Protocols needed for mental health eVisits

University of Pittsburgh Medical Center data from the first three years it offered care through a patient portal indicate a need for mental health care offerings, according to research published in the American Journal of Managed Care.

From the 3,601 eVisits conducted between April 2009 and mid-June 2012, 23.9 percent chose the "other" option when their reason for visiting the site wasn't among the offered diagnoses, such as sinusitis and urinary tract infections.

Of these 685 patients, 13.4 percent received mental health diagnoses, primarily for anxiety and depression. Those users tended to be female and younger than other eVisit patients.  It also took physicians longer to respond to them.

The article conludes that protocols are needed for prompt attention to common mental health concerns to be addressed in eVisits.

Three possible criteria for Internet-based care include:

  • A problem with a clear "diagnostic data set" accessible to a patient and easily articulated in an online encounter
  • Patient understanding that the online interaction is problem-specific and might carry risks
  • Treatment decisions should be algorithmic and not require a personal relationship with a physician

This third criteria might be more challenging to provide with mental health care, the authors write, citing the need for more research.

While the Department of Veterans Affairs has been at the forefront of offering mental health care via telemedicine, Carolinas HealthCare System is among the civilian providers making mental health care part of comprehensive primary care.

To learn more:
- here's the research