Feasibility, acceptability, and sustainability of telepsychiatry for children and adolescents.
OBJECTIVE
This study examined the feasibility, acceptability, and sustainability of a telepsychiatry service for children and adolescents living in nonmetropolitan communities.


METHODS
Using high-bandwidth interactive video teleconferencing, psychiatrists at a children's hospital provided care to patients of primary care physicians at four nonmetropolitan sites. Review of one-year utilization provided feasibility data. Surveys of referring physicians examined acceptability of telepsychiatry. Reimbursement records provided sustainability data.


RESULTS
Overall, 387 sessions were provided to 172 youths (mean=2.25 sessions) whose clinical profiles were representative of national samples. Referring providers endorsed high satisfaction with telepsychiatric care, although pediatricians were consistently more satisfied than family physicians. Sustainability of telepsychiatry is challenged by infrastructure costs and low reimbursement by public payers.


CONCLUSIONS
Telepsychiatry is a feasible and acceptable approach to providing psychiatric services to youths in underserved communities. Sustainability will depend on developing financial alternatives to fee-for-service, especially if caseloads emphasize publicly funded programs.
Myers
Kathleen M
KM
Department of Child Psychiatry and Behavioral Medicine, Children's Hospital and Regional Medical Center, 4800 Sand Point Way, NE W3636, Seattle, WA 98105, USA. kathleen.myers@seattlechildrens.org
Valentine
Jeanette M
JM
Melzer
Sanford M
SM
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003258:Consumer Behavior; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D019538:Health Care Surveys; D006776:Hospitals, Pediatric; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D017216:Telemedicine; D014861:Washington