An Update on Telepsychiatry and How It Can Leverage Collaborative, Stepped, and Integrated Services to Primary Care

Psychosomatics. 2018 May-Jun;59(3):227-250. doi: 10.1016/j.psym.2017.12.005. Epub 2017 Dec 26.

Abstract

Introduction: In this era of patient-centered care, telepsychiatry (TP; video or synchronous) provides quality care with outcomes as good as in-person care, facilitates access to care, and leverages a wide range of treatments at a distance.

Method: This conceptual review article explores TP as applied to newer models of care (e.g., collaborative, stepped, and integrated care).

Results: The field of psychosomatic medicine (PSM) has developed clinical care models, educates interdisciplinary team members, and provides leadership to clinical teams. PSM is uniquely positioned to steer TP and implement other telebehavioral health care options (e.g., e-mail/telephone, psych/mental health apps) in the future in primary care. Together, PSM and TP provide versatility to health systems by enabling more patient points-of-entry, matching patient needs with provider skills, and helping providers work at the top of their licenses. TP and other technologies make collaborative, stepped, and integrated care less costly and more accessible.

Conclusion: Effective health care delivery matches the intensity of the services to the needs of a patient population or clinic, standardizes interventions, and evaluates both process and clinical outcomes. More research is indicated on the application of TP and other technologies to these service delivery models.

Keywords: collaborative; consultation; model; stepped; telemedicine; telepsychiatry.

Publication types

  • Review

MeSH terms

  • Cooperative Behavior
  • Delivery of Health Care / organization & administration*
  • Humans
  • Mental Health Services / organization & administration*
  • Patient-Centered Care / organization & administration
  • Primary Health Care / organization & administration*
  • Psychiatry / organization & administration*
  • Psychosomatic Medicine / organization & administration
  • Telemedicine / organization & administration*