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Expanding Access to Psychiatric Care: Implementation of Psychiatric e-Consultation and Tele-consultation for Primary Care in a Safety-net Health System
- Journal of Health Care for the Poor and Underserved
- Johns Hopkins University Press
- Volume 33, Number 2, May 2022
- pp. 767-778
- 10.1353/hpu.2022.0062
- Article
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Abstract:
Technology can expand access to specialty health services for disadvantaged and underserved populations. A novel psychiatric consultation service involving both electronic consultations (e-consultations) and telephonic consultations (tele-consultations) was implemented by hospital-based staff and trainee psychiatrists in 12 primary care sites within a public safety-net health system. Utilization data were collected over a three-year period. A brief provider satisfaction survey was distributed to primary care providers. Over the three-year study period, 490 technology-enabled consultations were provided, of which three-fifths were e-consultations and two-fifths were tele-consultations. Most addressed medication questions (81%). Average time spent by the consulting psychiatrist was 30 minutes. Four-fifths (80%) of primary care providers reported being extremely or moderately satisfied with the service. The model represents multimodal support for primary care providers in providing community-level mental health care, including the provision of same-day consultation. This report demonstrates the feasibility of such a service in lowresource settings.