Seattle Children's Offers Care from a Distance
Seattle Children’s employs a mix of technologies to provide telepsychiatry services, depending on the state and partner site being served.
When establishing a virtual-care partnership with Alaska Native Medical Center, Evans traveled to Anchorage to install the software for their telehealth system onto her laptop, while working with IT departments in both locations to ensure sessions are encrypted.
Back at her office, she uses a Cisco DX80 videoconferencing kit that provides a point-to-point connection between herself and clients. A mobile-friendly app-based software option is in the works to make telehealth more user friendly and, Evans notes, “to offer the future capability of potentially connecting to patients in a nonclinical location, such as from their homes.”
Setting up the technology was easy. Licensing and credentialing were more onerous, says Evans, noting that the processes took about a year to complete in Alaska.
The efforts can pay off, says Myers, whose research found that children with attention deficit hyperactivity disorder who received 22 weeks of virtual visits with a behavioral therapist saw better outcomes than peers getting in-person care from a family doctor who had held one virtual consultation with an ADHD specialist over the same period.
“Providers who thought it impossible to develop a therapeutic alliance through telemental health are very surprised to see its effectiveness once they try it,” Myers says.
Telemedicine for minor acute conditions and services such as psychiatry is growing, says Dr. Lori Uscher-Pines, a senior policy researcher for RAND. The ubiquity of video chat has increased patient comfort with the idea of virtual care, but adoption rates remain in the single digits, she notes.
“Costs to establish these programs are going down,” says Uscher-Pines. “It used to be very expensive to purchase a telemedicine cart or provision the broadband capacity required.”
Telepsychiatry Gives Patients Critical Access to Care
In Nebraska, 88 of the state’s 93 counties don’t have enough mental health professionals, according to data cited by the American Hospital Association. And many providers are clustered in the state’s more densely populated eastern cities.
“If you look at the numbers, the entire region — all of the Midwest — is underserved,” says Dr. Jennifer McWilliams, a child psychiatrist at Children’s Hospital & Medical Center in Omaha, which launched a telepsychiatry program in 2016. “We’re inspired to improve access for kids who would otherwise not receive any psychiatric care.”
With 250,000 patients spread across a five-state region, Children’s uses geographical analysis to select community sites that can serve as connection hubs, linking McWilliams and other providers with youths who might be better served by the convenience and flexibility of telepsychiatry.