Therapy sessions conducted over video chat are bound to become the norm as the coronavirus pandemic rages on, requiring patients of all ages to self-isolate.
As the coronavirus outbreak sweeps through the United States and Europe, compelling government leaders to issue city- and state-wide lockdowns, more people, especially seniors, who are most at risk of infection, are isolating themselves in their homes.
Mental healthcare providers and patients are now turning to telepsychiatry for their checkups and medicine management. Telepsychiatry is a tried-and-true form of care that allows homebound patients to seek care comparable to what they would receive in person.
“Doctors can reach patients in their homes, meet patients where they are,” said Dr. Shabana Khan, a member of the American Psychiatric Association’s telepsychiatry committee. “It’s a very effective tool to get care where it needs to be. It’s used for cognitive behavior therapy, trauma therapy, medicine prescribing.”
Telepsychiatry can be especially helpful to elderly patients who are unable to travel to a doctor’s office in person. A 2018 study of seniors with an average age of 75 found not only that over 80% of patients were able to see and hear their doctors clearly on video chat but also that 90% felt comfortable discussing sensitive topics.
As the coronavirus pandemic rages on, seniors will need increased access to telemedicine services. Traditionally, Medicare would only cover the cost of telehealth services on a limited basis, and beneficiaries would have to pay their regular copays and meet their deductibles as with any other medical service. On March 6, however, the Centers for Medicare and Medicaid Services announced that the agency would waive telehealth copayments for Medicare beneficiaries for the duration of the coronavirus public health emergency.
“These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus,” CMS administrator Seema Verma said in the White House briefing room March 17.
Increasing access to telepsychiatry services will also free up space in hospitals and emergency departments, the first stop for many people who start exhibiting coronavirus symptoms.
“Clinicians on the front lines will now have greater flexibility to safely treat our beneficiaries,” Verma added.
Young adults can benefit from telepsychiatry as well. Dr. Khan, who also co-chairs the American Academy of Child and Adolescent Psychiatry’s telepsychiatry committee, said sessions over video chats work well for adolescents and children with some forms of autism and anxiety disorders.
“When we’re seeing a patient by video and they’re at a pediatrician’s office or at a community mental health center or school programs, we’ll have staff on sight with nurses to monitor vitals, and with social workers,” Khan said.
If patients need medication as part of their treatment, psychiatrists can write prescriptions without having to see the patient in person. Machines on the patient’s end can measure blood pressure and take other vital signs and send the results to the prescribing physician in his or her office.
“That’s one model where we make sure we’re getting the information we need. At home, patients may be able to gather that data to be transferred to our electronic medical records, and we also do regular safety assessments,” Khan said.
Patients are sometimes hesitant to upload medical records electronically, though, because of privacy concerns. Laws under the Health Insurance Portability and Accounting Act, or HIPAA, are designed to keep a patient’s medical history confidential. However, recent high-profile security breaches, such as the 2017 Equifax data breach, which exposed the private financial records of about 150 million people, make people cautious about disclosing their personal records.
As part of his administration’s decision to waive telehealth fees for Medicare beneficiaries, Trump announced that, at least for now, penalties for HIPAA violations would not be enforced. Still, a majority of patients are willing to try telehealth if it means receiving better care at a lower cost.
Researchers and members of the White House coronavirus task force do not yet know how long the coronavirus outbreak will last or for how long people will have to remain in isolation. Even if the virus remains at large for months, Khan said physicians would be prepared to provide telehealth care to their patients.
“Hospital systems, professional organizations, and policymakers are making a lot of changes to make sure we have treatment when it’s needed,” Khan said. “And if there were to be an increase in individuals seeking mental healthcare, we’re going to account for that.”
