Researchers at UC Davis have received a five-year, $2.5 million grant to study whether viewing videotaped interviews with patients to assess them and guide their mental-health treatment is more cost-effective and better for patient outcomes and satisfaction than real-time telepsychiatric evaluation.
The study will involve videotaping interviews of patients and their providers in their primary-care clinic that later are viewed and evaluated by psychiatrists, who will make diagnostic evaluations and treatment plans that can be carried out by primary-care doctors and community therapists. This approach is called “store-and-forward,” or asynchronous telepsychiatry, because the patient is not being evaluated in real time.
The research will compare the effectiveness of this style of telepsychiatry to real-time, or synchronous telepsychiatry, in which a psychiatrist evaluates patients via live, interactive videoconferencing. In both approaches, the psychiatrist provides primary-care providers with assessments and treatment plans and is 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 study principal investigator is Peter Yellowlees, professor in the Department of Psychiatry and Behavioral Sciences and Director of the Graduate Program in Health Informatics. Yellowlees is an international leader in the use of telepsychiatry to expand the availability of psychiatric consultation.
“Using store-and-forward technology allows us to provide opinions to primary-care doctors much more quickly than would usually be the case,” Yellowlees said. “We’ve demonstrated that this approach is feasible and very efficient in earlier research, and patients report that it is highly convenient for them as they are able to have their full evaluation done in their primary-care office.”
The current investigation will involve 250 English- and Spanish-speaking adults receiving treatment over two years in their primary-care setting. The study also seeks to refine the technical approaches to using asynchronous telepsychiatry in a clinical setting, identifying which techniques are the most clinically and cost-effective, examining patient and provider satisfaction, and determining certain particular patient groups derive more benefit than others.
“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,” Yellowlees said.
The grant is funded by the Agency for Healthcare Research and Quality of the U. S. Department of Health and Human Services. Additional researchers include Donald Hilty, Alberto Odor, Ana-Maria Iosif, Paul Leigh, Michelle Parish, Mina Hah, Glen Xiong and Robert McCarron, all of UC Davis, and Jay Shore of the University of Colorado.