Skip to main content

Advertisement

SpringerLink
Log in

Ensuring Successful Telepsychiatry Program Implementation: Critical Components and Considerations

  • Hot Topic
  • Published:
Current Treatment Options in Psychiatry Aims and scope Submit manuscript

Abstract

Purpose

Telepsychiatry in the USA witnessed exponential growth in the last decade, having been proven to be a cost-effective and sustainable approach to delivering high-quality mental health services. This surge was aided by the availability of high-speed Internet, improved software, and an increase in demand paired with expanded reimbursement models. Despite a growing interest in adopting telepsychiatry programs, many health organizations continue to face challenges at the implementation stage. This review aims to identify the critical components and the associated challenges met at the planning, deployment, and maintenance phases of telepsychiatry program implementation.

Recent findings

Four critical components for telepsychiatry implementation have been identified: (1) patient population, (2) originating site, (3) tele-clinician, (4) the information and communications technologies, and a potential fifth (5) a telepsychiatry organization to help align these components. Recommendations to anticipate and address these challenges include assessing the needs of the patient population, incorporating standardized processes and data analytics into existing organizations workflow, sourcing qualified and culturally competent tele-clinicians and providing ongoing clinical oversight, technological support, and monitoring of connectivity.

Summary

The rapid growth of telepsychiatry programs in the USA is concomitant with a number of critical implementation challenges. Recommended strategies and applied solutions are discussed in this review.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References Recommended Readings

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Mahmoud H, Vogt EL, Sers M, Fattal O, Ballout S. Overcoming barriers to larger-scale adoption of telepsychiatry. Psychiatr Ann. 2019;49(2):83–8.

    Article  Google Scholar 

  2. Cash CD. Telepsychiatry and risk management. Innov Clin Neurosci. 2011;8(9):26–30.

    PubMed  PubMed Central  Google Scholar 

  3. Yellowlees P, Burke MM, Marks SL, Hilty DM, Shore JH. Emergency telepsychiatry. J Telemed Telecare. 2008;14(6):277–81.

    Article  Google Scholar 

  4. Bolle SR, Trondsen MV, Stensland GO, Tjora A. Usefulness of videoconferencing in psychiatric emergencies--a qualitative study. Health Technol (Berl). 2018;8(1):111–7.

    Article  Google Scholar 

  5. Hilty DM, Ferrer DC, Parish MB. John­ston B, Callahan EJ, Yellowlees PM. The effectiveness of telemental health: a 2013 review. Telemed J E Health. 2013;19(6):444–54.

    Article  Google Scholar 

  6. Yellowlees P, Shore J, Roberts L. Practice guidelines for videoconferencing-based telemental health–October 2009. Telemed J E Health. 2010;16(10):1074–89.

    Article  Google Scholar 

  7. Nelson EL, Cain S, Sharp S. Consider­ations for conducting telemental health with children and adolescents. Child Ado­lesc Psychiatr Clin N Am. 2017;26(1):77–91.

    Article  Google Scholar 

  8. Leonard S. The development and evalu­ation of a telepsychiatry service for pris­oners. J Psychiatr Ment Health Nurs. 2004;11(4):461–8.

    Article  CAS  Google Scholar 

  9. • Spivak S, Spivak A, Cullen B, Meuchel J, Johnson D, Chernow R, et al. Telepsychiatry use in U.S. mental health facilities, 2010–2017. Psychiatr Serv. 2019. https://doi.org/10.1176/appi.ps.201900261 Reviewing telepsychiatry use trends over the past decade and outlining lessons learned on how historically barriers have been mitigated.

  10. Chan S, Parish M, Yellowlees P. Telepsychiatry today. Curr Psychiatry Rep. 2015;17:1–9.

    Article  Google Scholar 

  11. Dorsey ER, Topol EJ. State of telehealth. N Eng J Med. 2016. https://doi.org/10.1056/NEJMra1601705.

  12. • Lokken TG, Blegen N, Hoff MD, Demaerschalk BM. Overview for implementation of telemedicine services in a large integrated multispeciality health care system. Telemed E-health. 2019. https://doi.org/10.1089/tmj.2019.0079 Laying out a general framework that healthcare facilities may utilize to enhance the probability that the implementation of integrated telemedicine programs is successful.

  13. Mikulic M. Which of the following has been a challenge to implementing telemedicine practices in your organization? Statista. 2018. https://www.statista.com/statistics/870073/telemedicine-program-implementation-challenges/. Accessed 10 Nov 2019.

  14. Daniel H, Sulmasy LS. Health and public policy committee of the American college of physicians. Policy recommendations to guide the use of telemedicine in primary care settings: an American College of Physicians position paper. Ann. Intern. Med. 2015;163(10):787–9.

    Google Scholar 

  15. Shore JH, Yellowlees P, Caudill R, et al. Best practices in videoconferencing-based telemental health. Telemed E-health. 2018;24:827–32.

    Article  Google Scholar 

  16. Soltis-Jarrett V, Shea J, Ragaisis KM, Shell LP, Newton M. Integrated behavioral healthcare: assumptions, definition and roles: position paper from the international society of psychiatric-mental health nurses. Arch Psychiatr Nurs. 2017;31:433–9.

    Article  Google Scholar 

  17. American Medical Association. Digital health implementation playbook. N.P.; 2018.

  18. California Telehealth Resource Center. The CTRC Telehealth Program Developer Kit. N.P.; 2014.

  19. Shore JH, Savin D, Novins D, Manson SM. Cultural aspects of telepsychiatry. J Telemed Telecare. 2006;12:116–21.

    Article  Google Scholar 

  20. Overview. Workforce. The Substance Abuse and Mental Health Services Administration. 2019. https://www.samhsa.gov/workforce. Accessed on 10 Nov 2019.

  21. American Telemedicine Association. Practice guidelines for video-based online mental health services. 2013. https://www.integration.samhsa.gov/operations-administration/practice-guidelines-for-video-based-online-mental-health-services_ATA_5_29_13.pdf. Accessed 10 Nov 2019.

  22. National Council Medical Director Institute. The psychiatric shortage: causes and solutions. 2017. https://www.thenationalcouncil.org/wp-content/uploads/2017/03/Psychiatric-Shortage_National-Council-.pdf. Accessed Nov 12, 2019.

  23. Chakrabarti S. Usefulness of telepsychiatry: a critical evaluation of videoconferencing-based approaches. World J Psychiatr. 2015;5:286–304.

    Article  Google Scholar 

  24. Mishkind MC. Establishing telemental health services from conceptualization to powering up. Psychiatr Clin N Am. 2019;42:545–54.

    Article  Google Scholar 

  25. Koladycz R, Fernandez G, Gray K, Marriott H. The Net Promoter Score (NPS) for insight into client experiences in sexual and reproductive health clinics. Glob Health Sci Pract. 2018;6(3):413–24. https://doi.org/10.9745/GHSP-D-18-00068.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mahmoud H. Raymond ML, Dahdouh. Leveraging Technology to Enhance Access to Behavioral Health Services: Impact, Cost-effectiveness and Challenges. Poster presented at: NatCon 2019; Presented at: Natcon 2019: March, 24; Nashville, TN.

  27. Pruthi S, Stange KJ, Malagrino GD, Chawla KS, NF LR, Kaur JS. Successful implementation of a telemedicine-based counseling program for high-risk patients with breast cancer. Mayo Clin Proc. 2013;88:68–73.

    Article  Google Scholar 

  28. American Psychiatric Association, American Telemedicine Association. Best practices in videoconferencing-based telemental health. American Psychiatric Association. 2018. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry/blog/apa-and-ata-release-new-telemental-health-guide. Accessed 10 Nov 2019.

  29. Kruse CS, Bouffard S, Dougherty M, Parro JS. Telemedicine use in rural native American communities in the era of the ACA: a systematic literature review. J Med Syst. 2016;40(6):145. https://doi.org/10.1007/s10916-016-0503-8.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Regroup. A True Collaboration: A Tribal Community Meets Unique Patient Needs With Integrated Telepsychiatry. 2018; https://blog.regrouptelehealth.com/case-study-potawatomi-tribal-community-meets-unique-patient-needs-with-integrated-telepsychiatry.html

  31. Vogt EL, Mahmoud H, Elhaj O. Telepsychiatry: implications for psychiatrist burnout and well-being. Psychiatr Serv. 2019. https://doi.org/10.1176/appi.ps.201800465.

Download references

Author information

Authors and Affiliations

  1. Regroup Telehealth, Chicago, IL, USA

    Hossam Mahmoud MD, MPH, DFAPA & Bridget Mitchell MSW

  2. Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA

    Hossam Mahmoud MD, MPH, DFAPA

  3. University of Balamand, Koura, Lebanon

    Emile Whaibeh MPH

Authors
  1. Hossam Mahmoud MD, MPH, DFAPA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emile Whaibeh MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bridget Mitchell MSW
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The authors Hossam Mahmoud and Bridget Mitchell first conceived of the presented idea. All authors contributed to the literature search and the drafting of the manuscript. All authors critically revised and approved the final manuscript.

Ethics declarations

Conflict of interest

Hossam Mahmoud declares no conflict of interest. Emile Whaibeh declares no conflict of interest. Bridget Mitchell declares no conflict of interest

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Hot Topic

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mahmoud, H., Whaibeh, E. & Mitchell, B. Ensuring Successful Telepsychiatry Program Implementation: Critical Components and Considerations. Curr Treat Options Psych 7, 186–197 (2020). https://doi.org/10.1007/s40501-020-00208-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40501-020-00208-w

Keywords

Search

Navigation