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There are substantial shortages of mental health care providers in rural America ( 1 ), and primary care providers serve as the sole clinical contact for the vast majority of patients with mental illness ( 2 ). Distance and limited resources prohibit the traditional kinds of specialty referrals seen in more developed regions ( 3 ). Telemedicine has been cited as providing at least a partial solution to these shortages and difficulties by linking distant specialists with rural providers.
Traditionally, there have been two main types of telemedicine: synchronous, which typically relies on live, two-way interactive video transmission to a remote area, and asynchronous (store-and-forward), which transmits clinical information via e-mail or Web applications for later review by a specialist. Synchronous communication used for psychiatric treatment, or telepsychiatry, has been well described in the literature, is diagnostically valid, and is associated with good clinical outcomes and high patient satisfaction ( 4 , 5 ). This type of service, however, has not been implemented as widely as predicted because of administrative issues (for example, complex scheduling across clinics, patients, and providers), reimbursement and financial issues, long waiting times and a lack of specialists who are interested ( 6 ), and the absence of the required technical infrastructure in rural underserved areas ( 4 , 6 ).
Asynchronous telemedicine has been commonly used and well received by pathology, cardiology, radiology, dermatology, and other fields ( 7 ). Psychiatrists have long-standing expertise in providing consultations about patients without conducting a full face-to-face assessment ( 8 , 9 , 10 ), and this study addressed the feasibility of the next logical step, which is to develop a process for, and undertake a number of, asynchronous video-based telepsychiatry consultations.
AsyncHealth is the Mental Health Platform for Health Systems and Enterprise. Rapid, reliable mental health triage and clinical consultation with research-grade asynchronous telepsychiatry, built for businesses that serve clients
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