Perspective

Article excerpt

Telemedicine is particularly well suited to psychiatry. It allows you to see and talk to your patient, which is what we do. The absence of the other senses is mostly a nonissue, with the exception of some neurological testing--which occasionally is necessary.

I started using telepsychiatry in the early 1970s in Chicago at the Illinois State Psychiatric Institute. At that time, we had to run a cable from the main psychiatric hospital to two outpatient clinic sites in our catchment area that were part of our community mental health initiative. It worked like a charm. The technology was sufficient to do a psychiatric evaluation and a medication check. It also provided a productivity boost, as it reduced travel times going to and from the outpatient clinics. Today, the same effect can be achieved with computers, Internet access, and a pair of $35 Web cameras.

I did not find that using the technology resulted in any less of a meaningful therapeutic relationship with patients. If anything, the uniqueness of the interview methodology allowed the patients to want to cooperate more; the technology was a "hook." I presume that's even more the case with today's kids.

In addition to having the equipment necessary to establish a connection with remote sites, as well as support for the equipment, an important element in the success of a telepsychiatric intervention is the human support at the other end of the connection, such as a nurse to give an injection, if needed, or to take an order for a prescription. …

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