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Program evaluation of a telepsychiatry service for older adults connecting a university-affiliated geriatric center to a rural psychogeriatric outreach service in Northwest Ontario, Canada

Published online by Cambridge University Press:  22 July 2013

David K. Conn*
Affiliation:
Department of Psychiatry, Baycrest Centre, Toronto, Ontario, Canada Division of Geriatric Psychiatry, University of Toronto, Toronto, Ontario, Canada
Robert Madan
Affiliation:
Department of Psychiatry, Baycrest Centre, Toronto, Ontario, Canada Division of Geriatric Psychiatry, University of Toronto, Toronto, Ontario, Canada
Jenny Lam
Affiliation:
Department of Psychiatry, Baycrest Centre, Toronto, Ontario, Canada
Tim Patterson
Affiliation:
Telehealth Services, Baycrest Centre, Toronto, Ontario, Canada
Sandy Skirten
Affiliation:
District Mental Health Service for Older Adults Program, Northwest Ontario, Ontario, Canada Canadian Mental Health Association, Fort Frances, Ontario, Canada
*
Correspondence should be addressed to: Dr. David Conn, Department of Psychiatry, Baycrest Centre, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada. Phone: +1-416-785-2456. Email: dconn@baycrest.org.

Abstract

Background:

Weekly telepsychiatry consultations have been provided since 2002 to six communities in Northwest Ontario. Staff from a single community psychogeriatric outreach service who work within these communities facilitate the referrals.

Methods:

The program evaluation included (a) a chart review of the last 100 referrals, (b) analysis of patient and staff evaluations, (c) a survey mailed to all physicians in referring communities, and (d) three focus groups of staff working in local community agencies.

Results:

The mean age at the time of consultation was 76.7 years. Sixty-eight percent of patients were females. The most frequent diagnoses were dementia (54%), depression (28%), and mild cognitive impairment (19%). The most frequent medication recommendations were antidepressants or cholinesterase inhibitors. Two hundred ninety-four patient assessments and case consultations were carried out between 2002 and 2009. Post-session evaluation surveys rated the provision of information, whether objectives were met, and overall usefulness of recommendations. The mean scores for these questions on a 5-point scale were between 4.6 and 4.85. Referring physicians were confident and satisfied with the recommendations made for their patients. All planned to continue to use telepsychiatry as a care option for the future. The focus groups added useful information about challenges and potential barriers to utilizing the program.

Conclusions:

The program was rated as being highly valued across all modalities of evaluation. Members of the referring team believe that access to a geriatric psychiatrist has broadened the team's knowledge base, its use of assessment tools, and increased their ability to better construct their patients’ treatment plans.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Australian Institute of Health and Welfare. (2008). Rural, Regional and Remote Health: Indicators of Health Status and Determinants of Health. Rural Health series no. 9. Cat. no. PHE 97. Canberra, Australia: AIHW.Google Scholar
Baer, l., Elford, R. and Cukor, P. (1997). Telepsychiatry at forty: what have we learned? Harvard Review of Psychiatry, 5, 717.CrossRefGoogle ScholarPubMed
Boydell, K. M., Greenberg, N. and Volpe, T. (2004). Designing a framework for the evaluation of paediatric telepsychiatry: a participatory approach. Journal of Telemedicine and Telecare, 10, 165169.CrossRefGoogle ScholarPubMed
Brown, E. M. (2013). The Ontario telemedicine network: a case report. Telemedicine and e-Health, 19, 373376.CrossRefGoogle ScholarPubMed
Canadian Institute for Health Information. (2006). How Healthy are Rural Canadians? An Assessment of their Health Status and Health Determinants. Ottawa, Canada: CIHI.Google Scholar
Diachun, L., Hillier, L. M. and Stolee, P. (2006). Interest in geriatric medicine in Canada: how can we secure a next generation of geriatricians? Journal of American Geriatrics Society, 54, 512519.CrossRefGoogle ScholarPubMed
Ramos-Rios, R., Mateos, R., Lojo, D., Conn, D. K. and Patterson, T. (2012). Telepsychogeriatrics: a new horizon in the care of mental health problems in the elderly. International Psychogeriatrics, 24, 17081724.CrossRefGoogle ScholarPubMed
Shore, J. H. (2013). Telepsychiatry: videoconferencing in the delivery of psychiatric care. American Journal of Psychiatry, 170, 256262.CrossRefGoogle ScholarPubMed
Shulman, B., Conn, D. K. and Elford, R. (2006). Geriatric telepsychiatry and telemedicine: a literature review. Canadian Journal of Geriatrics, 9, 139146.Google Scholar
Urness, D., Hailey, D., Delday, L., Callanan, T. and Orlik, H. (2004). The status of telepsychiatry services in Canada: a national survey. Journal of Telemedicine and Telecare, 10, 160164.CrossRefGoogle ScholarPubMed
Whitten, P. S. and Mackert, M. S. (2005). Addressing telehealth's foremost barrier: provider as initial gatekeeper. International Journal of Technology Assessment in Health Care, 21, 517521.CrossRefGoogle ScholarPubMed
Yellowlees, P., Shore, J. and Roberts, L. (2010). American Telemedicine Association: practice guidelines for videoconferencing-based telemental health: October 2009. Telemedicine and e-Health, 16, 10741089.CrossRefGoogle ScholarPubMed