Telemedicine in children and adolescents

Abstract

Psychiatric care for children and adolescents is limited in remote and underserved areas because of the shortage of child and adolescent psychiatrists. Telepsychiatry has the potential to alleviate this problem. This article reviews the procedures used to develop telepsychiatry, equipment needed for videoconferencing in telepsychiatry, benefits and limitations of telepsychiatry, and confidentiality issues in telepsychiatry. Many questions regarding confidentiality, legality, reimbursement, cost-effectiveness, and technology still need to be resolved. However, telepsychiatry has the potential to be a useful treatment alternative.

Masthead

“…Estimates of young people with psychological or psychiatric problems who are seen in primary care range from 15 to 40% (Clatney et al 2008;Hilty et al 2009;Stretch et al 2009). Consequently, a large burden of responsibility for children's mental health falls on family practitioners, pediatricians, nurses and nurse practitioners ), social workers and child and youth workers (Provincial Centre of Excellence for Child and Youth Mental Health 2006), many of whom feel inadequately trained, ill equipped and uncomfortable in both recognizing and managing child and adolescent psychiatric disorders (Fremont et al 2008;Paing et al 2009). …”

Remote care of a patient with stroke in rural Trinidad: use of telemedicine to optimise global neurological care

“…We report this case to not only illustrate how this model of teleneurology can be successfully implemented at all levels of neurological care of individuals with severe multiple strokes,6 7 but to also collate the available data on the use of teleneurology in the remote care of patients with many other neurological diseases and injuries6 8 9 such as multiple sclerosis,10 11 dementia,12 epilepsy,13 neurosurgical care,14 Alzheimer’s disease,15 Parkinson’s disease,16 traumatic brain injury,17 neuro-ophthalmological conditions,17 neurophysiological disorders,17 abnormal movement disorders,17 post-traumatic headache,17 children and adolescent neurological diseases,18 migraine,19 spinal cord injury,20 21 neuro-oncological problems,22 neuropathological problems,23 stroke t-PA treatment,24 neurocritical care25 26 and pain care 27. Furthermore, deep brain stimulation via telemedicine is currently used for patients with essential tremor,28 Parkinson’s disease,16 and primary dystonia,29 and is under investigation for epilepsy, obsessive-compulsive disorder, Alzheimer disease, depression and other movement disorders 30.…”

Furthering the reliable and valid measurement of mental health screening, diagnoses, treatment and outcomes through health information technology

“…In recent years this scenario has been expanded through new technologies including telemedicine [32–35] and computerized questionnaires, some implementing computerized adaptive testing methodologies [36–40]. In this latter approach assessments are tailored to the individual through the use interactive response technology or branching logic based on specific responses to questions or characteristics (e.g.…”