When Madison Maroney (name changed for privacy) He moved from Boston to Wisconsin, there was one thing that the 40-year-old woman from the East Coast could not leave behind: her weekly therapy sessions. So now, two years later, in her home in the Midwest, she opens her laptop every week, starts a session, and through a live video, speaks through her microphone with a therapist on the other side of the country..
Sure, she could have found someone new. But she had been seeing her psychotherapist for about two years and the idea of starting again felt counterproductive: "We had a very personal relationship, and this made it possible for me to continue that relationship and our work together," says Maroney.
Therapists are reporting an increase in the number of patients requesting video sessions, says Marlene M. Maheu, Ph.D., executive director of the TeleMental Health Institute. Like Maroney, many people follow video sessions with their therapists after a long distance move or while traveling on business. However, others only find it more attractive than office visits.
"TeleMental Health Institute breaks many of the access barriers that currently exist between people and the care they need," says Maheu. More than 80 million Americans live in areas with a shortage of mental health professionals, according to the U. S. Health and Human Services Health Resources and Services Administration. Meanwhile, even in urban settings where mental health professionals abound, time and money can be an obstacle for people seeking professional help. Telemental health services, such as online chat and streaming video, facilitate all this.
How does it work?
"Video therapy is not that different from in-person therapy," says Maheu. "It's talking." Together, the patient and the doctor determine the duration and frequency of their appointment and the conversation depends on the needs of the patient as well as the training of the mental health specialist. Telemental health professionals are licensed in counseling, therapy, psychology and psychiatry, and each individual has a slightly different approach.
Typically, sessions with a trained expert start with a code designed to determine if the patient has privacy, which may be a concern for patients who take their calls from home, she says. (For example, saying that a red vehicle is parked outside could mean that a family member may be listening, while a green vehicle means that no item is out of reach).Also, Maroney sets up a white noise machine at the door where he takes the call to ensure privacy in the middle of a busy house. After confidentiality is guaranteed, time is counted just like any other session in person.
The benefits are tangible: research has shown that virtual visits can be effective in stress management, anger management, social anxiety, smoking cessation, pain, depression and obsessive behavior. And published this year in Psychiatric Services, the first large-scale study of Telemental health services found that virtual visits cut the hospitalization time of mental health patients by 25 percent.
Is it right for you? Potential problems (and possible solutions)
Increase of the digital document
Not only the therapists are the ones who initiate session to visit their patients.
More and more doctors, mainly general practitioners, now offer their services in online virtual centers, such as American Well Online Care (AmericanWell.com), Teladoc. com, MDLiveCare. com and even RiteAid's NowClinic (MyNowClinic.com / RiteAid). At these sites, certified doctors can diagnose, recommend a treatment and prescribe the medication through the telephone or online video consultations.
Virtual visits can cost from US $ 10 to US $ 150, depending on insurance benefits. Many large names, such as Aetna, Blue Cross Blue Sheild, Cigna, UnitedHealth and WellPoint offer coverage for a variety of online medical consultations.
"Telemedicine increases access to care, allowing patients to see a doctor or receive care when they would not receive care in another way," says Jon Linkous, executive director of the American Association of Telemedicine for Tomorrow. He points out that more points of care are vital to maintain health amid the shortage of US doctors. According to the projections of the Association of American Medical Colleges' Center for Workforce Studies, there will be a shortage of about 63,000 doctors in 2015, with greater shortages on the horizon, 91,500 and 130,600 for 2020 and 2025, respectively.
These doctors are also expanding the care of their patients online, increasing the provision of their services through email, says Linkus. And it seems to be working. A study by Kaiser Permanente in 2010, for example, looked at more than 35,000 patients with diabetes and hypertension and found that the exchange of email between doctor and patient over a period of two months improved the effectiveness of care, with an improvement of 6, 5% in the control of glycaemia, cholesterol and blood pressure.