1. What is telepsychiatry?
Telepsychiatry is the practice of psychiatry conducted via a video conference connection. A live, secure video connection is established between an offsite location (a clinic, doctor’s office or home office) and a mental health facility. A typical psychiatric office visit is conducted except that the physician and the patient are not in the same physical location.
2. Is there a startup cost?
There is no start up cost associated with using the telepsychiatry platform unless you need to purchase a webcam and microphone. On average both can be purchased for less than a total of $200.
3. What equipment is required?
All that is needed for connection to our network is a Windows (XP SP2 or newer) or Mac (Intel based) system with Internet access, a webcam and a microphone. We recommend a Logitech HD Pro Webcam C920 for the video and a Phoenix Duet USB Speakerphone for the audio. We can test any webcam and/or microphone you may have to see if they would be appropriate for our solution.
4. Is there a fee to use the platform?
There is no fee to use our platform.
5. Is it secure and HIPPA compliant?
Yes, all communications are sent using 256-bit AES encryption. We take appropriate measures to comply with the all HIPAA privacy and security rules.
6. How can telepsychiatry benefit hospitals and mental health clinics?
Facilities in remote rural locations that have a difficult time recruiting can benefit from telepsychiatry. Telepsychiatry providers can be physically located anywhere in the United States, but as long as they have the appropriate licenses, they can see your patients. Another use for telepsychiatry is to fill a part-time position. If your facility has enough volume only for a half-time provider, you might have an easier time finding a telepsychiatry provider to fill that need than recruiting a psychiatrist to work on-site part-time. Telepsychiatry can be your back-up for vacations, leaves or after hours on-call coverage.
7. Do you offer support?
Yes, we offer 24 hour support, seven days a week. Our trained IT professionals are able to assist with any technical difficulties you may encounter.
8. Is my existing camera and microphone compatible with your telepsychiatry platform?
Almost any third-party webcam or video conferencing equipment will work. We can test any webcam and/or microphone you may have to see if they would be appropriate for our solution.
9. Do you support other video conferencing equipment?
We are compatible with traditional boardroom style video conferencing equipment like Polycom and/or Cisco (Tandberg) hardware codecs. There is no need to substitute your existing telemedicine equipment. Our heterogeneous solution is capable to connect with most any platform available.
TMS - TRANSCRANIAL MAGNETIC STIMULATION
There is new hope for people who suffer with depression—Transcranial Magnetic Stimulation (TMS). It is especially helpful with treatment-resistant depression, for those who do not respond to antidepressants, as well as people who wish to avoid the side effects frequently caused by medication. TMS treatment usually includes four to six weeks of non-invasive, in-office treatments that take less than an hour each day, five days each week.
What is TMS?
TMS is a treatment that safely delivers magnetic pulses to areas of the brain that are responsible for mood. Instead of using invasive electrical currents like in electroconvulsive therapy (ECT), the magnetic pulses from TMS are similar in strength to those emitted during a typical MRI. The pulses are directed toward the prefrontal cortex of the brain to change the magnetic field and stimulate neurons within the mood center. This not only mitigates depression for a short time but can also result in long lasting relief.
Benefits of TMS
- Non-invasive—no anesthesia, electrodes or electrical current used
- Simple, in-office—administered by a technician and the patient can drive home afterward
- For treatment-resistant depression—those not helped by antidepressants can benefit
- No drug side effects—no reported nausea, weight gain, dry mouth or decreased sex drive
- Long-lasting—after initial 4-6 weeks, maintenance may or may not be needed later
How does TMS work?
TMS treatment is performed in a doctor’s office, while the patient is fully awake and seated in a comfortable chair. Because the magnetic pulses make a sound similar to that of a woodpecker, earplugs are provided. The TMS device is then placed in the proper position on the head and the magnetic pulses are delivered. The process usually takes between 20 and 40 minutes.
It is relatively simple.
- Patient takes a seat
- Device is placed on the head
- Pulses are delivered for a short time
- Patient returns to daily activities
Conditions treated by TMS
In the United States, the FDA approved TMS in 2008 as a treatment to alleviate the symptoms of treatment-resistant depression. It has also been approved for depression in Canada, Australia, New Zealand, Europe, and Israel. In addition, it has been CE approved in Europe for the treatment of bipolar disorder, PTSD, chronic pain, OCD, and adult AD/HD.
Advantages over other treatments.
In the past, the most common treatments for depression have been medication and/or psychotherapy. With TMS, psychotherapy is still encouraged because it can help people maintain mental health. However, unlike antidepressants, TMS has few if any side effects.
Reported side effects of antidepressants include:
- Weight gain
- Fatigue or drowsiness
- Dry mouth
- Decreased sexual desire or function
Side effects of TMS
Some patients report slight headaches or some discomfort at the treatment site just during the actual treatment. About a third of patients notice a prickly, tingly sensation on their scalp while the stimulating pulses are being administered. One in 1,000 patients experience a mild seizure; however, it should be noted that this risk is approximately the same as that cause by some antidepressants. In addition, the seizures related to TMS typically end when the magnetic stimulation is stopped.
Exceptions to TMS treatment
People who have metal implanted in or near their head should not have TMS. Exceptions include those with dental fillings, crowns and/or braces. Metals that prevent TMS treatment include:
- Pacemakers or implanted defibrillators
- Any stents from the neck up
- Aneurysm clips
- Metallic implants in ears or eyes
- Ammo fragments near the head
- Facial tattoos with metallic ink
- Any metal near the head that cannot be removed
TMS and insurance
As TMS is being used by more physicians and patients with notable positive results, more and more insurance companies now cover or partially cover the treatment. Major insurance companies in the United States that now cover TMS include Anthem Blue Cross Blue Shield and MHN (HealthNet). There are several other state and national companies that provide reimbursement when TMS is deemed appropriate. Your local TMS treatment provider can help you determine eligibility and many will submit the paperwork for you.