Videophones for intensive case management of psychiatric outpatients

Abstract

When visiting patients with serious mental illness at their homes, case managers carried a portable videophone. This was used to access the hospital clinical team via the home telephone line, when an acute clinical need arose in addressing questions related to medication management and treatment planning; travel was therefore avoided. In an acceptability study lasting 12 months, 24 patients received the supplemental videophone mental health service and 19 of them completed a satisfaction survey. Only one patient was not satisfied with the videophone treatment, while 74% of them were very satisfied. Specific areas of satisfaction concerned the savings of time and travel, assistance with medication questions and increased involvement in treatment. No patient reported any difficulty in using the equipment. Staff members were enthusiastic about the decrease in travel time and there were no complaints about the videophone process or encounters. During the study, 135 h of the case manager's time was saved by using the videophone for urgent access visits, equivalent to a saving of $4000 in salary costs. In addition, the patients saved 135 h in travel time. We believe that there are other potential uses of videophones for seriously mentally ill patients, including discharge planning, intensive post-discharge monitoring and transition to community life.

Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review

“…[28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] The only study published prior to 2007 involved a telehealth digital intervention. 45 Most of the studies used mixed methods, 28,29,31,32,34,35,[37][38][39][40][41][42][43][44][45][46][47][48][49][50] four used quantitative methods 30,33,36,51 and two studies used qualitative methodology. 52,53 The majority of the studies were feasibility and acceptability trials (42%), 29, 35, 36, 38, 40, 42-44, 50, 53 eight were designed to look specifically at implementation (31%), 28, 30, 32, 45-47, 49, 52 five were pilot studies (19%), 31,39,…”

“…44,53 Staff spoke of a telehealth intervention being particularly suited to supporting those who had a need or incentive to stay at home. 50 Digital interventions were also reported to aid communication and help build relationships between users and their medical team. 32,41,44,48 In a shared decision-making intervention for psychotropic medication, it was reported that users were able to disclose information that they felt uncomfortable or unable to tell a clinician directly, for example, about drug and alcohol relapse, pregnancy plans, wanting "hip-hop abs", and general concerns about using medication.…”

Satisfaction Ratings After Receiving Internet-Based Cognitive Rehabilitation in Persons with Memory Impairments After Severe Acquired Brain Injury

“…Four reviews of literature concerning patient satisfaction with telemedicine services show that satisfaction is high, generally over 80% and often reported at 100%. [7][8][9][10] Four studies, two with individuals who experienced a stroke, 11,12 one with inpatients in a gero-psychiatric setting, 13 and one with psychiatric outpatients, 14 have shown high satisfaction with videoconferencing, 11,13 virtual reality therapy, 12 and videophone usage. 14 Another study that provided patients with a range of problems (e.g., weight concerns, self-esteem issues, personality disorders) with five free sessions of cognitive-behavioral therapy via videoconferencing between separate hospital rooms showed high patient and therapist satisfaction.…”

Automated telehealth for managing psychiatric instability in people with serious mental illness

“…Among telehealth approaches for treating SMI, a mobile phone-based program that involved weekly completion of a 10-item early warning sign questionnaire, and online alerts sent to the treating psychiatrist if scores exceeded a given threshold, was shown to reduce hospitalizations in people with schizophrenia (Spaniel et al, 2008). Other telehealth interventions targeting this vulnerable group include video-conferencing (Nieves et al, 2009), informational websites (van der Krieke et al, 2012), telephone-based therapy (Cook et al, 2008), and smartphone-based interventions in early development that consist of frequent real-time symptom self-assessment and monitoring (Ben-Zeev et al, 2013). …”