Question 1

How can telepsychiatry help during COVID-19?

Accepted Answer

Right now, most Americans are stuck inside their homes, while the COVID-19 coronavirus pandemic continues across the U.S. and worldwide. Normal business functions have, for the most part, shut down indefinitely. Many people, however, need services beyond food and water. Staying mentally healthy during these difficult times is one of the most challenging parts of the entire ordeal, and also one of the most important. The field of telepsychiatry allows individuals who are subject to shelter-in-place orders to get the mental health services they need without having to risk physical proximity near other individuals.

Question 2

Are there certain conditions that benefit more from remote care for group therapy?

Accepted Answer

There is insufficient research to determine if group therapy done remotely is more suited for a specific type of patient.

However, remote care is often less intimidating than being in person. For example, a patient with an anxiety disorder such as social phobia or agoraphobia may be reluctant to put themselves in front of a group of strangers for the first time. They may be more likely to participate in remote groups instead.

Question 3

Is telepsychiatry as effective as in-person sessions?

Accepted Answer

The psychiatric professionals at Orbit Health are among the best in the industry. They can provide clinical diagnoses, treatments, and effective outcomes, as well as increase community health in wellness, especially in underserved areas.

The lack of physical proximity does not inhibit our experts’ ability to diagnose and treat patients suffering from any number of psychiatric conditions. The level of privacy and confidentiality is the same as in-person care.

Research shows that telepsychiatry is just as effective as in-person, face-to-face care. Many patients, in fact, find that psychiatric treatment via videoconferencing is less intimidating or embarrassing. Patients, psychiatrists, and other professionals have all reported high levels of satisfaction with telepsychiatry since its inception.

Question 4

How can telepsychiatry help your correctional facility?

Accepted Answer

Orbit Health brings the most qualified mental health professionals right to your facility, without the need for in-person contact. Telepsychiatry allows your facility access to qualified, capable psychiatrists, including specialists in the field of incarceration, located anywhere around the country. Telepsychiatry offers benefits such as:

You are not limited to the services of the nearest mental health treatment center.
Doctors are not put at risk by being placed in direct contact with inmates.
Increased access, including compliance with state and federal health regulations, at a reduced cost.
Reduced gaps in care: Get help from experts in post-traumatic stress disorder, incarceration, violence, gender transition, and any other specific issues faced by your inmates.

Question 5

How does Orbit Health provide mobile response teams?

Accepted Answer

Orbit Health’s innovative mobile response team works with local law enforcement agencies to provide alternatives to arrest and incarceration for those suffering from mental and emotional difficulties.

We provide urgent telepsychiatry evaluations to assess the safety and stability of patients in the community. Our mission is to help end the cycle of mass incarceration by providing ways to divert vulnerable people from incarceration, and toward the help that they need to be a productive member of society.

To learn more, contact Orbit Health today!

Question 6

What is the standard of care for telepsychiatry and/or telemedicine?

Accepted Answer

What is the Standard of Care for Telepsychiatry?

Telehealth is increasingly being adopted by providers, patients, hospitals, and clinics as a great way of providing access to much needed healthcare. Policymakers and lawmakers have generally fallen behind the current practice and therefore there can be some uncertainty around what standard of care should apply.

Moreover, “Standard of care” can be subject to interpretation based on several factors, including, but not limited to:

• Specialty or subspecialty, as it relates to the scope of practice of the provider

Notably, the applicable community is debatable in telehealth, as the doctor and patient care are in different geographic areas.

Each state may have its own opinions about standards of care for telehealth and multiple jurisdictions can potentially apply. In some, but not all states, the state medical board has language that states that standard of care for telemedicine is considered the same or similar to in person care.

As a provider, the best way to think about standard of care is to do what a reasonable and prudent provider do in similar circumstances. Reasonable and prudent care often depends on several components, such as:

• Patient case factors- although there are no absolute contraindications for telehealth, in rare cases the patient might object to the use of the technology for reasons such as paranoia/fear about being recorded or the technology being hacked, or difficulty keeping themselves in the frame of the camera due to cognitive issues. Also, if the patient is intellectually disabled and does not understand what is going on, perhaps thinking that they are watching TV.

• Setting to which care is being delivered- the environment is noisy, distracting, or not private, this can affect the quality of care provided.

• Types of technologies being used- if the technology does not allow adequate audio or video, this brings down the quality of assessment and treatment.

• Overall framework in which care is being provided- If telepsychiatry is conducted in the absence of other potentially important support for the patient

• Consent- consent requirements are determined by each state. Some states require specific verbal or written consent from the patient to conduct appointments via telehealth. Others do not have this requirement or have not opined on it.

• Limitations around AIMS testing. There are ways to conduct AIMS testing remotely, although the provider should be cognizant of potential limitations and this should be factored in the standard of care.

Ultimately, standards of care can be interpreted in a variety of ways, and telehealth makes it even more vague and sometimes confusing. Therefore, the provider should use their best judgment, considering clinical factors, their means to resources, and the overall nature of the care being provided.

Disclaimer- this article is our best effort to provide useful information and does not constitute legal advice. Please make sure to consult with entities such as state medical boards, their malpractice carrier, and potentially legal counsel prior to practicing healthcare.

Question 7

How does telepsychiatry work for forensic evaluations?

Accepted Answer

Identify a small, confidential area in your forensic setting that has internet access, a desk, and a chair. We will place a video screen there and provide psychiatrists via high quality videoconferencing technology. We can use the facility’s existing computers or devices to stream a connection over a web-based telepsychiatry platform.

Alternatively, we can provide a portable device that is dedicated to telepsychiatry and is always on. The technologies we use are specifically designed for telehealth encounters and are HIPAA-compliant.

When the subject of the forensic evaluation is ready to be seen, our telepsychiatrist will appear on the screen to conduct an expert evaluation. Forensic evaluations can be recorded if given permission from the subject’s attorney or by direction of the judge presiding over the case. Otherwise, the session will not be recorded. After the session(s), the telepsychiatrist will prepare his/her forensic report.

Contact Orbit Health to Get Connected to a Qualified Expert Witness Today: If you have a pending legal matter that would benefit from advice, opinion or testimony from a qualified psychiatric expert, you do not need to rely on whoever happens to be located nearby. It does not matter if there are no such experts in your area. Orbit Health will connect you with a qualified, professional, and effective forensic psychiatric expert, transmitted to any location that has internet access. Reach out to Orbit Health to discuss your options for telepsychiatry today.

Question 8

Where do patients receive treatment?

Accepted Answer

Patients can visit their local clinic, medical office, or hospital. Wherever you can set up a private space for video conferencing, patients can comfortably sit and engage with our mental health professionals.

Question 9

How can forensic telepsychiatry help your case? Which forensic issues?

Accepted Answer

In many cases, forensic evaluations and testimony can be accomplished remotely via videoconferencing. Forensic telepsychiatry makes sense, and it saves time and money. Attorneys and judges are increasingly accepting of the concept of forensic telepsychiatry as a convenient and effective way to utilize expert testimony.

Orbit Health can provide teleforensic experts to help sort through the following forensic issues:

Competency to Stand Trial. In matters involving criminal defendants or other parties who lack mental capacity, a forensic psychiatrist can evaluate whether the party possesses the mental faculties necessary to stand trial on their own behalf.
Insanity Defense/ Criminal responsibility. Crimes of passion often turn on the mental state of the defendant. A forensic psychiatrist can evaluate whether a defendant possessed the mental capacity to understand the consequences and morality of their actions, or whether they should be subject to a lesser penalty or alternative treatments instead.
Civil Commitment/ Involuntary treatment. Forensic psychiatrists evaluate whether individuals could pose a danger to themselves or others in order to inform a court’s decision as to the wisdom and morality of involuntary commitment to a psychiatric institution. A remote telepsychiatrist can perform an evaluation of an elderly or disabled individual and offer an opinion as to their mental capacity. Such opinions form the basis of whether an adult or elderly person should be placed under the legal care of another.
Competency to Make Treatment Decisions. End of life care is complicated at the best of times. When an injured or ill person appears to lack the ability to make competent decisions about their own health, it is important to have a psychiatrist evaluate their mental faculties and their emotional state. This can be accomplished remotely via telepsychiatry, wherever the patient is located.
Worker’s Compensation and Torts. Injured parties, whether they suffer a physical injury, a psychological injury, or both, require expert evaluation and testimony to prove or disprove their case. A forensic telepsychiatrist can evaluate the extent of their injuries and the emotional trauma connected thereto. Forensic psychiatrists can provide vital insight and opinion as to whether an injured worker possesses the capacity to return to work or should instead qualify for disability benefits.
Violence Risk Assessment. Judges often rely on forensic psychiatrists to evaluate the propensity of a defendant for violent action when deciding upon bail. With telepsychiatry, your defendant will have access to the most qualified and most neutral evaluation in order to ensure that the principles of justice are not violated.
Child custody and visitation. Child psychiatrists can play a vital role in determining the healthiest placement for children of divorce. With Orbit Health, the best child psychiatrists can be brought in remotely for an unobtrusive evaluation and opinion.
Psychic injury. A forensic psychiatrist can remotely evaluate a plaintiff following a traumatic event to establish the extent of their emotional trauma and provide an expert, reasoned opinion as to the severity of their psychic injury, all without the expense of flying a medical professional to your location.
Mental disability. Disability is available for mental and emotional disorders as well as physical ailments. Telepsychiatrists can remotely evaluate applicants regarding whether they are capable of working or should instead receive disability benefits.
Malpractice cases often turn on the credibility of each side’s expert: Was the medical professional’s conduct appropriate, or did they violate standards and norms? With telepsychiatry, the strength of your expert opinion will not depend solely on which licensed psychiatrists simply happen to be in your region.
Juvenile justice. Experts are often employed in cases involving juveniles to establish the mindset and maturity of juvenile defendants and opine on whether they should be tried as adults
Other issues: Probate/ Testamentary Capacity/ Undue Influence; Defense Base Act (workman’s comp for military contractors); Sentence Mitigation; Personal Injury; PTSD; TBI (traumatic brain injury); IME (Independent Medical Examinations); Fitness for Duty; Sexual Assault; Sexual Harassment; Immigration (Asylum, Trafficking T-Visa, VAWA); Intoxication/ DUI/ DFSA (Date Rape); Suicide

Question 10

What conditions are treatable through telepsychiatry?

Accepted Answer

Telemedicine allows for treatment of any condition that does not require physical presence to treat. Psychiatry is uniquely suitable for telemedicine practice. Therapy, counseling, diagnosis, and treatment for nearly every psychological disorder — whether related to mood, anxiety, cognitive functioning, substance dependency, etc. — can be conducted via telepsychiatric sessions.

Telepsychiatry has the added benefit of allowing for specialists to conference in from anywhere in the country, or even the world, meaning that you can treat more specific, more esoteric, or more exotic conditions as needed.