title: 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.
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.
authors.affiliation: Department of Psychiatry, Baycrest Centre, Toronto, Ontario, Canada.
authors.forename: David K
authors.initials: DK
authors.lastname: Conn
authors.forename: Robert
authors.initials: R
authors.lastname: Madan
authors.forename: Jenny
authors.initials: J
authors.lastname: Lam
authors.forename: Tim
authors.initials: T
authors.lastname: Patterson
authors.forename: Sandy
authors.initials: S
authors.lastname: Skirten
mesh_terms: D000046:Academic Medical Centers / Q000379:methods / Q000458:organization & administration; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000628:therapy; D003625:Data Collection; D003704:Dementia / Q000175:diagnosis / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000628:therapy; D005260:Female; D017144:Focus Groups; D005852:Geriatric Psychiatry / Q000379:methods / Q000458:organization & administration*; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017060:Patient Satisfaction; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration*; D017216:Telemedicine / Q000379:methods* / Q000458:organization & administration