Video Chatting….with your Therapist? The Rise of Clinical Video Telehealth

By: Kari Traver

They're heeere!  It's no longer extraterrestrial or Jetsonesque.  We can video chat in full color on large screen displays.  Skype, FaceTime, WebEx and GoToMeeting all allow us to see and hear our far away friends, family and co-workers.  From his Marine base in California, my nephew was able to "share" Thanksgiving dinner with the East Coast family.  He even gave us a "tour" of his apartment.  I thought this was quite cool, but is it effective in a clinical environment?

The U.S. Department of Veterans Affairs believes the answer is "yes".  They are leaders in this new area of health care.  The VA uses clinical video telehealth to make diagnoses, manage care, perform check-ups, and actually provide care.  Since September, Colonial Behavioral Health has been using WebEx to conduct clinical assessments of children, so I thought I'd ask our therapists, "How's it going?"

First I spoke with Lee Phillips, a licensed therapist at CBH.  “It’s been beneficial.  I’m able to see facial expressions, affect and type of mood.  A big part of the assessment is the mental status exam.  I can get a clear mental status.  I’m able to tell if the child is depressed, sad, angry, guarded or withdrawn.”  Phillips added, “I’m also able to talk to the parent.  If I’m assessing for the possibility of ADHD I can look for symptoms.  I can see if the child is fidgeting, looking all over the room, inattentive or fixated on an object.”  Phillips feels that it’s a time saver for both the family and the clinical practice because the check in and check out process is minimal as compared to a regular office visit.

Next I asked Philip Mitchell, who provides intensive in-home services to families by teaching problem solving skills and assisting parents in becoming their own advocates.  Mitchell said, “For the most part it has been successful.  Initially I was worried because we hadn’t used this technology before.  The audio was fine, the picture was clear.  I was able to have a person-to-person interaction.”  Mitchell did feel that there is a need for the technology to improve.  He said, “It is a little difficult because the body language is a little muted.”

I also heard from Lisa Perez, who conducts clinical assessments to determine a child’s level of need for services. She can then recommend the most appropriate service.  Perez used the novelty of the remote camera to her advantage.  “I would ask, ‘Have you ever used a web cam?’  Then I would make funny faces to put the child at ease.  Kids actually thought it was fun.  Since it was very new to them I felt they needed to get any silliness out of their system,” she explained.  It turned out that the children were more comfortable with the technology than the parents.  Perez said, “It was interesting to watch the kids help the parents.  Both the parents and the children found it empowering.”  At the end of each session Perez thanked the family for helping CBH try something new.

Until recently, videoconferencing solutions had been expensive and inflexible.  Now faster, cheaper internet access and a prevalence of secure, affordable solutions make it feasible for therapists to provide professional assessments to individuals in remote locations.  For Colonial Behavioral Health, clinical video telehealth is proving to be effective, convenient and empowering for our therapists and the families they serve.

Kari is the Chief Information Officer at Colonial Behavioral Health. She has over 26 years of experience in the field of Information Technology and 21 years within the Virginia behavioral health system. For 17 years, Kari has been responsible for Colonial's LAN, WAN, system development, database design, software and hardware implementation, project management and security.