Monday, 18 August 2003
This presentation is part of : Using Telecommunications to Improve Geriatric Mental Health Care

S003-001 Geriatric Psychiatry Telemedicine Consultation Project to Rural Nursing Homes in Virginia

David Trinkle, Department of Psychiatric Medicine, Department of Psychiatric Medicine, University of Virginia, Carilion Center for Healthy Aging, Roanoke, VA, USA

Objective: In many rural areas of the United States, nursing homes have had significant difficulty with access to geriatric psychiatry consultative services. This limits patient care, appropriate diagnosis and treatment of psychiatric disorders with high prevalence rates in nursing homes, hinders quality of life in nursing home milieus, and causes non-compliance with state and federal regulations. Recent advances in the concept of telemedicine along with recent approval for reimbursement from Medicare for telemedicine consults (including facility and professional fees), may pave the way for telemedicine to be the best immediate solution to these problems. In addition, telemedicine from sites already serving more urban nursing homes and where geriatric psychiatrists are located, may indeed prove to be the best long-term solution in that quality and standard of care will be significantly high.

We developed a protocol several years ago to implement geriatric psychiatry consultations to rural Virginia nursing homes. The goal was to not only meet the needs of nursing home residents and the nursing home administration, but to accomplish this in a simple, affordable manner that could easily be replicated in other communities. The protocol also covered many outcome measures, including patient/caregiver/staff satisfaction surveys and comparison to actual onsite visits.

This presentation will review the concept of telemedicine, standards being developed for telemedicine, and requirements for reimbursement for telemedicine, including appropriate coding. I will then review our protocol; the significant difficulties we have had in implementing this project over the last few years and the recent success we have had in getting it started. I will also review our current outcome data and give specific recommendations and protocols so that others can quickly begin similar projects in their community.

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