly because of technical limitations, Dr. Hilty said.

"A lot of studies were done at 128 [kilobytes per second], which might give you a negative view. With 384- and 512-kb connections, we'll find it is even more satisfying." Signal delays at the slower connection speed sometimes stilted interaction between the patient and physician, leading to conversation "collisions," turn taking, and numerous pauses.

The UC Davis telepsychiatry program has provided 2,500 consultations to primary care physicians and their patients since 1996. A broadband connection now provides "quite powerful resolution" for videoconferencing to a patient at one of 40-60 sites in California, Dr. Hilty said. Secure e-mail interaction is another feature.

Psychiatrists control cameras on both ends during a video conference, thus allowing a closer look at facial expressions or nonverbal clues. "You can zoom the camera on the patient end. Generally, they are not aware of changes to their camera unless you go side to side," Dr. Hilty said.

"Most people doing telepsychiatry are not trying to replace in-person care," he said. The goal is to provide physician-patient interaction in locations where in-person care is not available or quality is an issue. …

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