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College Telepsychiatry Finally Catching Up—Slowly

The majority of American college students feel overwhelmed, depressed, and/or anxious, according to the latest American College Health Association survey. Unfortunately, many schools lack easy access to needed mental health care—if they have any at all. And this doesn’t even take into account the students’ hesitation to seek help due to the stigma often associated with mental illnesses. With the growth of telemedicine, telepsychiatry and telemental health present a viable solution that could overcome many of these challenges.

Already proven to be just as effective as in-person treatments for mental disorders, telepsychiatry offers several benefits for both students and universities. Students will likely value the privacy and easy access, making them more likely to seek treatment. Other issues may also be alleviated, such as lack of transportation, time off from work or class, or childcare, since telepsychiatry hours are not limited to business hours. Universities will appreciate the ability to expand mental health services without requiring large outlays for buildings and staff.

As universities contemplate adding a telepsychiatry program to their resources, they must navigate through evolving legal, regulatory, and financial matters, many of which depend on local or state jurisdictions. These include:

  • Licensing – Some states require doctors to have a telemedicine license in order to practice telemedicine, while other states require physicians to be board certified in their specialties before they can practice telemedicine. Some states allow a doctor licensed in another state to work with telemedicine patients within their borders, but other states require doctors to be licensed in the patient’s jurisdiction.
  • Reimbursement – Increasing numbers of private insurers are covering telemedicine, as are Medicare and Medicaid. However, over half of U.S. states lack laws governing coverage from commercial carriers. For students on their parents’ health plans, this could be a problem.
  • Security – The telemedicine platforms must comply with HIPAA; data must be encrypted, and the web link must be secure. For instance, Skype is not HIPAA-compliant.
  • Informed consent – The states vary widely in their requirements for ensuring that patients understand the potential risks and options regarding treatment, or in this case, telepsychiatry. In a few states, patients must also be informed on how to receive follow-up care.

Although telepsychiatry can be very effective for disorders such as depression, panic attacks, or anxiety, urgent and severe cases still need in-person intervention. This includes cases where people may be in danger of harming themselves or others.

As telemedicine becomes more available on college campuses, recommendation from trusted sources (word-of-mouth) will spread the word about the accessibility and effectiveness of telepsychiatry, believes Dr. Nadia Islam, clinical director of the University of Southern California (USC) Telehealth. USC has operated an online behavioral health clinic since 2012; during this time, the professors associated with the program have found that many of their clients have admitted either that they would never have sought therapy in the past, or that they tried therapy before but didn’t stick with it; most of these patients tend to shy away from traditional office buildings.

By using a smartphone, tablet, or computer—at home or a local mental health agency—patients can bring the doctor into their homes or dorm rooms, instead of traveling to the doctor. This enables the doctor to see more patients each day, since moving from one patient to the next is a simple matter of ending one call and picking up another. And when both patients and doctors benefit, this can only be a win-win solution for everyone involved.

elderly woman at home on telemedicine visit

New Budget Deal Boosts Telemedicine Coverage

Earlier this month, President Donald Trump signed into law a bipartisan budget deal that impacts Medicare’s telemedicine coverage more than any past legislation, as described by one senator. After a brief government shutdown, Congress approved a two-year budget deal including parts of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, the Furthering Access to Stroke Telemedicine (FAST) Act, and the Increasing Telehealth Access to Medicare Act. Read more

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UC Riverside Testing MS Telemedicine

Telemedicine is already in use to help patients with stroke treatment or debilitating chronic conditions such as Parkinson’s disease; now, a study is exploring whether the platform can work for patients with multiple sclerosis. The University of California Riverside was awarded a $100,000 grant from biotech firm Genentech to set up a one-year pilot program in order to determine whether an MS telemedicine visit can replace office visits for patients who have difficulties with travel. Read more

elderly man with walker trying to stand

Telemedicine for Movement Disorders Is Well-Received

A professor at Emory University is finding great success in using telemedicine for movement disorders. Recently, Jaime Hatcher-Martin, MD, PhD, a movement disorders specialist at Emory University Hospital, was asked about her experiences with telemedicine. Having founded Emory’s movement disorders telemedicine clinic, Hatcher-Martin is ready to offer guidance to clinicians who are interested in telemedicine. Read more

woman with headache

Teleneurology Safe and Effective for Evaluating Headaches

A neurologist can safely evaluate a patient’s headaches using telemedicine, according to research published recently in Neurology, the medical journal of the American Academy of Neurology (AAN). The non-inferiority study found that patients who used teleneurology had the same outcomes as patients who visited a neurologist in-person. Read more

youth football player

Teleneurology Can Deliver Real-Time Concussion Care to Young Athletes

Each year, up to 3.8 million traumatic brain injuries occur—over 75 percent of which are sports-related. Although the professional and elite levels are addressing the issue, many youth and collegiate programs can’t keep concussion specialists on hand to provide an immediate response on the sidelines. A recent study, spearheaded by Mayo Clinic, explored whether telemedicine technology could be used by concussion specialists to assess players’ conditions in real time. Although teleneurology has already been shown to be effective for evaluating and treating acute neurologic conditions such as stroke, concussion management is a new territory. Read more

illustration of man having stroke

Telestroke Bill Would Expand Medicare Coverage

Congress is revisiting a bill that seeks to extend Medicare reimbursement for telestroke services across the nation. Under the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare would cover telestroke services regardless of the patient’s location; currently, coverage only encompasses specific rural areas. Read more

Elderly man using telemedicine for speech therapy on tablet computer

Telemedicine for Speech Therapy Preserves Language Skills

At Northwestern University, telemedicine for speech therapy is helping dementia patients improve deteriorating language skills. As neurodegenerative illnesses progress, patients often struggle with recalling names and words, such as a grandchild’s name or the appropriate words for ordering lunch. After completing an eight-week course of therapy sessions and home assignments, study participants demonstrated a significant improvement in recalling troublesome words; after six months, the improvement remained. Read more

A passerby helps a woman with stroke.

New Standards Published for Telestroke Programs

For the first time, official guidelines have been published for the use of telemedicine in potential stroke cases. The American Heart Association (AHA) and American Stroke Association (ASA) recently released a joint scientific statement describing quality measures and outcomes for telestroke. The document was prepared in response to the rapid growth of telestroke over the past decade. Now, hospitals can quantitatively measure their telestroke programs against these standards in order to ensure they are providing high quality care. Read more

Supporting Parkinson's patient with cane

Telemedicine Pilot Program Successful for Parkinson’s Patients

Patients with Parkinson’s disease are used to devoting an entire day and driving long miles to be seen by a specialist. That doesn’t mean it’s easy. Thanks to telemedicine, though, this could soon change. Last fall, Rush University Medical Center launched a telemedicine pilot program that allows patients to visit their physicians virtually, from the comfort of their own homes. Read more