Benefits of a Telepsychiatry Consultation Service for Rural Nursing Home Residents

Psychiatric care for rural nursing home residents is difficult to obtain. Two hundred and seventy eight (n = 278) telepsychiatry encounters for 106 nursing home residents were conducted. Data were collected to determine potential cost and time savings associated with this modality compared to in-person care. A total of 843. 5 hours (105. 4 8-hour work days) of travel time was saved compared to in-person consultation for each of the 278 encounters if they had occurred separately. Travel distance, cost of gasoline, personnel cost, and physician costs were all greatly reduced. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. This was shown to be cost-effective and appears to be a medically acceptable alternative to face-to-face care. Psychiatric care for nursing home residents is difficult to obtain, especially in rural areas, and this deficiency may lead to significant morbidity or death. Providing this service by videoconference may be a helpful, cost-effective, and acceptable alternative to face-to-face treatment. We analyzed data for 278 telepsychiatry encounters for 106 nursing home residents to estimate potential cost and time savings associated with this modality compared to in-person care. A total of 843. 5 hours (105. 4 8-hour work days) of travel time was saved compared to in-person consultation for each of the 278 encounters if they had occurred separately. If four resident visits were possible for each trip, the time saved would decrease to 26. 4 workdays. Travel distance saved was 43, 000 miles; 10, 750 miles if four visits per trip occurred. More than 3, 700 would be spent on gasoline for 278 separate encounters; decreased to 925 for four visits per roundtrip. Personnel cost savings estimates ranged from 33, 739 to 67, 477. Physician costs associated with additional travel time ranged from 84, 347 to 253, 040 for 278 encounters, or from 21, 087 to 63, 260 for four encounters per visit. The telepsychiatry approach was enthusiastically accepted by virtually all residents, family members, and nursing home personnel, and led to successful patient management. Providing psychiatric care to rural nursing home residents by videoconference is cost effective and appears to be a medically acceptable alternative to face-to-face care. In addition, this approach will allow many nursing homes to provide essential care that would not otherwise be available.