Adventures in telepsychiatry

I really didn’t plan to do telepsychiatry, it just happened.  Sort of like committing a crime, I had the motive, the means, and the opportunity.

I take care of a patient who can’t always get to her appointments, so I was already doing some work on the telephone with her. I really don’t like to do telephone appointments, but that’s the best a patient and I can do sometimes, and a telephone call beats no contact at all. The problems with telephone appointments are that they take a lot of concentration on my part because I can’t see the person I talking to, and it’s really easy for one of us to misunderstand the other without all the cues that come from being able to see each other.

I had a webcam, and a Skype account already, which I was planning  to use to talk with family members.

The patient and I were trying to unsnarl a minor miscommunication over the phone, when she said:

Wouldn’t it be a lot easier to do this with Skype?”

“Well, I guess we could try it,” I said.

It took about two minutes to get the cameras working, but then we were back to work, and it was clear after about ten seconds that our communication was a lot better than it would have been if we had  both been staring out the window and talking to each other on the phone.

I was really pleased that I had listened to her suggestion.

Through the rest of the day, I though about this Skype call, and by the evening, I was really struck by three ideas:

• I thought that the quality of communication on the Skype call wasn’t quite as good as a face-to-face meeting, but it was amazingly better than  just using the telephone,
• I could see that using Skype for psychiatry could potentially lead, not just to some big changes in my practice, but in psychiatry in general, and
• I had no idea what I was doing.

So, I decided to find out a little more about telepsychiatry, and since I had been thinking about something fun to blog about, I decided to chronicle what I discovered in case other people might be interested.