Comparison of Asynchronous Telepsychiatry Alongside Synchronous Telepsychiatry in Skilled Nursing Facilities (California)

Project Details - Ongoing

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Summary:

There is a critical shortage of psychiatric services for people with mental illness who live in skilled nursing facilities (SNFs), especially those living in rural settings. For over 30 years, psychiatric consultation via real-time video conferencing, universally known as synchronous telepsychiatry (STP), has increased access to psychiatric care in areas with provider shortages. However, STP is often underutilized because of administrative and cost barriers.

The research team previously developed and validated an alternative method of psychiatric consultation called asynchronous telepsychiatry (ATP). ATP utilizes a trained clinician to conduct video-taped interviews that are later reviewed by the consulting psychiatrist. ATP avoids the need to conform to a single office schedule, no-shows, and cancelations since the psychiatrist can review a batch of video-taped interviews during office hours rather than manage unused clinic hours due to patient cancellations. While ATP has been shown to be more cost-effective than STP in primary care settings, it is not utilized in SNFs. This study will compare ATP versus STP in the SNF population in a 12-month randomized controlled trial.

The specific aims of the project are as follows:

  • Assess whether ATP and STP improve health outcomes in SNFs. 
  • Assess use of healthcare resources. 
  • Assess the acceptability of ATP and STP by examining satisfaction surveys from SNF residents or their family member, and SNF providers. 

Two hundred and fifty SNF residents will be recruited from five SNFs and randomized to either the control (STP) or intervention (ATP) arm. The investigators will test the hypothesis that ATP is as effective as STP for SNF residents by assessing patient centered outcomes and satisfaction measurements, and that it is more cost-effective and will lead to reduced waiting times compared to STP.

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