Patient and Clinician Perspectives on Two Telemedicine Approaches for Treating Patients with Mental Health Disorders in Underserved Areas

Hall, Jennifer; Danna, Maria; Hoeft, Theresa J.; Solberg, Leif I.; Takamine, Linda; Fortney, John C.; Nolan, John P.; Cohen, Deborah J.

doi:10.3122/jabfm.2022.03.210377

Cited by 11 publications

(7 citation statements)

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“…Screening for depression and provision of appropriate mental health care are important for preventing and managing PND 3,44 . To address the availability of care in rural settings, if broadband capabilities exist, telehealth offers an option to provide trained specialists who can screen, refer, and treat depression in low‐resourced areas 18,45 . Other ways to address mental health conditions in rural communities include focusing on preventive measures in community settings and educating the community about the importance of treatment and prevention 46 ; recruiting and retaining a quality workforce 47 ; engaging nontraditional mental health professionals 48 ; integrating mental health services into primary care 49 ; and providing community‐based supports and services 50 .…”

Section: Discussionmentioning

confidence: 99%

Rural/urban differences in health care utilization and costs by perinatal depression status among commercial enrollees

Pollack

Chen

Cox

et al. 2023

The Journal of Rural Health

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PurposeTo understand differences in health care utilization and medical expenditures by perinatal depression (PND) status during pregnancy and 1‐year postpartum overall and by rural/urban status.MethodsWe estimated differences in health care utilization and medical expenditures by PND status for individuals with an inpatient live‐birth delivery in 2017, continuously enrolled in commercial insurance from 3 months before pregnancy through 1‐year postpartum (study period), using MarketScan Commercial Claims data. Multivariable regression was used to examine differences by rurality.FindingsTen percent of commercially insured individuals had claims with PND. A smaller proportion of rural (8.7%) versus urban residents (10.0%) had a depression diagnosis (p < 0.0001). Of those with PND, a smaller proportion of rural (5.5%) versus urban residents (9.6%) had a depression claim 3 months before pregnancy (p < 0.0001). Compared with urban residents, rural residents had greater differences by PND status in total inpatient days (rural: 0.7, 95% confidence interval [CI]: 0.6–0.9 vs. urban: 0.5, 95% CI: 0.5–0.6) and emergency department (ED) visits (rural: 0.7, 95% CI: 0.6–0.9 vs. urban: 0.5, 95% CI: 0.4–0.5), but a smaller difference by PND status in the number of outpatient visits (rural: 9.2, 95% CI: 8.2–10.2 vs. urban: 13.1, 95% CI: 12.7–13.5). Differences in expenditures for inpatient services by PND status differed by rural/urban status (rural: $2654; 95% CI: $1823–$3485 vs. urban: $1786; 95% CI: $1445–$2127).ConclusionsCommercially insured rural residents had more utilization for inpatient and ED services and less utilization for outpatient services. Rural locations can present barriers to evidence‐based care to address PND.

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Section: Discussionmentioning

confidence: 99%

Rural/urban differences in health care utilization and costs by perinatal depression status among commercial enrollees

Pollack

Chen

Cox

et al. 2023

The Journal of Rural Health

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“…Indeed, participants who were initially reluctant to use virtual care for mental healthcare identified an ongoing hybrid model of virtual and in-person care as important for supporting access to care for some clients and families. Additionally, access to collaborative activities such as case conferences, meetings and conferences or training activities may be supported by virtual technologies 27…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, access to collaborative activities such as case conferences, meetings and conferences or training activities may be supported by virtual technologies. 27 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, access to collaborative activities such as case conferences, meetings and conferences or training activities may be supported by virtual technologies. 27 The CAPA model adopted by the IWK CMHA service is a client-and family-centred model of mental healthcare rooted in principles of shared decision-making and matching care to client and caregiver needs. 14 15 Matching service modality to those needs adds a layer of consideration to decision-making regarding treatment options.…”

Section: Open Accessmentioning

confidence: 99%

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Understanding the uptake of virtual care for first and return outpatient appointments in child and adolescent mental health services: a mixed-methods study

Campbell,

Clark,

Chorney

et al. 2023

BMJ Open

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ObjectiveTo describe patterns of virtual and in-person outpatient mental health service use and factors that may influence the choice of modality in a child and adolescent service.DesignA pragmatic mixed-methods approach using routinely collected administrative data between 1 April 2020 and 31 March 2022 and semi-structured interviews with clients, caregivers, clinicians and staff. Interview data were coded according to the Consolidated Framework for Implementation Research (CFIR) and examined for patterns of similarity or divergence across data sources, respondents or other relevant characteristics.SettingChild and adolescent outpatient mental health service, Nova Scotia, Canada.ParticipantsIWK Health clinicians and staff who had participated in virtual mental healthcare following its implementation in March 2020 and clients (aged 12–18 years) and caregivers of clients (aged 3–18 years) who had received treatment from an IWK outpatient clinic between 1 April 2020 and 31 March 2022 (n=1300). Participants (n=48) in semi-structured interviews included nine clients aged 13–18 years (mean 15.7 years), 10 caregivers of clients aged 5–17 years (mean 12.7 years), eight Community Mental Health and Addictions booking and registration or administrative staff and 21 clinicians.ResultsDuring peak pandemic activity, upwards of 90% of visits (first or return) were conducted virtually. Between waves, return appointments were more likely to be virtual than first appointments. Interview participants (n=48) reported facilitators and barriers to virtual care within the CFIR domains of ‘outer setting’ (eg, external policies, client needs and resources), ‘inner setting’ (eg, communications within the service), ‘individual characteristics’ (eg, personal attributes, knowledge and beliefs about virtual care) and ‘intervention characteristics’ (eg, relative advantage of virtual or in-person care).ConclusionsShared decision-making regarding treatment modality (virtual vs in-person) requires consideration of client, caregiver, clinician, appointment, health system and public health factors across episodes of care to ensure accessible, safe and high-quality mental healthcare.

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“…The referral approach is more effective for patients with higher complexity or a desire for specific psychotherapy. 9 , 58 In patients suffering from chronic respiratory diseases, the possibility of monitoring different physiological parameters of patients during their daily routine activities using digital devices is one of the advantages of remote treatment. 14 Information is stored on a smartphone and available to the doctor.…”

Section: Telemedicine Applicationmentioning

confidence: 99%

Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study

Ansarian,

Baharlouei

2023

Arch Iran Med

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Today, technology has an important impact on the development of medical services, especially during the outbreak of COVID-19. Telemedicine, known by terms such as telehealth and digital health, refers to the utilization of technology to provide health care services at a distance that leads to improved monitoring, detecting and treatment of disease, and provision of individual care. It has been considered in various fields such as radiology, cardiology, pulmonology, psychiatry, emergency care and surgery. The most important advantages of using telemedicine are saving time for the doctor and the patient, reducing the cost of multiple visits to the doctor, reducing the spread of contagious diseases and caring for patients who cannot see a doctor, such as the elderly. In this paper, we review the research in the field of applying telemedicine, as well as its advantages and disadvantages. Next, we discuss the challenges in the field of using telemedicine which are privacy preserving, data security, cost of infrastructures, lack of physical examination and responsibility for patients’ compensation. One of the most important challenges is privacy preserving of patients’ information during transmission and process. We categorize and compare the various methods that have been proposed to protect peoples’ privacy.

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Patient and Clinician Perspectives on Two Telemedicine Approaches for Treating Patients with Mental Health Disorders in Underserved Areas

Cited by 11 publications

References 0 publications

Rural/urban differences in health care utilization and costs by perinatal depression status among commercial enrollees

Rural/urban differences in health care utilization and costs by perinatal depression status among commercial enrollees

Understanding the uptake of virtual care for first and return outpatient appointments in child and adolescent mental health services: a mixed-methods study

Applications and Challenges of Telemedicine: Privacy-Preservation as a Case Study

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