ED Telepsychiatry Cuts Admissions, Saves Money in S.C: From the Annual Meeting of the American Psychiatric Association

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HONOLULU - A statewide telepsychiatry consulting ser vice in South Carolina shortened emergency department stays and reduced hospital admissions for more than 6,000 mental health patients. In addition, those patients used out-patient psychiatric services more, and their care was less expensive.

Under the program, psychiatrists assess emergency department patients remotely via live video link. So far, 25 hospitals -none of which have readily available onsite psychiatric consulting services - are participating; the South Carolina Department of Mental Health plans to enroll 15 more within a year, according to Dr. Stephanie R. Chapman, who is a psychiatry resident at the University of South Carolina, Columbia.

"In our state, we have so many mental health patients who are not receiving the care they need in the emergency room. A lot of facilities have no psychiatrists working in them.

"Someone has to drive in days later to see these patients," she said. "It's a big problem. That is why this was initially implemented" in March 2009, Dr. Chapman said.

When telepsychiatry is called for, a video cart is rolled into the patient's room.

At the other end of the feed is a psychiatrist in either Charleston, Columbia, Aiken, or Greenville, S.C.

The patient and psychiatrist are able to see one another and talk over the link. The psychiatrist does the assessment over about 30 minutes, prepped beforehand with the patient's history, lab results, and other findings.

Afterward, the psychiatrist might recommend hospitalization or set up an outpatient appointment through the local mental health department, Dr. Chapman said.

At present, the service is available 16 hours a day. Psychiatrists take turns manning the feed at offices in the four towns, usually in 8-hour shifts. When a shift ends in Aiken, for example, a psychiatrist in the Greenville office might pick up the feed.

To see how the program is doing, Dr. …

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