Dr. Edward Kaftarian on Telepsychiatry

In this installment of "Your Questions Answered," Psych Congress Steering Committee member Edward Kaftarian, MD, responds to questions asked by attendees of a Psych Congress 2020 session he presented on telepsychiatry. Dr. Kaftarian is CEO of Orbit Health Telepsychiatry, Encino, California, a member of the American Psychiatric Association’s Telepsychiatry Committee, and former vice chair of mental health for the American Telemedicine Association.

Q: How does the standard of care for telepsychiatry compare to the standard of care of in-person care?

A: Standard of care for psychiatry can be interpreted as what a reasonable or prudent clinician would do for the patient, depending on the circumstances. There are some limitations to telepsychiatry, such as an inability to physically touch the patient during an examination. Nevertheless, the basic approach to assessing and treating a patient remains the same, regardless of whether a patient is seen by telepsychiatry or in-person. Some state medical boards, like in California, explicitly state that the standard of care for telemedicine is the same as in-person, while other states do not address this issue at all. Ultimately, psychiatry providers would be prudent to consider the standard of care for telepsychiatry in much the same way as in-person care. 

More information can be found here.

Q: Is it appropriate to use telepsychiatry in inpatient settings?

A: The short answer is “yes.” Telepsychiatry for inpatients is nothing new and has demonstrated significant value for understaffed institutions. It is also a favorite way for psychiatrists to work. However, keep in mind the importance of the psychiatrist and onsite staff maintaining good communication. This is helpful in order to share relevant updates regarding the patient’s status and to coordinate care.

More information can be found here.

Q: How do you make sure patients have adequate equipment and a good internet connection before the appointment time?

A: Testing your bandwidth can easily be done by going to several speed test sites online. These sites will tell you both the upload and download speeds. Although audio and video can be run directly through the computer, sometimes the factory camera, speaker, and/or microphone that comes with the computer is not of the highest quality. Audio can be optimized by purchasing a microphone/speaker combination device. Video can be optimized by purchasing a webcam device. Both devices are easy to use and work automatically when plugged into the USB port. Audio and video settings can be accessed in the settings of the computer.

More information can be found here.

Read more on telepsychiatry:
Using Telehealth to Treat Adults With Cognitive Impairment
Transition to Virtual Mental Health Care Occurred Rapidly in Pandemic’s Early Weeks
Telepsychiatry Program Increases Rate of ED Discharges to Home