Telemedicine Services of Psychological Services - Research Paper Example

Assessment of a Telemedicine Based Cognitive Therapy Venture for treatment of Post Traumatic Stress Disorder in Military Veterans Introduction Post Traumatic Stress Disorder (PTSD) is recognized as a major health burden in US military veterans, due to its high prevalence and high rates of disability associated with the disorder. PTSD refers to a set of conditions where there are recurrent thoughts of some past traumatic event that takes place in the mind of military personnel impacting the quality of life and often leads to depression and suicide. Thus in these officers it is a chronic condition, and causes psychological suffering and social disability often leading to homicide. Hence the proper and timely management of PTSD is highly important. Barriers that compromise treatment of PTSD include accessibility to the health care centers, under diagnosis of the issue and often lack of perceived benefit from traditional treatments (Cantor and Price, 2007). Macksley Health Company who is a pioneer in offering many health care solutions to the US Government for various treatment options decides to launch a venture with the US Government for these military veterans who suffer from PTSD and are not being managed effectively. Apart from offering a state of the art telemedicine based treatment approach the company also desires to make it a profitable venture and that is what this study and project would evaluate. Background Though the recently developed evidence based treatments like CPT are quite effective for the treatment of mental health issues in these veterans, however these treatments are not widely available as a large portion of the US military veterans live in the rural communities and hence have poor access to specialized mental health care. A study done by Carole Porcari (2006) on the use of videoconferencing technology on the assessment of PTSD versus face to face clinician administered PTSD scale reflected the total and the subset scores were highly correlated with both the methods as the correlation coefficient was 0.828 and the relationship was statistically significant (p< 0.01)(Porcari,2006). In a study done by Hassija et al in 2011, the clients who were victims of rape and domestic violence were referred to the Wyoming Trauma Telehealth Treatment Clinic (WTTTC) who offer psychological services through the teleconferencing to the rural survivors for these incidences. Fifteen such clients were included in the study and received at least four sessions of trauma focused treatment through video conferencing based technology at the distal rape at distal rape and domestic violent care centers. The participants had significant reductions in PTSD and depression scores and apart from that the clients were highly satisfied with the video conferencing telemedicine services (Hassija et al, 2007). Methodology Data was collected from a randomized interview questionnaire (Table 1) from 50 PTSD patients based on their experience with current level of PTSD treatments they are receiving on the basis of various parameters. The response of the patients is presented in Fig 1. Do you receive Timely Treatment for your condition always Are you fully aware of your condition and its impact on the family Do you become violent in behavior Do you sometimes suffer from Depressed Mood Do you feel your family is affected by your problem Table 1: Interview Questionnaire Fig1: Response on the Interview Questions from the PTSD patients The telemedicine based approach planned is as follows: 1. Laptops will be hired and presented to 200 patients of PTSD 2. Internet usage and Telephone Bills will be reimbursed by our company 3. 2 Physicians and 1 Tele-caller would be recruited to deliver the telemedicine therapy including videoconferencing with the patients 4. The telemedicine approach will include twenty sessions of 1 hour duration per week on totality and as well on one to one basis based upon the follow up by Tele-caller every 3 days. 5. There would be provisions for Ambulance Hiring and Diagnostic Tests on as and when basis in case of critical patients. 6. E –mails and patient education literature would be distributed on an e- platform per day, which will include motivational notes, wellness messages and awareness on the issue would be provided. Cost Benefit Analysis of the Venture Considering the current expenditure of the US government on 200 PTSD patients on a span of 5 months is 200000$ and by appointing the Company Macksley Health for the telemedicine services the cost calculations are provided in Table 2. Expected Capital from Government        US $ ( 200 patients * 200$ /month * 5 months)       200000 Expenses         Mini-laptop & Internet usage         (35$/Monthly Rent * 200 patients * 5 months       35000 Physician Remunerations         2 Physicians @ 4000$/Month       40000 1 Tele-caller Salary         2000$/Month       10000 Ambulance & Emergency Service         3000$/Month       15000 Diagnostics Tests       20000 Variable Expense(If any)       5000 Total Expenses     125000           Total Profitability / 5 months   75000 Profitability/Month     15000 Table 2: Cost Benefit Analysis of the telemedicine venture Fig 2: Expresses the % profitability of the Telemedicine venture in next 5 months Discussion & Conclusion PTSD is a serious condition in US Military Veterans which left untreated and undertreated may have consequences like suicide and also be detrimental to the family of the patient. Currently our survey proves that 73% of these patients are not timely managed for their condition, 85% of the patients were not aware of the condition, around 30% of the patients suffered from episodes of violent behavior in spite of treatment, 90% of the respondents suffered from depressed mood which could aggravate their PTSD condition and lastly 80% of the patients were ignorant how their family has to cope with these patients and their condition. Based on these conditions a telemedicine based treatment venture is going to be proposed by Macksley Health Company to the US Government to accept them as their partner of choice for treating these patients. In the telemedicine based approach laptops and connectivity would be provided to the patients by Macksley Health Company and along with the recruitment of health care personnel to deliver the needful. There would be provisions for emergency ambulance and diagnostic services too. The cost benefit analysis projected calculates out with an expenditure of 125000$ per 200 patients for 5 months. The expected capital the company will receive from the US Government would be 200000$ for 200 patients for 5 months. This figure is arrived by calculating current cost to the US Government based on their expenditure on 200 PTSD patients. The net profitability of the venture calculates out to be 75000$ per 5 months with a monthly profitability of 15000$. The profitability % as calculated out was 60% considering the amount of profit/ expenditure. Considering the above criteria the venture of Macksley Health Company is predicted to be profitable and effective for treating military veterans who suffer from PTSD. References Cantor, C.; Price, J. (2007). "Traumatic entrapment, appeasement and complex post-traumatic stress disorder: Evolutionary perspectives of hostage reactions, domestic abuse and the Stockholm syndrome". Australian and New Zealand Journal of Psychiatry 41 (5): 377– 384. Hassija, C and Gray,M.(2011) Effectiveness of feasibility of videoconferencing technology to provide evidence based treatment to rural domestic violence. Telemedicine and e Health Vol 17, No 4:1-7. Porcari,C (2006). Telemedicine and PTSD Assessment of Veterans: A Study of Equivalence Between Videoconferencing (VTC) and Face-to-Face (FTF) Methods .Thesis Submitted to the Department of Psychology Eastern Michigan University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE in Clinical Psychology Intensive Cognitive Therapy for PTSD: A Feasibility Study Read More