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State moves to allow virtual checkups for youth

Arkansas children with mental illnesses might be able to get virtual checkups starting in May.

LITTLE ROCK, Ark. (AP) — Arkansas children with mental illnesses might be able to get virtual checkups starting in May.

The Department of Human Services proposed a state Medicaid rule change Wednesday that would permit video conferencing and distance education for people younger than 21 who have mental illnesses.

People diagnosed with schizophrenia, depression, attention deficit disorder or other mental health problems would still have to be initially assessed in person, said Department of Human Services spokeswoman Amy Webb, but subsequent treatments could be made via the Internet. The exchanges would be face-to-face in real time at state-sanctioned sites.

"We have psychiatrists having to drive all over the state and children traveling outside their hometown," Webb said. "This will allow (doctors) to interact without all the traveling and give them more time to be doctors."

The agency said tens of thousands of children are served by only a handful of child psychiatrists in Arkansas. Webb said the change will reduce travel times for patients and doctors and increase accessibility for rural areas.

Health care providers will be required to connect to the Arkansan Telehealth Network and meet minimum technological standards. Screen sizes cannot be less than 20 inches in diameter, and meet bandwidth and picture-quality thresholds.

Telemedicine has been covered by Medicaid in Arkansas for people 21 and older since 2000, Webb said. She said the delay in the service for younger patients is a result of studies needed to set appropriate guidelines for the service.

Dr. Lynn Bufka, assistant executive director for practice, research and policy for the American Psychological Association said although telemedicine is not a new practice, it is still evolving, particularly when it comes to psychology.

"Part of what makes our work successful is the ongoing relationship developed with somebody," Bufka said. "... Professionals are concerned about that quality if they're meeting via teleconference."

Take, for instance, the placement of the camera in relation to the monitor, Bufka said. Cameras are typically placed above the monitor, meaning that patients and doctors cannot look each other in the eyes during psychological exams.

"In person, I can see peoples' emotional reactions and their walk and their mannerisms, which could change based on their emotional state," she said. "Being able to see that and capture that is very beneficial."

Another concern, she said, is a child's ability to differentiate what they see in a video conference checkup from television or movies. But overall, the technology has been beneficial in providing care to rural areas, Bufka said.

Officials hope the change can take effect in mid-May, but the proposal first has to be OK'd by the Administrative Rules and Regulations Committee. A joint House and Senate Interim Committee on Public Health, Welfare & Labor reviewed the change without discussion Wednesday.

 

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