Imagine a 17-year-old girl having suicidal thoughts. A concerned relative takes her to the emergency room at the local hospital. Though professional care is certainly needed, emergency personnel are uncomfortable with how to care for her without access to a specialist. Unfortunately, like many facilities today, urban or rural, the hospital does not have a psychiatrist on the medical staff who can respond in-person to the emergency room. Without access to a specialist to assess the risk of suicide, the doctor is not comfortable releasing her. She sits in the E.R. for 36 hours, vulnerable and scared, before transfer to a mental health facility can be arranged.
In many cities across the nation, a shortage of mental health care professionals, especially in rural communities, has caused a significant number of patients to go without treatment or in extreme cases, wait days or weeks for psychiatric help.
JSA created a telemedicine model which provides fast, flexible, around-the-clock access to emergent, urgent and routine psychiatric evaluation for individuals in need. Founded in 2007 by internationally-recognized psychiatrists, JSA provides scheduled and emergency psychiatric care, with access to a team of child, adolescent, adult, and substance-abuse specialists.
According to the Hogg Foundation of Mental Health, Texas suffers from a severe shortage of professionals. In fact, 171 of the 254 counties in the state have no psychiatrist.
Because of these numbers, JSA has stepped in to provide psychiatric evaluations in emergency rooms, rural mental health centers, schools and jails to fill the void.
Well-versed in the discipline of emergency psychiatry, published author, JSA president and chief executive officer Avrim Fishkind, MD has leveraged available technologies in order to overcome the continued shortage of mental health practitioners across Texas and Louisiana.
“High-definition capability allows psychiatrists to meet the need for care in emergency settings, an area of particular shortage,” said Fishkind, who is also the past-president of the American Association for Emergency Psychiatry and a member of the General Assembly of the American Psychiatric Association.
“Telepsychiatry is becoming the fastest expanding segment within the field,” said Fishkind. “Psychiatrists cannot possibly provide in-person coverage to the 4,700 medical emergency rooms, medical floors units and intensive care units in the United States, nor reach patients and clinics in rural areas.”
Telepsychiatry, or the pairing of practitioner and patient over interactive video conference, is not a new concept. In fact, the first attempts at telemedicine in the 1950’s and early 1960’s were carried out using telepsychiatry.
A key concept in all successful telepsychiatry programs is identifying a technology enabler.
With the help of trusted technology partner Unified Communications, a leading provider of conferencing solutions, products and services, JSA decided that the HD video offerings from LifeSize were the best solution to meet their needs. The compact size of the LifeSize Express and LifeSize Passport products and its point-to-point connectivity made it easy to deploy in all types of environments. Like all LifeSize products, the resolution scales with the bandwidth, so more rural locations would not require upgraded networks in order to see a high-quality image. JSA uses LifeSize’s multi-point call capacity for training, peer-review, and case consultations.
“There is no other vendor in the industry that can compete with LifeSize on quality, price and customer support,” said Fishkind.
Because most of JSA's clients are mental health centers, schools, hospitals and jails, making good use of taxpayer dollars is important. Whether it be a more integrated room with special A/V equipment added on or a simple HD monitor and video system placed on a mobile cart, LifeSize is flexible enough to deploy virtually anywhere.
“Telepsychiatry is becoming the fastest expanding segment within the field.”
– Avrim Fishkind, MD, President and Chief Executive Officer, JSA Health Telepsychiatry
Since implementing LifeSize HD video, JSA has seen tremendous growth in its business. After seeing its first patient in early 2008, JSA has had over 45,000 patient encounters.
“We are now serving over 25 clients in over 80 locations and counting,” said Fishkind. “The openness and interoperability of LifeSize products makes it easier for us to connect with more people in more places.”
JSA psychiatrists enjoy the flexibility of being able to practice in multiple locations without travel. Because all that is needed is a high-speed internet connection, a growing number of JSA’s doctors have HIPAA-compliant video systems in their home offices. In addition, patients can access specialty doctors within their home communities, eliminating the need to travel to urban medical centers.
“In one day, I saw patients in four different Texas clinics that would have required me to drive over 600 miles in my car in a single day,” said Fishkind.
To learn more about JSA and how it uses LifeSize HD video solutions to provide mental health services to patients, listen to the Tech Talk Podcast: Telepsychiatry on the New York Times' Bits Blog or visit www.JSAHealthMD.com.
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LifeSize is changing the way healthcare is delivered. Frost & Sullivan named LifeSize HD videoconferencing solutions the most effective for healthcare providers, with the highest overall rating for features, ease-of-use and service, and price competitiveness.