From the equipment side of things, these days, you need little more than a computer at each end, each with a camera and a secure videoconferencing program installed, and a good internet connection. You also will need a quiet and private office location at each end.
Assuring that your work is compliant with HIPAA, licensing, and other regulations is also becoming easier to accomplish, though I refer to you resources below for more information on this subject.
Securing payment for telepsychiatric services remains the biggest obstacle, but an increasing number of state Medicare, Medicaid and private insurance companies are approving telebehavioral health care. And with the advent of accountable care, an increasing number of health plans and other organizations are contracting directly for telepsychiatric services with the goal of improving health of the population under their care.
Once all of the equipment and logistical steps are complete, the actual practice of telepsychiatric services is surprisingly easy to adjust to. I personally have a two-monitor setup for this practice. One monitor is for the patient video, while the second monitor allows me to look up labs, and review and write notes. I start and end my telepsychiatric visits a little different than I do in-person, but it’s not far into the session before I almost forget that I am talking to the patient electronically.
There are lots of resources out there to help you get started in telebehavioral health. TelehealthResourceCenters.org provides a number of helpful documents. Medicaid’s telemedicine website is very helpful in describing the regulatory perspective for telemedicine, while the SAMHSA-HRSA TeleBehavioral Health Training and Technical Assistance page provided a number of helpful training and other resources. And finally the American Telemedicine Association website provides a wide range of materials including a helpful set of practice guidelines.
Advances in technology, regulatory, and payment solutions have continued to make telebehavioral health care easier to set up and deliver. Given the evidence that telebehavioral care leads to outcomes similar to that seen with in-person care, it may be worth considering adding this service modality to your practice.
Marc Avery, MD, is a Clinical Associate Professor and Associate Director for Clinical Services at the AIMS Center, at the University of Washington School of Medicine in Seattle. He serves on the Psychiatry Advisor editorial board.
- Hilty DM, et al. The Effectiveness of Telemental Health: a 2013 review. Telemed J E Health. 2013;19(6):444-54.