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Geriatric Telepsychiatry: Opportunities, Models, and Outcomes

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Geriatric Psychiatry

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Abstract

Contemporary healthcare is patient-centered in terms of quality care, access, and affordable options. Stepped and integrated care models emphasize customized care, interdisciplinary teamwork, and integration of services based on co-location, shared responsibility, and funding. Telepsychiatry (TP) is as effective as in-person care and has been broadly used to provide psychosomatic medicine (formerly consultation-liaison psychiatry) to primary care and other healthcare settings. The literature reveals that TP leverages a wide range of treatments at a distance to clinics, nursing homes, and patient homes and how telemedicine models of care provide flexibility for TP services to patients, providers, and caregivers. There is steady growth of the TP evidence base, and geriatric patients are as open to using TP as other populations and report high satisfaction. TP outcomes for geriatric patients are comparable to in-person care and quite in parallel with outcomes for patients of all ages. TP also enables more patient points of entry, addresses patient-provider needs-skill mismatches, and leverages other resources. Telemedicine and TP overcome geographical, physical limitations and access to care obstacles. More formal TP research studies and health services effectiveness studies are needed for geriatric patients in culturally diverse populations, related to team-based or interdisciplinary care, and employing full stepped or integrated care models.

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References

  1. Akinci F, Patel PM. Quality improvement in healthcare delivery utilizing the patient-centered medical home model. Hosp Top. 2014;92(4):96–104.

    Article  PubMed  Google Scholar 

  2. Hilty DM, Ferrer D, Callahan EJ, et al. The effectiveness of telemental health: a 2013 review. Telemed J e-Health. 2013;19(6):444–54.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hilty DM, Yellowlees PM, Parish MB, et al. Telepsychiatry: effective, evidence-based and at a tipping point in healthcare delivery. Psychiatr Clin North Am. 2015;38(3):559–92.

    Article  PubMed  Google Scholar 

  4. Ortman JM, Velkoff VA, Hogan H. An Aging Nation: The Older Population in the United States. https://www.census.gov/prod/2014pubs/p25–1140.pdf. Accessed 1 Nov 2016.

  5. Jeste DV, Alexopoulos GS, Bartels SJ, et al. Consensus statement on the upcoming crisis in geriatric mental health: research agenda for the next 2 decades. Arch Gen Psychiatry. 1999;56(9):848–53.

    Article  CAS  PubMed  Google Scholar 

  6. lAgeing. (Online) 2012. At: www.who.int/topics/ageing/en. Last accessed November 1, 2016.

  7. Schulz R, Martire LM. Family caregiving of persons with dementia: prevalence, health effects, and support strategies. Am J Geriatr Psychiatry. 2004;12(3):240–9.

    Article  PubMed  Google Scholar 

  8. Yellowlees PM, Shore JH, Roberts L, et al. Practice guidelines for videoconferencing-based telemental health. Telemed J E-Health. 2010;16(10):1074–89.

    Article  PubMed  Google Scholar 

  9. Turvey C, Coleman M, Dennison O, et al. ATA practice guidelines for video-based online mental health services. Telemed J e-Health. 2013;19(9):722–30.

    Article  PubMed  Google Scholar 

  10. Hilty DM, Shoemaker EZ, Myers KM, et al. Issues and steps toward a clinical guideline for telemental health for care of children and adolescents. J Child Adolesc Psychopharmacol. 2016;26(3):283–95.

    Article  PubMed  Google Scholar 

  11. Sheeran T, Dealy J, Rabinowitz T. Geriatric telemental health. In: Myers K, Turvey CL, editors. Telemental health. Amsterdam: Elsevier; 2013. p. 171–95.

    Chapter  Google Scholar 

  12. Rabinowitz T, Murphy KM, Amour JL, et al. Benefits of a telepsychiatry consultation service for rural nursing home residents. Telemed J e-Health. 2010;16(1):34–40.

    Article  PubMed  Google Scholar 

  13. Conn DK, Madan R, Lam J, et al. Program evaluation of a telepsychiatry service for older adults connecting a university-affiliated geriatric center to a rural psychogeriatric outreach service in Northwest Ontario, Canada. Int Psychogeriatr. 2013;25(11):1795–800.

    Article  PubMed  Google Scholar 

  14. Urness D, Hailey D, Delday L, et al. The status of telepsychiatry services in Canada: a national survey. J Telemed Telecare. 2004;10:160–4.

    Article  PubMed  Google Scholar 

  15. De Las Cuevas C, Arrendondo MT, et al. Randomized controlled trial of telepsychiatry through videoconference versus face-to-face conventional psychiatric treatment. Telemed J e-Health. 2006;12:341–50.

    Article  PubMed  Google Scholar 

  16. Fortney J, Pyne JT, Turner E, et al. Telemedicine integration of mental health into rural primary care settings. Int Rev Psychiatry. 2015;27(6):525–39.

    Article  PubMed  Google Scholar 

  17. Shore JH, Mishkind MC, Bernard J, et al. A lexicon of assessment and outcome measures for telemental health. Telemed J e-Health. 2013;3:282–92.

    Google Scholar 

  18. Elderkin-Thompson V, Silver RC, et al. When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. Soc Sci Med. 2001;52:1343–58.

    Article  CAS  PubMed  Google Scholar 

  19. Srinivasan S, Jones A, Hilty DM. Geriatric telepsychiatry in academic settings. In: Srinivasan S, Glover J, Bouknight J, editors. Geriatric telepsychiatry. New York, NY: Springer. In Press.

    Google Scholar 

  20. Kroenke K, Spitzer RL, Williams JB. The PHQ-9. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17(1):37–49.

    Article  CAS  Google Scholar 

  22. Phoenix C, Orr N. Pleasure: a forgotten dimension of physical activity in older age. Soc Sci Med. 2014;115:94–102.

    Article  PubMed  Google Scholar 

  23. Vahia IV, Ng B, Camacho A, et al. Telepsychiatry for neurocognitive testing in older rural Latino adults. Am J Geriatr Psychiatry. 2015;23(7):666–70.

    Article  PubMed  Google Scholar 

  24. Sheeran T, Rabinowitz T, Lotterman J, et al. Feasibility and impact of telemonitor-based depression care management for geriatric homecare patients. Telemed J E-Health. 2011;17:620–6.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Choi NG, Marti CN, Bruce ML, et al. Six-month post-intervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income homebound older adults. Depress Anxiety. 2014;31(8):653–61.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Dobbins ML, Roberts N, Vicari SK, et al. The consulting conference: a new model of collaboration for child psychiatry and primary care. Acad Psychiatry. 2011;35:260–2.

    Article  PubMed  Google Scholar 

  27. Odor A, Yellowlees PM, Hilty DM, et al. PsychVACS: a system for asynchronous telepsychiatry. Telemed J E-Health. 2011;17(4):299–303.

    Article  PubMed  Google Scholar 

  28. Yellowlees PM, Odor A, Parish MB, et al. A feasibility study of asynchronous telepsychiatry for psychiatric consultations. Psychiatr Serv. 2010;61(8):838–40.

    Article  PubMed  Google Scholar 

  29. Hilty DM, Marks S, Wegeland JE, et al. A randomized controlled trial of disease management modules, including telepsychiatric care, for depression in rural primary care. Psychiatry. 2007;4(2):58–65.

    PubMed  PubMed Central  Google Scholar 

  30. Myers KM, Vander Stoep A, Zhou C. Effectiveness of a telehealth service delivery model for treating attention-deficit hyperactivity disorder: results of a community-based randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2015;54(4):263–74.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hilty DM, Johnston B, McCarron RM. How telemental health adds to traditional outpatient and newer models of integrated care for patients, providers and systems. In: Mucic D, Hilty DM, editors. Key issues in e-mental health. New York, NY: Springer; 2015. p. 129–50.

    Google Scholar 

  32. Hilty DM, Chan S, Torous J, et al. New frontiers in healthcare and technology: internet- and web-based mental options emerge to complement in-person and telepsychiatric care options. J Health Med Inform. 2015;6(4):1–14.

    Google Scholar 

  33. Williams K, Pennathur P, Bossen A, et al. Adapting telemonitoring technology use for older adults: a pilot study. Res Gerontol Nurs. 2015;2:1–7.

    Google Scholar 

  34. Ament BH, Wolfs CA, Kempen GI, et al. The benefit of a geriatric nurse practitioner in a multidisciplinary diagnostic service for people with cognitive disorders. BMC Res Notes. 2015;8:217.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Pedone C, Rossi FF, Cecere A, et al. Efficacy of a physician-led multiparametric telemonitoring system in very old adults with heart failure. J Am Geriatr Soc. 2015;63(6):1175–80.

    Article  PubMed  Google Scholar 

  36. Lind L, Karlsson D. Telehealth for “the digital illiterate”—elderly heart failure patients’ experiences. Stud Health Technol Inform. 2014;205:353–7.

    PubMed  Google Scholar 

  37. Hilty DM, Rabinowitz T. Telepsychiatry settings: interventions, outcomes and innovations. In: Hategan A, Bourgeois JA, Hirsch C, editors. On call geriatric psychiatry. Cham: Springer; 2016. p. 317–33.

    Chapter  Google Scholar 

  38. Hilty DM, Nesbitt TS, Marks SL, et al. How telepsychiatry affects the doctor-patient relationship: communication, satisfaction, and additional clinically relevant issues. Prim Psychiatry. 2002;9(9):29–34.

    Google Scholar 

  39. Kim T, Biocca F. Telepresence via television: two dimensions of telepresence may have different connections to memory and persuasion. J Comput-Mediat Commun. 1997. https://doi.org/10.1111/j.1083–6101.1997.tb00073.x.

  40. Cukor P, Baer L, Willis BS, et al. Use of videophones and low-cost standard telephone lines to provide a social presence in telepsychiatry. Telemed J. 1998;4(4):313–21.

    Article  CAS  PubMed  Google Scholar 

  41. Hoffman P, Kane JM. Telepsychiatry education and curriculum development in residency training. Acad Psychiatry. 2015;39(1):108–9.

    Article  PubMed  Google Scholar 

  42. Glover JA, Williams E, Hazlett LJ, et al. Connecting to the future: TP in postgraduatemedical education. Telemed J E-Health. 2013;19(6):1–6.

    Article  Google Scholar 

  43. Hilty DM, Rabinowitz T, Yellowlees PM, et al. “Telepsychiatry’s evidence base shows effectiveness: new models (asynchronous), more psychotherapy, and innovations with special populations (Child, Gero, Other)”, Symposium, American Psychiatric Association, Toronto, Canada, 2015.

    Google Scholar 

  44. Hilty DM, Crawford A, Teshima J, et al. A framework for telepsychiatric training and e-health: competency-based education, evaluation and implications. Int Rev Psychiatry. 2015;27(6):569–92.

    Article  PubMed  Google Scholar 

  45. Royal College of Physicians and Surgeons, CanMEDS Framework. 2015. At: http://canmeds.royalcollege.ca/en/framework. Last accessed November 1, 2016.

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Author information

Authors and Affiliations

  1. Northern California Veterans Affairs Health System, 10535 Hospital Way, Mather, 95655, CA, USA

    Donald M. Hilty

  2. Palmetto Health, Columbia, SC, USA

    Shilpa Srinivasan

  3. University of Vermont Medical Center, Burlington, VT, USA

    Terry Rabinowitz

Authors
  1. Donald M. Hilty
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  2. Shilpa Srinivasan
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  3. Terry Rabinowitz
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Corresponding author

Correspondence to Donald M. Hilty .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada

    Ana Hategan

  2. Baylor Scott and White Department of Psychiatry, Texas A&M University College of Medicine, Temple, Texas, USA

    James A. Bourgeois

  3. Division of General Medicine, University of California Davis Medical Center, Sacramento, California, USA

    Calvin H. Hirsch

  4. Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, California, USA

    Caroline Giroux

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Hilty, D.M., Srinivasan, S., Rabinowitz, T. (2018). Geriatric Telepsychiatry: Opportunities, Models, and Outcomes. In: Hategan, A., Bourgeois, J., Hirsch, C., Giroux, C. (eds) Geriatric Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-67555-8_35

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  • DOI: https://doi.org/10.1007/978-3-319-67555-8_35

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  • Online ISBN: 978-3-319-67555-8

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