Video psychiatry aims to reduce ER crowding, lack of rural services

afrank@newsobserver.comAugust 16, 2013 

— Rural areas without enough mental health resources will get access to psychiatrists through online video chatting in a program Gov. Pat McCrory announced Friday in Greenville.

The state budget provides $4 million over two years for East Carolina University to install video communication technology in 60 to 80 hospital emergency departments. Hospitals have complained about overcrowding and long waits in emergency rooms caused by a rise in behavioral health patients going to the ER for care.

Psychiatrists and psychologists will use real-time video and audio meetings with patients and ER health care providers to diagnose, treat and prescribe medication for mental health, and drug and alcohol abuse problems. This digital process is called telepsychiatry.

ECU will develop a network of psychiatrists from mental health resource-rich communities willing to work with rural hospitals.

“No matter where you live in North Carolina, you will soon have better access to mental health providers with the expansion of telepsychiatry across our state,” McCrory said in a statement.

He was joined by Aldona Wos, Secretary of Health and Human Services, for the announcement.

Fifty-eight of North Carolina’s 100 counties are considered Health Professional Shortage Areas by the federal government because they lack mental health resources.

Telepsychiatry is “one of the most effective ways” to improve underserved individuals’ access to mental health care, according to the American Psychiatric Association. The use of telemedicine in general is growing across the nation, with about 43 states developing or already using government-run programs.

ECU, which has been using telemedicine since 1992, has been working with Albemarle Hospital Foundation since 2011 to bring telepsychiatry to 14 eastern North Carolina hospitals. During that time, more than 4,000 psychiatric assessments were done, and patients saw their lengths of stay reduced, according to the foundation.

The success of that program led lawmakers to recommend statewide use of telepsychiatry.

“We serve a much larger number of patients with telepsychiatry than we were ever able to reach,” Sy Saeed, head of ECU’s telepsychiatry program, said in a statement released by ECU.

Saeed could not be reached for additional comment.

Shorter ER visits

The number of people in need of mental health or substance abuse care who walk into emergency rooms increased by 38 percent between 2008 and 2011, according to the N.C. Hospital Association. The length of stay for these patients rose by 65 percent between 2010 and 2012, up to about 16 hours. Rural hospitals without behavioral health staff often lack the expertise needed to decipher what, exactly, is wrong with these walk-ins and where they need to go, said Janet Ragle, director of clinical services at Wilson Medical Clinic.

Ragle said telepsychiatry will allow patients to get whatever treatment they need faster and reduce the amount of time ER staff will have to spend on such patients.

In ECU’s telepsychiatric process, a patient is first placed in a room or medical bed in the ER. A nurse then rolls in a portable cart with a monitor, camera and microphone. A psychologist or social worker on the other end of the network connection does a preliminary assessment of the patient, and then a psychiatrist conducts a full interview. The psychiatrist finally recommends a course of treatment to the doctor at the hospital who made the referral.

Wos said by investing in the program the state was “confronting one of North Carolina’s biggest and most important healthcare challenges.”

“During my travels to hospitals around North Carolina, it is apparent that improving quality and access to mental health services must be a priority,” she said in a statement.

ECU will begin the program with oversight by the DHHS Office of Rural Health and Community Care, starting in January.

Frank: 919-829-4870

News & Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service