Telepsychiatry to Be Implemented in San Antonio Hospitals

Face-to-face psychiatric care may become a thing of the past for San Antonio hospitals—at least when it comes to initial psychological consultations.

Following a 72 percent jump in emergency room psychiatric assessments between 2007 and 2012, Methodist Healthcare (Methodist) is introducing video conferencing technology that will give psychiatrists across the nation the ability to perform the initial mental health evaluations of patients in San Antonio. The majority of Methodist’s hospitals, starting with Methodist Specialty and Transplant Hospital, will introduce “telepsychiatry” during the first quarter of 2014.

“[Because of cuts in outpatient care funding,] our emergency rooms are getting inundated with mental health patients who do not have the resources,” said Liza Jensen, the executive director of Methodist’s psychiatric department. “The demand was exceeding our ability to manage it.” In the last year, the number of psychiatric assessments in Methodist’s emergency rooms reached almost 10,000, and it could take hours—and even days—before patients were able to speak with a mental health professional.

The introduction of telepsychiatry, which is commonly used in rural and underserved markets and is gaining popularity in urban areas where hiring psychiatric professionals has grown difficult, will make same-day psychological evaluations available to patients reporting mental distress and will cut down wait times for patients. The patients will communicate with off-site psychiatrists through a secure video screen, allowing the psychiatrist to order hospital admission, prescribe medications, or write discharge instructions.

According to a study in Ontario, Canada, patients consulted through video technology experienced clinical outcomes equivalent to those experienced by patients who received their consultation face to face, and both groups of patients reported similar levels of satisfaction with their psychiatrists’ service. The study, however, consisted only of a psychiatric consultation and four months of follow-up appointments. Thus, the effectiveness of using video technology to conduct other kinds of mental health services, such as psychotherapy, was not evaluated.

While the program will help Methodist’s hospitals to save time, the costs of the program will be significant. The hospitals are not expected to save any money in the process of implementing the video technology, and nine full-time employees, including advanced practice nurses, licensed professional counselors, and licensed clinical social workers, will be required to choose to accept other jobs in the psychiatric program or to accept severance packages. However, the benefit of the telepsychiatry program will be large and will allow Methodist to break even in the long run.