Telemedicine, as we have pointed out before, certainly has the potential to rationalize capacity, improve access and lower unit costs for delivery of health care services. It is unclear what types of services may or may not be amenable to delivery by some form of telemedicine. Mental health services have been a concern, due to belief in some quarters that an in-person relationship and assessment is needed. A recent studied carried in the Journal of Clinical Psychiatry, however, confirms what other studies have suggested; that for most patients tele-psychiatry is an acceptable, even preferable alternative. (J. Clin. Psy. Study) The population in this study was a group of older veterans with depression.
There were 241 patients in the study. About half were randomly assigned to in-person therapy and half to some form of teletherapy. The outcomes were quality of life as measured by the SF 36 form, patient satisfaction and service delivery perception. In all respects, telepsychiatry was equal to in-person treatment, whether after 4 weeks, 8 weeks, 3 months or 12 months. As noted above, this isn’t unexpected, as a series of studies have come to similar conclusions. This suggests that payers and others should feel comfortable encouraging the use of telemedicine in mental health. There is a substantial shortage of psychiatrists and other mental health professionals and telemedicine allows capacity anywhere in the country to be used for patients anywhere in the country. It allows patients to be treated from home. It has lower cost of service, so unit prices should be lower. The biggest problem is getting regulators to not be parochial; to have universal license reciprocity.