Procedural and methodological issues in telepsychiatry research and program development

Objective: The authors reviewed the literature related to telepsychiatry-ap plications of videoconferencing technology for mental health care-which off ers hope for an affordable means of solving long-standing workforce problem s, particularly in geographical areas where specialist providers are not re adily available. Methods: To conduct a comprehensive review of the telepsyc hiatry literature, the authors searched the MEDLINE database (1970 to Febru ary 2000), using the keywords telepsychiatry, telemedicine, and videoconfer encing, Studies were selected that included the use of videoconferencing te chnology for the provision of any form of mental health care services. Resu lts and conclusions: Psychiatric interviews conducted by telepsychiatry app ear to be generally reliable, and patients and clinicians generally report high levels of satisfaction with telepsychiatry. A significant limitation o f the literature is the lack of empirical research on telepsychiatry, espec ially cost analyses and clinical outcome studies. The authors outline a res earch agenda addressing the procedural and methodological issues that shoul d shape future research: study design, outcome measurement, consideration o f patient characteristics, and program design.