Tower of Babel Problem in Telehealth: Addressing the Health Information Exchange Needs of the North Carolina Statewide Telepsychiatry Program (NC-STeP).

Telepsychiatry is a viable option for providing psychiatric care to those who are currently underserved or who lack access to services. While the current technology is adequate for most uses, and continues to advance, there remain barriers to its widespread utilization. One such barrier when working with different healthcare systems is that they utilize different electronic medical record systems (EMRs). This paper describes the experience of the North Carolina Statewide Telepsychiatry Program (NC-STeP) with this problem and how the program successfully resolved it by establishing a web portal that connects participating hospital emergency departments and remote psychiatric providers to share secure electronic health information regarding patient encounters across different EMRs. The Portal also facilitates scheduling, status tracking, and reporting on each patient encounter, as well as delivers the necessary data for the billing to process charges for each consult and to administrators for the operation of the program. The portal effectively bridges the needs of the multiple actors in the telepsychiatry virtual encounter. It provides an efficient experience for the patient and the point-of-care provider, a reliable document exchange for the psychiatric provider, and effective record keeping for the billing and government entities.