•  Patient Safety and Emergency Management
•  Steve Daviss, M.D.

There are several unique considerations to patient safety and emergency management when practicing telepsychiatry:

• When evaluating patient safety, assess the patient’s level of agitation, the potential for harm to self or others, as well as any safety hazards that might be accessible by the patient during the session.
• The psychiatrist should become familiar with the facility where the patient is located, including any immediate professional staff who will be available in case of a clinical crisis; institutional emergency procedures; and ways to obtain collateral information about the patient in question.
• Being mindful of these issues during a telepsychiatry session will help the provider determine any need for higher levels of acute care, such as involuntary hospitalization, as well as changes in levels of patient observation. If necessary, the psychiatrist will also be able to coordinate any changes in the administration of medications upon any change in these patient safety/emergency considerations.
• Technology should be used to manipulate the image and sound quality of the video during the session to allow for the inspection of the patient for verbal and visual cues of agitation or other possible factors related to patient safety.