“I think you have to be careful in determining where telemental health would be beneficial to use and in which cases it might not be an appropriate method to deliver care,” Dr. Alexander said in an interview.
Developing trust and rapport with patients through videoconferencing also can be a challenge, added Dr. Alexander, who is director of the TelAbility telehealth program at the University of North Carolina at Chapel Hill. He recommends that specialists use the technology to continue an existing doctor-patient relationship or to provide care in a consultative model in which the child’s primary care doctor is present along with the patient and patient’s family.
The AAP advocates for the use of telemedicine so long as it is conducted within the context of the medical home. Fragmented telemedicine services that could disrupt continuity of care should be avoided, according to a 2015 AAP policy statement (Pediatrics. 2015 Jun. doi: 10.1542/peds.2015-1253). The academy also calls for the expansion of pediatric telemedicine to increase access to care for underserved communities and improve quality of care for children.
More partnerships between mental health specialists and primary care providers are a key step in delivering high quality pediatric telemental care, Dr. Alexander said.
“Some larger pediatric practices already do this by hiring and colocating individuals at their practice site, but other, smaller practices might not have the room, finances, sufficient patient population, or enough local providers to make this happen,” he said. “A telemedicine program, located within the practice, could enable this specialized service to be provided in a convenient, coordinated setting.”
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