Abstract
Although a great deal has been written about the potential for telemedicine to increase access to care, applications in paediatrics are sparse. This chapter details how one paediatric telepsychiatry program has facilitated the creation of integrated healthcare solutions in patient psychiatric care for children and youth in remote and rural communities. It demonstrates how the telepsychiatry model of healthcare service delivery has improved access, enhanced capacity, and promoted knowledge exchange in rural communities. A case study is used to highlight theoretical and empirical research on the value of televideo information technology in mental healthcare and its impact on the healthcare stakeholders who utilize this technology. An overview of the clinical, education, and evaluation components of the program is outlined, with a focus on knowledge translation and exchange as the underpinning foundation to the success of the program.
TopThe Toronto Paediatric Telepsychiatry Program (Tptp)
In the province of Ontario, Canada, the problem of access to specialty mental health care in rural communities is particularly problematic. In Canada, 20 percent of children and youth have a diagnosable mental health problem, yet only 1 in 6 receive any treatment (Offord et al., 1987). The ratio of child psychiatrists to children with mental health needs is approximately 1:6,148 (Steele & Wolfe, 1999). Furthermore, approximately 2% of child psychiatrists practice primarily in areas with populations of less than 20,000 while approximately 18% of the population resides in rural areas (Steele & Wolfe, 1999). Northern Ontario alone is the size of France and England combined.
Key Terms in this Chapter
Paediatric Telepsychiatry: The use of electronic communications technology to provide and support health care for infants, children, adolescents, and young adults when distance separates the practitioner from the patient, parent, guardian, or referring practitioner. This definition specifically excludes from discussion the use of ordinary telephone communication between practitioners and patients and the use of communications technology for education of practitioners.
Telepsychiatry: The use of electronic communications technology to eliminate or reduce geographic barriers to receiving psychiatric services.
Knowledge Exchange (formerly knowledge transfer): Knowledge exchange is collaborative problem-solving between researchers and decision makers that happens through linkage and exchange. Effective knowledge exchange involves interaction between decision makers and researchers and results in mutual learning through the process of planning, producing, disseminating, and applying existing or new research in decision making.
Stakeholders: Stakeholders refer to all individuals involved in/having an interest or stake in paediatric telepsychiatry. They include the funders of the program, the administrative staff, psychiatric consultants; mental health service providers in rural communities, and young people and their families.