A statement from APA’s Telepsychiatry and Mental Health IT Committees

As telepsychiatry has expanded, so has the number of online clinics. There are new specialized digital services that offer to prescribe stimulants, antidepressants like ketamine, and nearly any other medication. Such services offer new means to access treatment and innovative care delivery models. But as such new and innovative services proliferate, one thing must remain constant: a commitment to high-quality, safe, and appropriate care.

New platforms that connect patients to clinicians should preserve high-quality care. Leading medical and telemedicine societies, including American Psychiatric Association, American Medical Association, and American Telemedicine Association, hold virtual visits and care to the same high standards as in-person care. This means also holding to the same standards when it comes to prescriptions, including physicians conducting a thorough examination and establishing a patient-physician relationship. It means working with patients to help with monitoring responses and potential adverse events. Also, just like with in-person care, it means not abandoning patients and ensuring safe and appropriate discharge plans. Finally, safeguards to ensure the legitimate practice of telemedicine, including when a controlled substance may be prescribed include, but are not limited to:

• Health data security: Before a telemedicine visit is initiated, a patient’s identity is verified (if a patient connects from a site where staff/clinicians are present with the patient - staff can assist with verification; for clinically unsupervised settings such as home, technology such as biometric patient identification or facial recognition can be used).
• Appropriate consents for treatment are obtained as required by HIPAA and state laws and regulations. Payers may also have consent requirements.

Using telehealth to increase access to care is important and must continue as an option. Ensuring telehealth is not used to support dangerous clinical practices is equally important. In psychiatry, there is strong evidence that telehealth visits can be as effective as in-person visits, for nearly all conditions, when offered in an appropriate manner. As our field continues to lead in telehealth, psychiatrists must ensure that we continue to offer care that does not compromise safety. Innovation must be used to advance patient care rather than place it at risk.

More information

• Stay up to date on advances in telepsychiatry through APA’s Telepsychiatry Blog
• APA Telepsychiatry Toolkit
• APA Position Statement on Telemedicine in Psychiatry (.pdf)