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Ontario expands its usage of tele-psychiatry

TORONTO – As the demand for mental health services continues to grow and the workforce of psychiatrists continues to age, timely access to these specialists is becoming a critical issue.

Modern technology may provide part of the solution. Psychiatrists are now able to connect with individual patients or community care teams over a secure two-way video conference network that spans Ontario.

These video consultations over the Ontario Telemedicine Network (OTN) – one of the largest telemedicine networks in the world – allow doctors to diagnose and treat patients who may be on the other side of the province or around the block. Psychiatrists who have integrated the technology into their practice say it is just as effective as consulting with a patient in their office. The payoff can be a more efficient use of time and resources.

“There just aren’t enough psychiatrists to meet the increasing demand,” says Dr. Robert Campbell, Physician Lead, Assessment & Mood and Anxiety Program, Regional Mental Health Care, London and St. Thomas. “We have to find innovative ways to deliver care to more people.”

The ratio of psychiatrists to residents has slipped by almost 9% over the past decade, and it promises to decline further. Of the 1,854 psychiatrists practicing in the province, almost half are 55 and older. And today, fewer medical students are choosing psychiatry as a specialty.

At the same time, the need for mental health services is increasing. In Ontario, 780,000 residents contacted a health professional for mental healthcare in one year. The World Health Organization is now predicting that depression will affect more people than any other illness within the next 20 years. In Canada, mental illness is already the number one cause of disability.

In the most recent National Physician Survey, 71% of family and general practitioners identified patient access to psychiatrists in Ontario as only fair to poor.

“We need to make the best use of our resources, and tele-psychiatry offers some real advantages,” says Dr. Ed Brown, Chief Executive Officer of OTN. “Tele-psychiatry can be easily integrated into a physician’s daily practice. There are some 1,600 video consulting rooms around the province that are easily accessed and can quickly connect psychiatrists to their patients.”

Last year, more than 16,000 psychiatric consultations were conducted over the telemedicine network.

For Dr. David Goldbloom, Senior Medical Advisor, Education and Public Affairs at Toronto’s Centre for Addiction and Mental Health (CAMH), video consulting is perfectly suited to psychiatry. He has been using the network for several years. “Research shows that it is just as palatable for patients as in-office consultations. Plus, it’s fun, it comes with a financial incentive, and can be incredibly satisfying for both the patient and the physician to overcome the barriers of geography and specialist access.”

Psychiatrists using OTN are able to bill through OHIP, and they are paid a slight premium for doing so. To make the system even more convenient, OTN will soon be introducing new desktop technology that will allow psychiatrists to conduct video consultations from their own offices.

The Ontario Telemedicine Network (OTN) is an independent not-for-profit corporation funded by the Government of Ontario. OTN is a secure, encrypted video network that helps deliver clinical care and professional education among health care providers and patients.

Posted October 22, 2009