A friend insisted that I come to Baltimore to visit during an upcoming American Telemedicine Association conference. The conference is for pediatricians. I'm all about mental health and substance abuse technology. So why am I going?
According to the US Human Resources Service Administration (HRSA), New York has enacted legislation for Medicaid to pay for telemedicine solutions in Mental Health. It only makes sense for me to learn a little more about the solution.
At least one program, Project Teach, currently includes telephone interviews for psychopharmacologic concerns. The program is an example of how the state's Office of Mental Health is making good on the promise in the 2010 statewide plan to extend technology in mental health. Presumably, if New York is using telemedicine as a technological strategy to decrease the "burden of illness", other states must be on the same beam, and evidence I've seen shows New York is not in the lead in paying for expanding the technology.
An earlier research foray into telemedicine in mental health yielded a little knowledge on its use, and the first thing that usually comes up is that it's a solution for "rural and underserved communities". This friend I mentioned earlier said "what about the woman who lives in Queens, has a job there, and has to take a bus and two subway trains to get to her therapist in Manhattan?" Telemedicine seems a great way for her to work with her current therapist without having to take a lot of time off work.
The elements of telemedicine for mental health are pretty simple, really: Mental health services using live, interactive videoconferencing doesn't require tremendously expensive equipment. Some finesse is involved, like good lighting and camera angles to help with the feel of a professional environment, however, the technical requirements are available to most people. At the beginning of the year I bought a Netbook computer for $400, and there's a camera for videoconferencing. This seems like a pretty low-cost solution for rural use and for the woman who lives in Queens.
As long as there is a two-way video and voice communication between professional and consumer, a number of sessions, like visits to review medication effectiveness can easily be remote events and are worth paying for…and that's good for business in your local Community Mental Health Center.
So, there is value to telemedicine in mental health. I can't help but feel there's more we can do with the technology, medication review can't be the only service worth paying for. What about an individual therapy session? What about the use of social networks like Facebook for a sort of group therapy? Or actual group therapy with people connected via a teleconferencing service. If the value exists, then it's worth paying for. It's easy for a business man to see the value of how this technology can lower costs and increase productivity. Are insurance companies and Medicaid coming to realize the value of telemedicine in general practice of improving our mental health?
That's why I'm going to the conference, and I'll keep you posted.