The child telepsychiatry project--a randomized controlled trial: (a comparison of initial child psychiatry assessments conducted via telemedicine to assessments conducted face-to-face)

Elford, Rod (1997) The child telepsychiatry project--a randomized controlled trial: (a comparison of initial child psychiatry assessments conducted via telemedicine to assessments conducted face-to-face). Masters thesis, Memorial University of Newfoundland.

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Abstract

Telemedicine - the use of telecommunications technology to transmit medical information to and from a distant location, has many potential benefits. A variety of technologies can be used to conduct telemedicine and it has applications in every field of medicine. This thesis investigates the use of a PC-based videoconferencing system to conduct child psychiatric assessments at a distance. Using a randomized, controlled design, 23 patients and their parents completed a telemedicine interview and a face-to-face interview. Self-report questionnaires and semi-structured interviews were used to obtain data for the study. The data were coded and the evaluators blinded. The diagnosis~ treatment recommendations and participant satisfaction with the telemedicine and face-to-face assessments were compared. An independent evaluator concluded that in 22/23 cases (96%) the diagnosis and treatment recommendations made via telemedicine were clinically the same as the diagnosis and treatment recommendations made face-to-face. Overall, participants responded positively to the telemedicine assessments. All five psychiatrists stated that telemedicine assessments were an “adequate alternative” to face-to-face assessments and did not interfere with making a diagnosis. However, if given the choice they “preferred” to assess a patient face-to-face. The majority of patients “liked” using the system to talk to the psychiatrist and 5/17 children (29%) said they preferred talking to the doctor using the telemedicine system versus face-to-face. Parents were also positive toward the telemedicine system with 21/23 (91%) stating that if they had to travel a long distance to see a psychiatrist they would prefer to use the system. General conclusions include: -- 1) it was possible for psychiatrists to conduct a child psychiatry assessment using the PC-based videoconferencing system, -- 2) psychiatrists make the same diagnosis and treatment recommendations via telemedicine as they do face-to-face and -- 3) psychiatrists, patients and parents were satisfied with the telemedicine system.

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