Report: NC telepsychiatry project shows promise, needs funding

Posted April 1, 2014

Picture from the front of a new NC Center report on telepsychiatry in North Carolina.

— North Carolina leaders need to make sure both funding and new rules are in place to ensure a new statewide telepsychiatry program succeeds, according to a report released today by the N.C. Center for Public Policy Research.

"We've been studying mental health for five years and this, frankly, is one of the few bright spots that we've found," said Mebane Rash, editor of North Carolina Insight, the center's journal.

Telepsychiatry uses video conferencing to link psychiatrists to patients in remote locations. 

Gov. Pat McCrory announced the launch of the program in August, touting its benefits for rural North Carolina. 

"No matter where you live in North Carolina, you will soon have better access to mental health providers with the expansion of telepsychiatry across our state," McCrory said at the time. "Technology will help us connect people with appropriate treatment programs so patients can avoid long waits in the emergency room. North Carolina can be a national leader with this program."

Rash said that the program also will help big-city emergency rooms, where people in mental crises often wait dozens of hours for evaluation by a psychiatrist. 

The center's report looked at an pilot telepsychiatry started by the Albemarle Hospital Foundation in 2010, which served northeastern North Carolina. Results from that project showed emergency room waiting times cut in half and involuntary hospitalizations cut by one-third. 

The statewide program incorporates the Albemarle project and is run from East Carolina University, which has had its own successful telepsychiatry program.

Despite early successes, Rash said, lawmakers still need to step in to ensure that the program can expand and thrive.

One thorny issue highlighted in the center's report involves the technology used to link doctor with patient. Currently, the carts used in hospitals can cost up to $19,000 because they have to meet certain federal health care privacy and insurance regulations. 

"We think iPads can be configured to meet the (privacy) requirements," Rash said.

If that's the case, the state would need to get clarification that Medicaid would pay for the service a psychiatrist provides over that link. Lawmakers also need to make sure that private insurers will pay for consultations provided over video links. 

There are other legal clarifications that may be needed as well, she said. For example, current law requires a psychiatrist providing video consultation to be licensed both in North Carolina and wherever they are physically located. This could be a "tension point," Rash said, as it becomes possibles for psychiatrists to provide consultations from across the nation and perhaps from other countries.

Tackling these sorts of questions soon, she said, would allow North Carolina to become a national model for telemedicine.


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  • Nicole Collins Apr 1, 2014
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    I was in the ER 3 days waiting to talk to a psychiatrist before they would release me. They had no one available so I took up a precious bed in the ER for 3 days for an evaluation before they could release me. This would be a great help as the future is going toward telemedicine. Hopefully our legislature can see the big picture and fund this properly which will save time and money in the long run.

  • Kenny Dunn Apr 1, 2014
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    True enough. Happens every day. However, I'd say that increasing access is a good thing if those who need it can actually use it. It does not remotely address all, or even the most pressing, issues though.

  • outhousecat Apr 1, 2014

    Talking to the psychiatrist is just the beginning. Meds have to be ordered by somebody. Where I work, psych patients are laying in bed for days at the time (sometimes weeks) without having their psych meds ordered because the hospitalists won't do it and the psychiatrists are too understaffed to see all their patients. I can't even count how many patients have deteriorated in the hospital while waiting for a psych bed because no docs will step up to the plate and take care of them. Psych patients are treated like second class citizens, even by medical personnel who don't want to be bothered.

  • SFSOLDIER Apr 1, 2014

    That dude creeps me out! I would freak out if he showed up to talk to me!