I’ve mentioned here pretty often than I am not a technology sophisticate. I use technology every day in my work life, but I am a slow-adopter. For some of you, this article may be so old-hat that you will ask “Kathy, where have you been?” But I know there are others out there like me, so here goes anyway.
My mother-in-law had back surgery in Miami early this month. Since my 89-year-old mother lives with us, it has been impossible for me to go down to see her since the surgery. This past weekend, we arranged to skype a conversation so she could talk to me and my mom and we could “see” how she is doing. That word I just used…”skype” did not exist as a verb until August 2003 when a group of Estonia-based developers released the first version of what became Skype.
So what in the world is a skype? It is a company that created a technology that allows one computer to make voice and video calls to another computer free of charge. It also allows one to make phone calls from your computer to land lines and cell phones for a very low charge. Of course, it is the free-of-charge calls to other computers, especially video calls, that makes it so exciting. The process of doing this has become “to skype” or “we skyped.”
The technology allows high quality computer connections without going through a telephone service. As long as you have a high-speed internet connection, there are no voice/video delays. As long as your web cams are decent quality, picture and voice quality are excellent…and Skype has built-in tools to help you improve quality if you are having any difficulty.
But here’s the rub…Skype has become so popular that our Sunday morning attempt to connect was unsuccessful. The servers were all busy! So what’s a computer video newbie to do? Well, use Google Chat instead, of course.
SOS has recently switched all of our email to a Google corporate account. This gives us access to a number of other tools…Google Chat is one that we have used in-house for instant messaging. While I only learned about this through our Google account (I told you I am technology-impaired), this tool is also available to anyone who wants to use it…just check out the link above. I had not input the settings correctly before this weekend, so we combined old-fashioned cell phone technology with Google Chat computer video. There was a lack of synchronization between our cell phone service and the video, but now that I have my webcam microphone set up as the sound source it will be synced on future calls.
Yahoo! Messenger has provided similar service and functionality for years, and for Microsoft fans, Windows Live Messenger also allows these same capabilities. Ichat is a similar service used by Apple aficionados.
I must tell you that I do not have much interest in using this technology for work, but for personal contacts with family members who live far away, these are wonderful tools. My assessment of this may change over time. For many of you, the time may be now. Video conferencing is a wonderful way for scholars and far-flung colleagues to work together. It is also a fantastic way to provide behavioral health services to remote and home bound clients.
Several months ago, a Florida psychology listserv to which I belong was the setting for considerable discussion about remote provision of services. While some of the practitioners were hesitant to consider providing psychotherapy via computer video, some have already begun doing so. Community behavioral health organizations are actively considering such services for rural clients and others who require case management but are not readily available for visits. Over time, providing low-income, seriously mentally ill individuals with an inexpensive computer, internet service and webcam could save thousands of dollars in case manager travel and time costs, not to speak of hospitalization costs when deterioration not noticed on a telephone call but readily apparent on a video conference, is beginning.
The biggest push for these services may come from Medicare, Medicaid and other payers. A December 2008 article from the American Telemedicine Association details Medicare’s authorization for payment for remote services. These are provider and location-of-recipient dependent, so check out the details before you decide to start billing Medicare for such services. Since psychotherapy is a covered service for the purposes of telehealth, I expect more practitioners will begin to provide these services. I hope more abundant research on comparative efficacy will follow.
Has your organization begun providing any services remotely using video conferencing? What methods do you use? What benefits and limitations do you experience? If you are not already providing services in this fashion, what might it take to move you to do so?
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