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Research at WFUBMC to Evaluate Telemedicine for Mental Health Care

Can technology that lets doctors "examine" patients who are miles away be used to provide mental health treatment to employees at their workplaces, residents in nursing homes or inmates in prison?

Wake Forest University Baptist Medical Center will answer part of that question with a $577,000 grant from the National Institutes of Health to evaluate video-conferencing as a way to provide mental health care to nursing home patients in isolated areas.

"When nursing homes have no access to a psychiatrist, residents who are confused or have behavior problems usually get treatment in emergency rooms," said Bev Jones III, M.D., assistant professor of psychiatry. "Providing ongoing care through video-conferencing could reduce the problems associated with depression and dementia, conditions that are common in nursing homes."

Jones, principal investigator for the study, said that if the project is successful, video-conferencing could eventually be used to provide mental health treatment to employees in work places, in correctional facilities and in adult group homes. The equipment is easy to install and costs less than $5,000.

In the first phase of the study, Medical Center patients 60 and older with possible depression, memory problems and movement disorders who agree to participate will be interviewed by two psychiatrists. One interview will be face-to-face; the other will be through video-conferencing, where the patient and doctor see and hear each other over a personal computer monitor.

The study will test the effectiveness of video-conferencing by evaluating the doctors'' ratings and diagnosis. In a pilot study of 50 patients, Jones found that video-conferencing was effective for diagnosing and treating geriatric patients with depression. Patients did not object to

the technology and some actually preferred it. The new study also includes memory problems and movement disorders, such as tremor and Parkinson''s disease, conditions also common in older adults.

In the second phase of the five-year study, video-conferencing equipment will be installed at Stokes-Reynolds Hospital in Danbury, which provides long-term nursing care, and at Oak Summit Nursing Center in Forsyth County. Nursing home residents who agree to participate will also receive face-to-face and video-conferencing interviews with psychiatrists to compare the two methods.

As part of the grant, Jones, who is principal investigator, will study for a master''s degree in public health science to learn more about alternative ways to provide mental health care.

The Medical Center is already using similar telemedicine technology to send medical tests such as X-rays and ultrasound examinations over the phone lines. Being able to get this information quickly allows Medical Center radiologists to consult on difficult cases and for its pediatric cardiologists to diagnose heart problems in newborn babies at distant hospitals.

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