Garoni D, Sarantidis D, Katsadoros K
KLIMAKA for the Development of Human and Social Capital.
Telepsychiatry Section, Hellenic Psychiatric Association, Athens, Greece.
Psychiatriki. 2016 Oct-Dec;27(4):287-295. doi: 10.22365/jpsych.2016.274.287.
Telepsychiatry was introduced in the early 1950's for the provision of mental health services from a distance. In 1990 the progress made in telecommunications technologies caused a significant expansion in telepsychiatry services. It can refer to store and forward technologies, interactive technologies, remote monitoring technologies and it is applied to contribute to the lift of restrictions placed on providing mental health services. Restrictions may exist due to geographic isolation, lack of specialized services, high cost of moving patients etc. The positive cost-benefit analysis and the reliability of diagnosis and efficacy of interventions through telepsychiatry have been documented in various research papers referring to a wide range of contexts such as prisons, remote areas, general and psychiatric hospitals. Since 2003 the Mobile Mental Health Unit of South- Eastern (SE) Cyclades has been using videoconferencing in order to provide mental health services in thirteen islands. This area shares many of the characteristics of remote areas such as residential dispersion, lack of mental health services and frequent lack of access to services in urban centers. Telepsychiatry in conjunction with physical presence of professionals was launched by the Mobile Mental Health Unit in order to provide assistance to the evaluation of patients, to therapeutic interventions, to medicine prescription, to crisis intervention, to psychoeducation of patients and their families and to the implementation of educational and administrative activities . The use of existing technology in combination with the development of human resources has enabled continuity of care, crisis intervention and avoidance of involuntary hospitalization for a significant number of persons. Moreover, it has improved cooperation and coordination between the interdisciplinary team and local authorities and agencies. When professionals located in different parts are collaborating via telepsychiatry it is necessary to ensure that they have immediate and simultaneous access to data concerning the patient. This need is served by the electronic medical record that facilitates access to patient records, improves the quality of care, reduces the probability of making wrong decisions and contributes to the promotion of research and service evaluation. KLIMAKA's electronic medical record contains more than ten thousand cases of which 4544 are related to individuals served by the Mobile Mental Health Unit during the years 2003-2010. This article presents the basic functions and parameters of the electronic medical record, the applications of telepsychiatry in the whole range of services provided by the scientific staff and provides information on how human and technology resources are distributed to the branches of the Mobile Mental Health Unit of SE Cyclades.
远程精神病学于20世纪50年代初被引入，用于从远处提供心理健康服务。1990年，电信技术取得的进展使远程精神病学服务得到了显著扩展。它可以指存储转发技术、交互式技术、远程监测技术，并且被应用于有助于解除对提供心理健康服务所施加的限制。限制可能由于地理隔离、缺乏专业服务、转移患者的高成本等原因而存在。在各种研究论文中，针对监狱、偏远地区、综合医院和精神病医院等广泛背景，记录了远程精神病学的积极成本效益分析以及干预措施诊断和疗效的可靠性。自2003年以来，东南基克拉泽斯群岛的移动心理健康部门一直在使用视频会议，以便在13个岛屿上提供心理健康服务。该地区具有许多偏远地区的特征，如居民分散、缺乏心理健康服务以及在城市中心经常无法获得服务。移动心理健康部门推出了远程精神病学与专业人员实地出诊相结合的服务，以便为患者评估、治疗干预、药物处方、危机干预、患者及其家属的心理教育以及教育和行政活动的开展提供帮助。利用现有技术并结合人力资源开发，使得大量患者能够获得持续护理、危机干预并避免非自愿住院治疗。此外，它还改善了跨学科团队与地方当局及机构之间的合作与协调。当位于不同地点的专业人员通过远程精神病学进行协作时，有必要确保他们能够即时同时获取有关患者的数据。电子病历满足了这一需求，它便于获取患者记录，提高了护理质量，降低了做出错误决策的可能性，并有助于促进研究和服务评估。KLIMAKA的电子病历包含一万多例病例，其中4544例与移动心理健康部门在2003年至2010年期间服务的个人有关。本文介绍了电子病历的基本功能和参数、远程精神病学在科研人员提供的全方位服务中的应用，并提供了有关人力和技术资源如何分配到东南基克拉泽斯群岛移动心理健康部门各分支机构的信息。
