The Role of Telepsychiatry

Abstract

You are working a busy Friday night in your suburban emergency department (ED), and there has been an unusually high volume of patients presenting with psychiatric complaints this evening. As they are placed into rooms and medically assessed, an increasing number of beds in the department are not turning over as these patients wait for psychiatric consultations; there is no on-call psychiatrist at your hospital. As the night progresses, patients in the waiting room become upset about the wait time, anxious patients grow restless in the noisy environment, and the ED staff begins to feel the rising level of stress. Fortunately, the charge nurse remembers that the ED has recently launched a new telepsychiatry program. She retrieves a mobile telehealth unit comprised of a monitor and camera, and wheels it into a patient’s room. Within 10 minutes, the patient is speaking to a board-certified psychiatrist via a secure two-way video connection. The psychiatrist later calls you to discuss the case, give medication recommendations, inform you that the patient requires inpatient admission, and tells you that she will begin the process of finding a bed at an appropriate facility. The mobile unit is wheeled into the next patient’s room, and the process is repeated.