Using Asynchronous Telepsychiatry to Improve Mental Health Outcomes

The future of telehealth extends beyond current practices, incorporating artificial intelligence to enhance mental health outcomes. Despite its recent surge in popularity during the pandemic, telepsychiatry is not a new concept, but rather dates to the 1950s and ’60s in Nebraska. It has since seen significant changes, with various models emerging over time.

While synchronous telepsychiatry involves real-time interactions via video or phone, asynchronous telepsychiatry allows for delayed consultations, providing greater flexibility and efficiency. Asynchronous telepsychiatry involves recording patient interactions and sending them to mental health experts for delayed review. This method can be implemented through various means, such as text or voice messaging, letters, e-consults, and EMR screening questionnaires. The use of recorded video interviews has proven effective in primary care clinics, patient homes, and nursing homes.

Applications: Asynchronous telehealth is widely used in medical training, such as having residents present patient assessments to psychiatrists for review. Remote patient monitoring has also gained traction with the advent of apps and wearables. A number of research studies using asynchronous video consultations for clinical care have demonstrated its feasibility, good clinical outcomes, patient and provider satisfaction, and cost-effectiveness. The hybrid care approach, combining in-person and asynchronous methods, has become the standard for many treatment programs, offering greater efficiency and scalability.

Benefits: Asynchronous telehealth supported by AI offers numerous benefits that enhance both patient care and provider efficiency. These benefits include:

Adoption in other industries: Several industries have already adopted asynchronous video processes as routine practice, including broadcasting, retail, sales, marketing, advertising, social media, education, and customer support. Health care can learn from these industries to improve patient care—such as retail, which has successfully integrated online and in-person interactions to provide a seamless customer experience.

Use in health care: The asynchronous (often called “store and forward”) approach to care is now routine in many areas of health care, including dermatology, ophthalmology, radiology, cardiology, and pathology. This method allows physicians to practice from various locations, providing flexibility and efficiency. Psychiatry is projected to follow this trend, with increasing numbers of consultations becoming asynchronous in the coming years.

Efficiency of asynchronous consultations: Asynchronous consultations have been a part of mental health care for many years, often in the form of curbside consults. Collaborative care programs, e-consults via the EMR, and professional supervision in residency programs have also utilized asynchronous methods effectively.

Role of AI: While much has been written about the usefulness of artificial intelligence in streamlining administrative components of health care, it can also be used to significantly reduce time spent on interviewing, data collection, and documentation during patient consultations. AI-assisted avatars can conduct interviews, while other AI tools can transcribe and summarize recorded audio and video files and generate initial medical notes. This allows psychiatrists to focus more on data analysis and treatment planning, improving their efficiency and scaling the number of patients who may receive care.

Workforce shortages: Asynchronous video visits can help address the issue of too many patients and too few clinicians by scaling the number of patients seen, helping clinicians become more efficient.

Physician burnout: Asynchronous consultations provide flexibility and control over psychiatrists’ work schedules, reducing burnout, improving work-life integration, and enhancing their overall well-being.

Environmental benefits: Telehealth, including asynchronous consultations, can reduce carbon emissions by minimizing patient travel. Studies have shown significant reductions in driving miles, time, and costs for patients, as well as a decrease in crash-related injuries and carbon dioxide emissions.

The integration of asynchronous telehealth and artificial intelligence offers significant opportunities to improve mental health outcomes. Hybrid care, combining multiple technologies, has become the standard of care, providing greater access and efficiency for patients and providers. Embracing these technologies thoughtfully and ensuring they align with professional values and standards will benefit both providers and patients. ■