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EP-116 - A Pilot Study Examining the Use of Asynchronous and Synchronous Telepsychiatry in Skilled Nursing Facilities

Monday, April 30
9:55 AM - 10:10 AM
Location: Education Zone, Booth 2416, Screen 2

Background: For over 30 years, real-time synchronous telepsychiatry (STP) has been the traditional method of delivering psychiatric care to areas with provider shortages. However, STP is under-utilized because of administrative and cost barriers, problems that could be overcome by using a novel telepsychiatry model, asynchronous telepsychiatry (ATP). This pilot study assessed the acceptability and feasibility of ATP for skilled nursing facility (SNF) populations by comparing it to STP in a 12-month, randomized clinical study.

Methods: The study was conducted at two SNFs in the greater Sacramento, California area. The first served as a post-acute rehabilitation and skilled nursing facility (98 beds), while the second operated as a dementia and Alzheimer's nursing facility (150 bed). Both SNFs lacked on-site psychiatric services. Participants included in the study, average age of 74 (range 44 to 96), were SNF residents with non-emergent psychiatric issues. Each had multiple chronic medical problems in addition to their psychiatric symptoms.

STP consultations, scheduled based on the patients' and psychiatrist's availabilities, were typically conducted in a clinic-like manner wherein multiple STP consultations were conducted over a half-day period. ATP interviews consisted of a patient interview conducted by the SNF onsite facility social services staff using the MINI questionnaire. ATP video-recorded consultations were then stored and viewed by the treating psychiatrist. Consultation notes were generated within 5 days. Follow-up STP and ATP consultations occurred at 6 and 12 months.

The primary outcome measurement was the psychiatrist-completed Clinical Global Impression (CGI). We also examined the medication recommendations reduction or addition of medications made by the psychiatrist. Finally, participant responses to a modified version of the Parent Telemedicine Satisfaction Survey were collected.

Conclusion: We will present the clinical outcome measures data generated over the course of the study. We will also analyze these data to show that ATP has the potential to be a viable alternative to STP for delivering telepsychiatry to SNF populations.

Learning Objectives:

Glen Xiong

Associate Clinical Professor
University of California at Davis

Dr. Xiong is affiliated with the University of California at Davis where he has worked with Dr. Yellowlees on studies involving asynchronous compared to synchronous telepsychiatry for nearly 10 years. He is presently works part-time with UC Davis, and also serves as Medical Director of Mental Health for Doctor On Demand. He recently received a NIH funded award from the Agency of Healthcare Quality & Research to study telepsychiatry in skilled nursing facilities. He is board certified in Internal Medicine, Psychiatry, and Post-Acute/Long-term Care Medicine.

Presentation(s):

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Michelle Parish

SRA 4 Supervisor, Research Project Manager at UC Davis Health System
University of California at Davis

Michelle Burke Parish is a project manager in clinical research at the University of California, Davis in the Department of Psychiatry and Behavioral Sciences. Mrs. Burke Parish has a Masters Degree in Psychology and is a candidate for a Doctor of Philosophy in Nursing Science and Healthcare Leadership at the University of California, Davis. She has participated in research in clinical psychology, neuroscience and telepsychiatry and e-health. She is a contributing author in the area of telemedicine, e-health and applications of social media in healthcare.

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