After the widespread introduction of telemedicine during the COVID pandemic, various medical specialties found utility in continuing to use this process. While some specialties that required constant direct physical contact found that telemedicine was not a viable long-term solution, other areas found it to meet patient and provider needs in a way that was more convenient than in-person appointments. Telepsychiatry, or the use of two-way videoconferencing for psychiatric appointments, has continued as a high-use case, with over 90% of mental health providers continuing to do some or all appointments virtually.

Telemedicine and the Wild West of Security

When telemedicine was rolled out, it was often from necessity, and the speed of rolling it out necessitated using whatever equipment and network protocols were already in place. Rather than creating a traditional implementation plan with workflows rolled out and security discussed, there was an emphasis on putting software in place and not looking at anything else; the goal was to facilitate appointments now. Software ranged from consumer software with light security to professional applications that were HIPAA compliant.

Unfortunately, even the most dedicated IT specialists found themselves at a bit of a loss if they hadn’t worked on externally facing telemedicine products. External IT firms quickly learned that meeting HIPAA and HITECH standards wasn’t a matter of meeting a checkbox; rather than traditional security metrics, these regulations provide guidance that needs to be met, but never a clear way to test whether this standard was met. This created a wild west scenario where each group had its own implementation and hoped for compliance, realizing that missing compliance could cost significant penalties if PHI was leaked.

Telepsychiatry: A Wide Use Case

As mentioned earlier, one of the largest continuing uses of telemedicine is psychiatry. As a specialty that often does not require physical contact, specifically in ongoing management appointments, both providers and patients found having appointments over videoconference to be more convenient, with mental health providers being able to cover multiple offices, and patients being able to have a high rate of showing up to appointments as travel and need for time off for an appointment were removed as barriers to care.

Retrain Your Staff or Outsource?

Adding telepsychiatry to an existing medical practice may seem simple; a matter of adding video software and email reminders to make sure patients have a link to click into either a stand-alone video application or one built into an electronic health record. However, when looked at as a combination office and IT project, it becomes clear that there are additional steps involved, as this is an entirely new service, not just a variation of an old one.

A clinic has two basic options when adding or replacing traditional services with telepsychiatry: either training staff on new processes or using a telepsychiatry outsourcing firm. The advantages of training staff are keeping existing processes similar; keeping the same basic roles and responsibilities among the same people a clinical provider and patients already know; and a lower cost. The disadvantage is limited support; the need to decide on software, health records, and video without experience; and a need to decide on equipment and processes from scratch.

Outsourced telepsychiatry staffing services, such as FasPsych, will create a plan based on experience; help purchase and set up any needed equipment, software, or electronic health record; ensure security compliance with all needed standards; assist with the use of billing codes; and possibly integrate your services into a network to ensure full-service utilization. The downside of outsourcing can be the additional costs involved and possible issues if leaving the outsourcing group; however, these can be mitigated if you ensure your plans meet the services offered by the outsourcing group.

Next Steps

If telemedicine for psychiatry works best with insourcing for your group, then the next step would be to begin to research EHR and video software. If outsourcing works better, then contacting a leading telepsychiatry staffing firm would be the next step.