Telepsychiatry, also known as telebehavioral health, involves providing psychiatric services through telehealth technology.
This allows psychiatric nurses, behavioral health providers, and mental health professionals to evaluate, diagnose, and treat patients remotely using video conferencing, phone calls, and other forms of technology and mobile devices.
With the growth of telehealth nursing services in recent years, telepsychiatry is becoming an increasingly popular way for psychiatric nurses to provide care to patients.
It improves access to mental health services for patients in rural hospitals or underserved areas. It also allows nurses to reach more patients efficiently without traveling.
For psychiatric nurses interested in starting a telepsychiatry practice, this step-by-step guide covers everything you need to know to prepare nurses to get started in 2024.
But Why Start a Telepsychiatry Nursing Practice?
Nurses who are interested in starting a telepsychiatry nursing practice can enjoy the flexibility of working from home or anywhere else with an internet connection.
This can be a great option for nurses with families or other commitments, as it allows them to set their own hours and work around their schedules.
Telepsychiatry nursing also allows nurses to reach patients in underserved areas who may not have access to in-person psychiatric care.
This quality care is especially important in rural areas and areas with a shortage of other mental health care professionals.
In addition, telepsychiatry nursing services are often more affordable for patients than traditional in-person psychiatric nursing care. This is because there are no overhead costs associated with maintaining a physical office.
Many registered nurses also find that telepsychiatry nursing is a rewarding and fulfilling way to practice. They appreciate the ability to connect with patients remotely and help them improve their mental health.
If you are a nurse who is interested in starting a telehealth psychiatry nursing practice, there are many resources available to help you get started.
With its many benefits, telepsychiatry nursing is a great option for nurses who are looking for a flexible and rewarding career.
Below is the…
Step-by-step guide on How to Start a Telepsychiatry Nursing Practice
Step 1: Get Properly Trained and Educated in Telepsychiatry
While all advanced practice psychiatric nurses have strong clinical training, practicing telepsychiatry requires some additional communication skills, and knowledge. Before starting your own telepsychiatry practice, consider getting additional training and education in this specialty. Some options include:
Completing a telepsychiatry certificate program. There are both university-based and online options available. These go beyond the basics to provide in-depth training on clinical, ethical and technical aspects of telepsychiatry.
Attending telepsychiatry conferences and seminars hosted by professional organizations. These offer opportunities to learn from leading experts and network with others practicing telepsychiatry.
Reading books, articles and guidelines on telepsychiatry standards and best practices. Stay up to date on the latest clinical, technological and ethical issues.
Completing a rotation or observership with an established telepsychiatry practice. Learn through hands-on experience prior to starting your own practice.
Step 2: Check Licensure and Credentialing Requirements
Since telepsychiatry involves treating patients located across state lines, it’s crucial to check licensure requirements. To practice telepsychiatry, you’ll need:
An active registered nursing license in the state where you are located.
Proper licensure in each state where your patients are located. Most states require either a full medical license or a telemedicine license.
Proper certifications and credentials for your specialty. For example, Psychiatric and Mental Health Nurse Practitioner (PMHNP) certification.
Registration with the U.S. Drug Enforcement Administration (DEA) to prescribe controlled substances if applicable.
National Provider Identifier (NPI) number used for billing services.
Also check with individual telepsychiatry and telehealth platforms, organizations, and healthcare systems about their credentialing requirements for telehealth care providers. Staying properly credentialed in multiple states takes considerable time and effort. Some choose to start by only seeing patients in states where they have full licensure and expand from there.
Step 3: Set Up a Dedicated Telepsychiatry Space
To provide professional psychiatric services, you’ll need an appropriate clinical environment. Ideally set up a dedicated room or office space solely for telepsychiatry sessions. Key factors include:
Privacy – Conduct sessions in a quiet, private room with a door to prevent interruptions and ensure patient confidentiality.
Technology setup – Have a fast internet connection, high-quality web camera, microphone and speakers. Dual monitors can help you view notes and records during sessions.
Appearance – Present a professional background and environment. Ensure proper lighting, camera placement at eye level and professional attire.
Comfort – Use an ergonomic chair and position camera and computer for easy use and eye contact. Reduce distractions and noise.
Emergency protocol – Have a safety plan for high-risk situations. Know procedures for contacting local emergency services if needed.
HIPAA compliance – Take all necessary precautions to protect patient privacy and confidential data.
Step 4: Select a Secure Telepsychiatry Platform
There are many technology platforms and software solutions available for telepsychiatry. It’s critical to choose an option that is HIPAA-compliant and provides the features you need. Here are some key considerations when selecting a telepsychiatry platform:
Ensure the platform is HIPAA-compliant and uses encryption to protect sensitive patient data. Avoid free consumer-grade platforms.
Look for features such as scheduling, EHR integration, screen sharing, breakout rooms, waiting rooms and the ability to record sessions.
Select a platform compatible with your devices, camera, microphone etc. Test it ahead of time.
Ease of use – Pick a platform that’s intuitive for both you and patients. Complex platforms add unnecessary hurdles.
Check that reliable tech support is available in case of issues. Downtime can severely impact your practice.
Review privacy policies, terms of service and consent process to ensure they meet legal and ethical standards.
Some top telepsychiatry platform options include Doxy.me, TheraPlatform, VSee, Zoom for Healthcare and AdvanceMD.
Step 5: Handle Billing, Reimbursement and Finances
One of the biggest challenges when starting a telepsychiatry practice is navigating the financial side, including insurance billing, reimbursement and costs. Here are some tips to manage the finances:
Accept insurance – Contract with both private insurers and government payers like Medicare and Medicaid in the states where you practice. This allows you to reach the most patients.
Use proper coding – Bill telepsychiatry sessions using the appropriate CPT codes for psychiatric diagnostic interview, psychotherapy, medication management, etc.
Credential with insurers – Complete the credentialing process and enroll as a provider with insurers you plan to bill.
Use billers experienced in telepsychiatry – Consider hiring an experienced medical billing company or service to handle insurance claims.
Collect copays/deductibles – Have a system for collecting any applicable copays or deductibles directly from patients.
Set sliding scale fees – Offer options for uninsured patients using a sliding fee scale based on income. Apply for grants to cover uncompensated care.
Calculate overhead costs – Factor in costs for technology, licensure, administrative fees, support staff, office space and other overhead. Set appropriate rates.
Step 6: Establish Referral Networks and Agreements
Building up a steady referral network is key for a sustainable telepsychiatry practice. Consider developing referral relationships with:
Primary care providers – Educate local PCPs on how telepsychiatry can support whole person care for their complex patients. Make referral processes seamless.
Community health centers – Partner with FQHCs and clinics serving rural/underserved communities lacking mental health specialists.
Hospitals and health systems – Contract to provide telepsychiatry services for emergency departments, inpatient consults and other needs.
Community mental health agencies – Collaborate to expand access and coordinate care, while preventing duplication.
Employers/unions – Offer mental health services for employees and develop EAP contracts.
Create formal agreements delineating services, sharing information and procedures for referrals remote monitoring and follow-up. Ensure all operations comply with HIPAA.
Step 7: Develop Policies and Procedures
To guide day-to-day operations and maintain standards, healthcare professionals should develop detailed practice policies and procedures. They should cover areas such as:
Technology protocols – Instructions for using telepsychiatry platform features, troubleshooting, etiquette, documentation.
Clinic schedule – Hours of operation, appointment types and lengths, how to schedule/reschedule.
Intake process – Consent forms, releases, screenings, assessments and intake workflows.
Treatment protocols – Best practice guidelines for suicide risk, medications, psychotherapy etc. used with patients.
Coordination procedures – Communication, referrals and follow-up with other providers.
Privacy/HIPAA – Confidentiality, release of records, data security and other privacy practices.
Contingency plans – Procedures for handling clinical emergencies, referral, high-risk situations and technology failures.
Quality assurance – Activities to monitor quality of care and patient outcomes for continuous improvement.
Step 8: Market Your Telepsychiatry Practice
Creating awareness and marketing your services is essential for building up your patient caseload. Some effective marketing strategies include:
Website – Create a professional website highlighting your services, background, contact info, patient forms and telepsychiatry process.
Search engine optimization – Optimize website with keywords so patients can find you through search engines like Google.
Social media – Establish an online presence by creating professional profiles on platforms like LinkedIn and Facebook.
Print materials – Distribute brochures and flyers describing services to prospective referral sources.
Community presentations – Offer talks about mental health and available services to local organizations.
Networking – Attend conferences and meetings to connect with those involved in healthcare and mental health.
Advertising – Consider placing ads in local publications, community calendars or radio.
Always ensure marketing content and activities comply with ethics rules and legal standards in telehealth nursing degree programs. Focus on educating potential referral sources on how you can help telehealth nurses meet community needs.
Step 9: Continue Education and Professional Development
As with any nursing specialty, it’s important to stay up to date with the latest evidence-based practices, technologies and issues in telepsychiatry. Ongoing learning helps improve the care you and nurse practitioners can provide. Options include:
Reading peer-reviewed journals and publications related to telepsychiatry, technology and mental health.
Attending conferences, seminars and courses related to telebehavioral health.
Joining professional associations and telepsychiatry networks to access resources and connect with peers.
Earning telepsychiatry certifications – Demonstrate and maintain expertise through credentialing.
Completing continuing education on new modalities like virtual reality and topics like trauma-informed care.
Participating in research studies to help build the evidence base for telepsychiatry.
Mentoring other nurses interested in incorporating telepsychiatry into practice.
Step 10: Partner With a Collaborative Care Team
Providing quality psychiatric care involves working with other healthcare professionals to support patients. Build a collaborative care team to coordinate telepsychiatry treatment:
In-person therapists – Partner with therapists located near patients for in-person counseling and interventions. Provide consultation and oversight.
Primary care providers – Coordinate with PCPs on patient care plans, medication management, lab work and medical issues.
Care navigators – Hire support staff to help patients schedule visits, provide education, and facilitate referrals.
Pharmacists – Collaborate to monitor medication adherence, side effects, interactions and access.
Community services – Develop relationships with local crisis resources, case managers and peer supports.
Hospitalists – Consult on patients admitted for mental health issues and coordinate after discharge.
With a supportive care team, you can provide safe, comprehensive, quality care for complex cases and improve patient health outcomes. Formalize agreements for coordinating care while maintaining patient privacy.
Starting a telepsychiatry practice provides exciting opportunities to expand patient access, to quality mental healthcare services, serve remote communities, and bring innovation to psychiatric nursing.
By following this step-by-step guide, psychiatric nurses can build successful and sustainable telepsychiatry practices.
With proper preparation, following legal and ethical standards, leveraging technology and embracing a collaborative approach, telepsychiatry practices can flourish in the years ahead and transform psychiatric care delivery.
What is the demand for telepsychiatry services?
Demand for telepsychiatry continues to grow rapidly, fueled by mental health provider shortages and expanded insurance coverage. Telepsychiatry helps improve healthcare access, and reduce wait times for psychiatric care. The global telepsychiatry market is projected to grow at a CAGR of over 17% from 2022-2027.
What is the pay for telepsychiatry nursing?
Telepsychiatry nurses can earn competitive salaries, comparable to in-person psychiatric care. Average yearly salaries range from $80,000 to $120,000. Telepsychiatry may allow increased efficiency and patient load. Many negotiate hourly or per-session fees.
What are the challenges of telepsychiatry?
Some challenges include building rapport remotely educate patients, performing assessments without visual cues, managing technology issues, coordinating care teams across distance, and ensuring patient safety and privacy. With proper training and preparation, these can be overcome.
Can telepsychiatry prescribe medications?
Yes, telepsychiatry providers can do psychiatric evaluations, prescribe medications and manage ongoing treatment just as with in-person visits. Exceptions include controlled substances which require additional DEA registration based on locations.
What about liability and malpractice insurance?
Carrying professional liability insurance tailored to telepsychiatry and to receive telehealth services per visit is strongly recommended. Most policies for mental and health care providers cover telehealth services, but confirm to ensure proper coverage.
Does telepsychiatry require extra equipment?
A computer, secure internet connection, webcam, microphone and headset are minimum basics. For best video and audio quality, invest in items like wide-angle HD cameras, dual monitors and noise-cancelling mics.
What telehealth regulations apply?
Providers must follow all applicable federal and state telehealth regulations for licensure, HIPAA compliance, consent requirements and reimbursement for human services. Regulations vary across different states.
How do you build rapport via video?
Actively listen, maintain eye contact through the camera, demonstrate care through words and facial expressions, and be patient helping patients adjust to video visits. With practice, the patient-provider connection during virtual visits can be just as strong.
Can telepsychiatry provide the same quality of health care now?
Numerous studies show telepsychiatry is just as effective for psychiatric assessment, diagnosis, medication management patient education, therapy and patient satisfaction when practiced properly. But it isn’t appropriate for acute care for patients in crisis or for medical institutions requiring hands-on medical exams.
What tips do you have for starting out?
Start slow and focused. Don’t spread yourself too thin across states and services.
Spend time mastering the technology and building clinical skills.
Be patient working with patients to adjust to remote care.
Closely track outcomes, costs and revenue to identify what’s working.
Don’t underestimate the time involved for administration, coordination and marketing.