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远程精神病学的最新进展及其如何利用协作式、递进式和整合式服务来支持初级保健。

An Update on Telepsychiatry and How It Can Leverage Collaborative, Stepped, and Integrated Services to Primary Care.

机构信息

Mental Health, Northern California, Veterans Administration Health Care System, Mather, CA; Department of Psychiatry & Behavioral Sciences, UC Davis, 10535 Hospital Way, Mather, CA 95655 (116/SAC).

Departments of Psychiatry and Family Medicine, Burlington, Vermont; Division of Consultation Psychiatry and Psychosomatic Medicine, University of Vermont College of Medicine, Burlington, Vermont; University of Vermont Medical Center, Burlington, Vermont.

出版信息

Psychosomatics. 2018 May-Jun;59(3):227-250. doi: 10.1016/j.psym.2017.12.005. Epub 2017 Dec 26.

Abstract

INTRODUCTION

In this era of patient-centered care, telepsychiatry (TP; video or synchronous) provides quality care with outcomes as good as in-person care, facilitates access to care, and leverages a wide range of treatments at a distance.

METHOD

This conceptual review article explores TP as applied to newer models of care (e.g., collaborative, stepped, and integrated care).

RESULTS

The field of psychosomatic medicine (PSM) has developed clinical care models, educates interdisciplinary team members, and provides leadership to clinical teams. PSM is uniquely positioned to steer TP and implement other telebehavioral health care options (e.g., e-mail/telephone, psych/mental health apps) in the future in primary care. Together, PSM and TP provide versatility to health systems by enabling more patient points-of-entry, matching patient needs with provider skills, and helping providers work at the top of their licenses. TP and other technologies make collaborative, stepped, and integrated care less costly and more accessible.

CONCLUSION

Effective health care delivery matches the intensity of the services to the needs of a patient population or clinic, standardizes interventions, and evaluates both process and clinical outcomes. More research is indicated on the application of TP and other technologies to these service delivery models.

摘要

简介

在以患者为中心的护理时代,远程精神病学(TP;视频或同步)提供了与面对面护理一样好的优质护理,促进了获得护理的机会,并利用远程广泛的治疗方法。

方法

本文是一篇概念性综述文章,探讨了 TP 在新型护理模式(如协作式、阶梯式和整合式护理)中的应用。

结果

身心医学(PSM)领域已经开发了临床护理模式,教育了跨学科团队成员,并为临床团队提供了领导力。PSM 具有独特的优势,可以指导 TP 并在未来的初级保健中实施其他远程行为健康护理选择(例如,电子邮件/电话、心理/心理健康应用程序)。PSM 和 TP 一起通过使更多的患者进入点、匹配患者需求与提供者技能、帮助提供者在其执照范围内工作,为医疗系统提供了多功能性。TP 和其他技术使协作式、阶梯式和整合式护理更具成本效益和可及性。

结论

有效的医疗保健服务将服务的强度与患者群体或诊所的需求相匹配,标准化干预措施,并评估过程和临床结果。需要更多的研究来应用 TP 和其他技术到这些服务交付模式中。

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