In a conversation at a recent Health 2.0 NYC event, this Editor asked Doug Naegele what was the most surprising topic at the recent American Telemedicine Association conference in Toronto. Doug has graciously contributed this short article. He is the founder of Infield Health, a firm dedicated to increasing health outcomes and reducing total cost of care by putting discharge instructions on mobile phones.
At the ATA Fall Meeting in Toronto last month, Dr. Peter Yellowlees gave a presentation on his work at University of California-Davis around telepsychiatry. I was struck by a few of his discussion points:
1. It may be helpful to see psychiatric consults as ‘data files’ and not events that require mandatory real-time evaluation.
2. If we accept that these consults can be described as data files, then they can be forwarded to remote psychiatrists for viewing, evaluation, and treatment recommendations much in the same way radiological scans are remotely evaluated.
3. The work that has been done in standardizing tele-radiology and tele-dermatology (clinical and reimbursement) through store-and-forward can be applied to psychiatry, in certain procedures.
Given the unmet need of skilled psychiatric services in low-resource areas, allowing room for the ‘asynchronous approach’ may help bring better mental health services to more people and at a lower total cost.
Questions for our readers: What are the implications of separating psychiatric consults from a real time evaluation? Can a person’s true mental state be assessed by someone not in same-time interaction, whether in person or on video? For instance, how do you account for cultural context, non-verbal cues, native language skills? What might be those ‘certain procedures’?