With the tremendous strides in clinical technologies, telemedicine is being increasingly engaged in the USA for helping the psychiatric patients to access the type of care they require and when it is needed most. Telepsychiatry has enough potential to significantly improving the treatment outcomes among psychiatric patients. 

Most of the emergency rooms in the USA are not equipped with a psychiatrist and yet over twelve in every hundred hospital emergency visits call for mental health diagnosis. Most emergency rooms in the country are purpose-designed to manage acute conditions, traumatic injuries, and physical emergencies. 

Although they are not meant to address psychiatric emergencies, such as schizophrenic or bipolar episodes, those cases are being witnessed by emergency rooms across the USA in phenomenal volume. 

A vast majority of the emergency rooms are yet to have a psychiatrist on board let alone engaging a  few mental health specialists to supervise the emergency room twenty-four seven. The answer could be telepsychiatry, that is, delivering psychiatry consultation and other allied services through telemedicine.

How Telepsychiatry is Reforming the Emergency Room

As per the latest data provided by the ACEP or American College of Emergency Physicians, a continuous increase of psychiatric patients over time in the outpatient care has resulted in a colossal number of psychiatric cases being referred to the emergency room. 

A vast majority of the emergency room physicians do not possess the particular training for offering the kind of psychiatric care required by the patients in during the occurrence of psychiatric event of any kind, such as an episodic onset or the like; and psychiatric evaluation of the patients in those incidents is limited by the emergency room practitioner’s training, which typically does not come under the scope of mental healthcare. 

However, with the help of telemedicine, the condition of patients can now be remotely assessed by a qualified psychiatrist, who will also be able to consult with the doctors present in the emergency room, provide referrals, and more. Telepsychiatry has finally made the requirement of being present in the emergency room in person for the psychiatrists largely irrelevant. 

An Emerging Trend That is Here to Stay

The ACEP recommends that telemedicine should be employed as and when required for reducing inpatient admissions and emergency room boardings among the psychiatric patients. 

Whereas traditional emergency room physicians may admit individuals with psychiatric disorders without a comprehensive and true evaluation of those patients’ requirements in the first place, ensuring the presence of a psychiatrist albeit virtually can reduce the rate of admissions to a great extent. Furthermore, a telepsychiatry consultation does help to facilitate the initialization of one’s course of treatment and also accelerate patient outcomes.

The ACEP acknowledges the application of psychiatry through the telemedicine delivery channel as a significantly beneficial tool for patient assessment in the emergency room. A recent study conducted by the JTT or Journal of Telemedicine and Telecare concluded that when the facility psychiatrist was not available in the emergency room, telemedicine empowered the emergency room professionals for expediting the improvements in patients asking for psychiatric care.

It is almost a standard practice at a large number of emergency rooms to hold the people with psychiatric problems until those patients can avail a consultation, which not only postpones the assessment procedure and treatment planning but also consumes valuable space needed by other emergency room patients while waiting for the arrival of an on-call expert in psychiatry. 

To suffice, telepsychiatry allows the patients to receive the care they are seeking more quickly and also reduce their likelihood of hospital admissions.

Telepsychiatry Simplified for the Beginners

Similar to any other consultation, the psychiatrist attends the patient in person through a webcam during a telepsychiatry visit, to which a telemedicine cart is usually attached. First, the psychiatrist discusses the condition and symptoms of the patient with the physician or other staff present in the emergency room and reviews everything that may be vital in achieving a diagnosis and devising an appropriate treatment regimen.

Next, the psychiatrist interacts directly with the patient over a real-time multimedia channel that utilizes crisp audio and high-quality video. Nearly all telemedicine carts feature the routine facilities for evaluating the patient, with assistance from healthcare personnel at times, to monitor and record one’s pulse rate, vitals, and more. 

As soon as the patient evaluation is over, the psychiatrist can start formulating a suitable course of treatment and converse with the attending doctor in the last phase of the consultation.

Telemedicine services can effectively be delivered to the patients by numerous means and the providers are required to comprehensively evaluate each one of them before zeroing in on a particular delivery method, considering a host of factors, including their patient demographics. 

Live Interaction

Amongst the most popular telemedicine services is the synchronous or live interactions, where the patients and their providers or two service providers engage in real-time communication. 

As these interchanges occur in real-time, they facilitate sharing of information in an increasingly transparent manner and also encourage the patient to ask follow-up queries. It may also aid an indifferent patient to put faith in the provider as trust or its lack is a typical deterrent for the patient populations trying out telemedicine. The particular telemedicine process does not produce any time lag. 

Store and Forward

Many providers utilize the asynchronous or store-and-forward method for telemedicine delivery, where vital information, such as photographic images, diagnostic tests, and videos, are stored first and then transmitted to a healthcare provider, commonly a specialist, later on.

The specialist examines the forwarded clinical data and then reverts. While the store-and-forward method limits the opportunity of asking queries because of the inherent time lag it produces, the particular telemedicine delivery method may streamline the operation as well for the very reason that it does not need to synchronize the schedules of all the participants involved in the process.

Remote Patient Monitoring

Remote patient monitoring is also another kind of telemedicine delivery method that is being widely leveraged these days, where the providers or patients, the former usually being the nurses, can input significant healthcare indicators and information, such as blood sugar levels, weight, or blood pressure, over an extended quantum of time. 

This medical data will then be organized into a unified dataset and be evaluated by the healthcare team to trace any meaningful deviations or patterns. It can prove to be an indispensable methodology or tool for patients with chronic health conditions, such as congestive heart failure or type-two diabetes. 

Mobile Health

In an analogous way, the mobile healthcare system may be employed in the form of a go-to-delivery method for particular patients, where the affected individuals are required to use technology that is readily available for registering and keying in critical data. As the people are actively involved in inputting data, the greater are the odds of reporting errors by the patients themselves. Furthermore, there are a number of other risks that are also present in the mobile healthcare system.

The Bottom Line

The healthcare providers are increasingly exploring various means for integrating the aforementioned telemedicine delivery methods into a more coherent and effective package.

A hybrid consultation is purpose-designed to include all the benefits of both synchronous and asynchronous interactions. 

While the hybrid consultation allows a specialist to usually accesses the complex diagnostics, which were completed earlier, it also permits the attending specialist to directly engage with the patients and/or their family members. According to the latest (2018) data provided by the Telehealth Resource Centers or TRC, these hybrid consultations can be most frequently found in specialties like cardiology and dermatology. 

No matter which telemedicine service you choose, it is imperative to realize that the objective remains same in all the cases, that is, improving the health outcomes of patients.

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