"People are comfortable sitting in front of a TV...
I am getting better information over telemedicine."
-Ellen Morse, RN, CFNP

 

 

 

 

 

 

 

 

"With telemedicine I see more families. They bring in their family, they bring in their children, they bring in their husband, they bring in their sister. They are quicker to bring in their family into a telemedicine session than into a private face to face."
-Ellen Morse, RN, CFNP

 
    Types of clinical services via telemedicine
Clinical services that are delivered within the NARBHA system via telemedicine include:
  • Psychiatric evaluations: A complete historical and diagnostic initial evaluation by a psychiatrist, usually requiring an hour and a half.
  • Medication management: The psychiatrist evaluates the patient regarding medication effectiveness, patient symptoms, medical problems, medication side effects, etc., and determines if the patient's medication(s) need to be adjusted, supplemented, changed, or stopped.
  • Inpatient staffings: Patients requiring inpatient or residential treatment are often sent to a remote facility. With the telemedicine network connecting several locations, all parties (including the patient’s outpatient psychiatrist in one location, the case manager and/or therapist in another location, and the inpatient/residential staff in a third location) can meet for coordination of care and discharge planning. The patient may attend for clinical or treatment planning.
  • Consultations: Specialty consultations or second opinions can be obtained through telemedicine. For instance, a child may need to be seen by a board-certified child psychiatrist or an adult may need to be seen by a neuropsychiatrist at the University of Arizona Medical Center. Multipoint conferencing allows the patient, outpatient psychiatrist, and specialty practitioner to interact in a single group meeting.
  • Emergency and commitment evaluations: The ability to provide psychiatric and civil commitment evaluations using telemedicine has improved care. Without it, patients have to be transported by ambulance or police to a distant location with a psychiatrist. Or the psychiatrist has to cancel a day of scheduled patients to travel to a remote site on short notice.
  • Title 36 Commitment hearings: Civil commitment hearings done over video allow the psychiatrist to meet with the judge to report the psychiatrist's findings from the commitment evaluation.
  • Family involvement in patient treatment: When a patient is placed out of the home (e.g., in an inpatient hospital or a residential treatment facility) the patient is far away from their family. This is especially true of patients who reside in the Arizona Strip, who have to travel to Flagstaff, Prescott, Show Low, Phoenix, or Tucson for out-of-home services. Families can go to their local clinic to use the telemedicine network to visit with their family member in treatment, to support the patient, and to be involved in the patient's treatment.
  • Other clinical services:
    • Intake assessments by clinical staff
    • Family team meetings among patients, families, therapists/case managers, and other agencies such as schools or Child Protective Services involved with the patient's care
    • Clinical supervision and staffings among clinical team members
    • Counseling (Counseling is not generally provided via the NARBHA telemedicine system but is and has been available for special circumstances, such as continuity of care with a known therapist after a member’s move or CPS placement out of region.)

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