Asynchronous Telepsychiatry - outcomes and effectiveness

Principal Investigator:  Peter Yellowlees, M.B.B.S., M.D.

This study will examine whether viewing videotaped interviews of patients to assess them and guide their mental-health treatment is more cost-effective and results in better patient outcomes and satisfaction than in person telepsychiatric evaluation. This project addresses a critical public mental-health problem: The need to improve access to high-quality mental-health services for diverse populations by implementing an efficient, simple health information technology solution.

The study will involve videotaping interviews of patients and their primary care providers in their primary care clinic that are later viewed and evaluated by psychiatrists who make diagnostic evaluations and treatment plans that can be carried out by their primary care physicians and community therapists. This approach is called “store-and-forward” or asynchronous telepsychiatry, because the patient is not being evaluated in real time.

The study will compare the effectiveness of this style of telepsychiatry to real-time, or synchronous telepsychiatry, in which a psychiatrist evaluates patients in their primary-care offices via live, interactive videoconferencing. In both instances, the psychiatrist will provide primary-care providers with an assessment and treatment plan and will be available for follow-up consultation by phone or email.

Asynchronous technology is used extensively for such specialties as dermatology, pathology and radiology, where photos of skin conditions, slides or X-rays are sent electronically for expert evaluation. UC Davis researchers have spearheaded its use for psychiatry evaluations over several years. The approach is generally used to assess patients with mood disorders, substance abuse disorders, or anxiety disorders and is not intended to replace traditional psychotherapy.

The current investigation will involve 250 English and Spanish-speaking adults receiving treatment over two years each. The study also seeks to refine the technical approaches to asynchronous telepsychiatry in a clinical setting, identify which are the most clinically and cost-effective techniques to use, examine patient and provider satisfaction, and whether particular patient groups benefit more than others.