Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-23T10:47:53.414Z Has data issue: false hasContentIssue false

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: [email protected].

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 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

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