Telehealth Interventions for Individuals With Chronic Illness: Research Review and Implications for Practice.

This article reviews outcome research on telehealth interventions for individuals with chronic illnesses. Only randomized controlled trials that provided data on specific health, quality of care, or clinical interview outcomes were selected. The overall findings suggested that telehealth interventions have shown promise as effective modes of treatment for people with chronic health conditions. Suggestions for improving the rigor and quality of future research are proposed, including the use of larger samples, conceptually meaningful control groups, cost analyses, strategies for enhancing ethnic minority recruitment, and experimental designs that examine interactions among different types of telecommunication technologies, specific health problems, and different patient populations. Implications for incorporating telehealth into psychological practice are also addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ten interdisciplinary principles for professional practice in telehealth: Implications for psychology.

Emerging telecommunications technology is changing psychological practice by enabling the provision of services across time and distance, yet there are significant concerns about these applications. In response to developments in telehealth—the term used for health services provided through these technologies—an interdisciplinary group developed a series of principles to inform health care practice. In this article, the authors review these principles and their implications for psychological telehealth, emphasizing that psychologists' ethical and professional requirements do not change with the introduction of a new tool. The principles provide a framework of critical ethical and professional issues that psychologists must consider in undertaking telehealth practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"High-Tech With the Human Touch: Using Telehealth to Reach America's Children." Correction to Wasem and Puskin (2000).

Reports an error in "High-tech with the human touch: Using telehealth to reach America's children" by Cathy Wasem and Dena Puskin (Professional Psychology: Research and Practice, 2000[Feb], Vol 31[1], 3-4). On page 4, the last sentence of text incorrectly reads, "For additional telehealth project, policy, legal, and funding information, visit OAT's web site at http://www.telehealth.hrsa.gov." The correct web site address is http://telehealth.hrsa.gov. (The following abstract of the original article appeared in record 2007-17617-001.) In the past decade, we have seen new telecommunication and information technologies used to provide health services, health professional and consumer education, and public health and administrative services. The application of these tools to health care, commonly referred to as telehealth, provides an unprecedented opportunity, as we embark on a new millennium, to take services to those in need-to "carry the water to the desert." Telehealth provides both a means to increase access, and to reengineer the processes of care, enhancing the equality and effectiveness of health services. This article illustrates how telehealth has helped children and youth in various health care settings. Many of these projects have been initiated with federal funds from OAT or other federal agencies. Some of the projects use technologies that require special phone lines and expensive equipment ranging from $15,000 to $50,000; others run over regular phone lines and use equipment costing between $500 to $1,000. Psychologists are involved in many of these projects as initiators of services, as members of multidisciplinary teams, and as researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High-tech with the human touch: Using telehealth to reach America's children.

[Correction Notice: An erratum for this article was reported in Vol 31(2) of Professional Psychology: Research and Practice (see record 2007-17403-001). On page 4, the last sentence of text incorrectly reads, "For additional telehealth project, policy, legal, and funding information, visit OAT's web site at http://www.telehealth.hrsa.gov." The correct web site address is http://telehealth.hrsa.gov.] In the past decade, we have seen new telecommunication and information technologies used to provide health services, health professional and consumer education, and public health and administrative services. The application of these tools to health care, commonly referred to as telehealth, provides an unprecedented opportunity, as we embark on a new millennium, to take services to those in need-to "carry the water to the desert." Telehealth provides both a means to increase access, and to reengineer the processes of care, enhancing the equality and effectiveness of health services. This article illustrates how telehealth has helped children and youth in various health care settings. Many of these projects have been initiated with federal funds from OAT or other federal agencies. Some of the projects use technologies that require special phone lines and expensive equipment ranging from $15,000 to $50,000; others run over regular phone lines and use equipment costing between $500 to $1,000. Psychologists are involved in many of these projects as initiators of services, as members of multidisciplinary teams, and as researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth issues in consulting psychology practice.

Consulting psychologists have recognized the importance of providing comprehensive consultation and clinical services for consumers with special needs. Often because of distance and access to consultation services, remote and underserved populations may not have the necessary access to consultant specialists in psychology and other disciplines. Such services are now available through an innovative model of telehealth. Telehealth technology and services have gained the attention of scientists, clinicians, consultants, and health educators in a variety of settings. Examined are consultation case scenarios using telehealth qualitative observations of consultants who have used telehealth and liability issues consultants may face using this technology. A model release of liability is provided for consulting psychologists who may consider its use in their consultation practice. Case examples using telehealth applications are discussed, as are special applications for health care delivery to undeserved rural populations using telehealth technology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An adaptation of the theory of interpersonal behaviour to the study of telemedicine adoption by physicians

Physicians' acceptance of telemedicine constitutes a prerequisite for its diffusion on a national scale. Based upon the Theory of Interpersonal Behavior, this study was aimed at assessing the predictors of physicians' intention to use telemedicine in their clinical practice. All of the physicians involved in the RQTE, the extended provincial telemedicine network of Quebec (Canada) were mailed a questionnaire to identify the psychosocial determinants of their intention to adopt telemedicine. Confirmatory factor analysis (CFA) was performed to assess the measurement model and structural equation modelling (SEM) was applied to test the theoretical model. The adapted theoretical model explained 81% (P<0.001) of variance in physicians' intention to use telehealth. The main predictors of intentions were a composite normative factor, comprising personal as well as social norms (beta=1.08; P<0.001) and self identity (beta=-0.33; P<0.001). Thus, physicians who perceived professional and social responsibilities regarding adoption of telehealth in their clinical practice had stronger intention to use this technology. However, it is likely that personal identity had a suppression effect in the regression equation, indicating that physicians' intention to use telemedicine was better predicted if their self-perception as telemedicine users was considered. These results have several implications at the theoretical and practical levels that are discussed in this paper.     

Telehealth and neuropsychological assessment: New opportunities for psychologists.

The advent of telehealth technology gives psychologists new opportunities to expand their practices in a cost-effective manner, but little is known about telehealth efficacy and costs. This study of 49 neuropsychology clients interviewed using videoconferencing and 49 matched in-person controls yielded no group differences in client ratings of interpersonal factors. Telehealth clients were more likely to want to repeat their experience, but psychologist satisfaction was lower for telehealth sessions. Telehealth costs were significantly lower than in-person costs. Concerns about ethical issues, billing, and licensure must be addressed to help practitioners capitalize on new telehealth opportunities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating psychosocial aspects of telemedicine and telehealth systems.

Telemedicine and telehealth evaluations often address the technological aspects of health care while neglecting the psychosocial implications of the technology. Currently, little is known about the meaning of telehealth care in terms of access, quality of care, or financial impact. This article focuses on the human aspects of using technology to provide mental health care and the insight that psychology can bring to the evaluation process. It discusses telehealth's impact on and interface with health care facilities, specifically in relation to training, informatics, remote consultations, patient outcomes, provider health, and professional practice. It also presents guidelines and suggestions for the implementation of a telehealth evaluation. It also presents guidelines and suggestions for the implementation of a telehealth evaluation, including evaluation design, examples of outcome-related questions that may be pertinent to telehealth evaluation, and suggestions for psychology's continuing role in telehealth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth and the evolving health care system: Strategic opportunities for professional psychology.

Telehealth (previously telemedicine)—the use of telecommunications to provide health information and care across distance—has recently reemerged as a potentially effective way to provide general and specialty health care services and appears poised to enter mainstream health service delivery. Because telehealth may become a significant part of the future of health care, it is critical to all professions that it be defined broadly. Barriers to the appropriate development of telehealth must be examined and addressed. Professional psychology's ongoing integrated legislative, legal, marketplace, and consumer education strategies for dealing with recent broader market-driven changes in the health care system provide a solid framework for analyzing and ensuring that psychological practice is poised to manage the opportunities and challenges presented by this emerging field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Designing websites for persons with cognitive deficits: Design and usability of a psychoeducational intervention for persons with severe mental illness.

The purpose of this study was to develop an understanding of the design elements that influence the ability of persons with severe mental illness (SMI) and cognitive deficits to use a website, and to use this knowledge to design a web-based telehealth application to deliver a psychoeducation program to persons with schizophrenia and their families. Usability testing was conducted with 98 persons with SMI. First, individual website design elements were tested. Based on these results, theoretical website design models were used to create several alternative websites. These designs were tested for their ability to facilitate use by persons with SMI. The final website design is presented. The results indicate that commonly prescribed design models and guidelines produce websites that are poorly suited and confusing to persons with SMI. Our findings suggest an alternative model that should be considered when designing websites and other telehealth interventions for this population. Implications for future studies addressing the characteristics of accessible designs for persons with SMI and cognitive deficits are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The coming age of telecommunications in psychological research and practice.

Rapid and far-reaching technological advances are revolutionizing the ways in which people relate, communicate, and live their daily lives. Technologies that were hardly used a few years ago, such as the Internet, e-mail, and video teleconferencing, are becoming familiar methods for modern communication. Telecommunications will continue to evolve quickly, spawning telehealth applications for research and the provision of clinical care in communities, university settings, clinics, and medical facilities. The impact on psychology will be significant. This article examines the application of developing technologies as they relate to psychology and discusses implications for professional research and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth and chronic disabilities: New frontier for research and development.

The primary purpose of this special section is to address key issues and current developments in telehealth outcome research for individuals with chronic disabling conditions. The special section begins with a critical review of contemporary telehealth and disability outcome research, followed by two articles that present the findings of 2 ongoing randomized controlled telehealth trials for adults with Type 2 diabetes and rural teenagers with uncontrolled seizure disorders. Future directions for outcome research on telehealth and chronic disability are discussed across all 3 articles, particularly the need for large N studies, the use of conceptually meaningful control groups and more rigorous cost utility analyses, and studies that evaluate the "best matches" among different types of telehealth interventions, specific health care concerns, and consumer populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Regulation of telepsychology: A survey of state attorneys general.

State attorneys general were surveyed regarding legal and regulatory issues related to delivery of behavioral health services in their states by electronic means. The data are discussed in the context of rapidly evolving technology and practice innovations that involve delivery of professional services by teleconference, the Internet, and other electronic media. Licensing, regulatory, and professional liability barriers are discussed, along with suggestions for practitioners who are considering engaging in behavioral telehealth services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Technological and Medical Advances: Implications for Health Psychology.

Behavioral telehealth, health informatics, organ and tissue transplantation, and genetics are among the areas that have been affected by advances in technology and medicine. These areas illustrate the opportunities and the challenges that new developments can pose to health psychologists. Each area is discussed with respect to implications for practice, research, public policy, and education and training: recommendations are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telehealth: A clinical application model for rural consultation.

This article describes how a child psychologist in a rural community provides the necessary comprehensive consultation and clinical services using a video telephone and the services of Kentucky Telecare. The authors present a clinical consultation model of health care for underserved populations where professional consultation with a team of professionals may benefit service providers in rural communities. The article examines an innovative model of telehealth care delivery through a university-based telehealth system to an underserved regional school system. A number of applications within a broad spectrum of services using telehealth technology are offered. Finally, shifts in administrative paradigms, clinical models, and information technology prevention services through telehealth are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The practice of psychological science: Searching for Cronbach’s two streams in social–personality psychology.

The present research surveyed a group of editors and editorial board members of personality and social psychology journals to examine the practice of psychological science in their field. Findings demonstrate that (a) although personality and social researchers tend to use many of the same approaches, methods, and procedures, they nonetheless show average differences in each of these domains, as well as in their overarching theoretical aims and perspectives; (b) these average differences largely conform to social and personality researchers’ stereotypes about each subgroup; (c) despite their methodological and philosophical differences, the 2 subgroups study many of the same research topics; and (d) the structure of social–personality research practices can be characterized as having 2 independent factors, which closely correspond to L. J. Cronbach’s (1957) correlational and experimental “streams of research.” (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rural backwaters or front-runners? Rural telehealth in the vanguard of psychology practice.

Over 20% of the United States population lives in rural areas, and rural clients often face serious access barriers to receiving psychology services. The acuity of rural need and growing ubiquity of the Internet among rural communities create opportunities for psychologists to provide assessment and treatment services to support rural clients at a distance using telehealth. This article reviews recent developments in telehealth that can improve quality of care for rural clients, including a review of cutting-edge technologies (monitoring devices, sensors, smart homes, etc.), methods of electronically mediated service delivery, and next steps for validation of telehealth psychology services. Also addressed are payer issues, privacy and confidentiality, and methodology concerns for this rapidly growing field of telehealth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical applications of telehealth in mental health care.

This article introduces the concept of telehealth and examines how telehealth expands both provider and patient access to health care. Current clinical applications are presented including equipment, research, and examples of direct clinical care. The article focuses on store-and-forward and video teleconferencing technologies providing information about the equipment and research pertaining to the clinical use of the equipment. The status of behavioral telehealth programs in the United States is reviewed and two case examples are provided. The first example discusses a direct patient care system and the second a remote clinical supervision system. The article concludes with suggestions for determining the value of adding telehealth to existing clinical practices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suitability of patient education materials for cardiac catheterization

Changes in healthcare delivery for such diagnostic procedures as cardiac catheterization have resulted in an emphasis on patient self-study, using booklets and videotapes given to them before the procedure. This transition mandates an evaluation of the appropriateness and effectiveness of these materials. The purpose of this study was to systematically assess the suitability of materials used to prepare patients for cardiac catheterization. Three videotapes and four booklets were evaluated using the Suitability Assessment of Materials instrument. Concrete objective information (procedural and sensation information) was also evaluated. Scores revealed only one video and two booklets suitable for patient education. None received a superior rating. These results suggest that some patient educational materials used to prepare patients for cardiac catheterization are unsuitable. Clinicians should augment current suitable materials to enhance their effectiveness.     

Clinical supervision in Canadian academic and service settings: The importance of education, training, and workplace support for supervisor development.

A national sample of Canadian psychologists who provide clinical supervision in academic or service settings (n?=?156) was surveyed regarding their background preparation for clinical supervision, satisfaction with current supervisory load, and workplace support for supervisory activities and development. With respect to supervisor training and development, the authors found that (1) almost two-thirds of the Ss received no formal training in supervision, (2) most initially felt inadequately prepared to supervise trainees, (3) subsequent self-study of supervision was perceived as helpful, and (4) self-study was associated with administrative encouragement for professional development. Exploration of supervisory load and workplace support showed that (1) a large majority of Ss were satisfied with their load, (2) satisfaction did not differ across academic and service settings, and (3) supervisors in service settings were more satisfied with opportunities for peer support around supervision. Ss called for more training in supervision and increased amounts of time on the job to devote to supervision. The need for increased training in supervision at all levels, continuing professional education, and workplace enhancements to facilitate supervision are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)