For the past several months, Miguel Stamati, M.D. has been seeing elderly patients at their nursing home without leaving his office. A psychiatrist specializing in geriatric care, Stamati has been using ViaTV Phones as part of a pilot project being run by the Menninger Clinic - Center for Telepsychiatry in Topeka, KS.

Dr. Stamati has been caring for elderly patients at the Apostolic Christian Nursing Home in Sabetha, KS, seventy-five miles away. The senior citizens the psychiatrist sees regularly via the ViaTV Phone suffer from dementia or depression. Providing treatment in the nursing home is much preferred over transporting the patient to Topeka. Taking the patient out of their habitual environment exposes them to the elements and increases their risk of accidents and unnecessary stresses.

In a recent ViaTV Phone interview, both Dr. Stamati (above and right) and Center for Telepsychiatry director Jim Reid (far right) talked with 8x8 about telepsychiatry, how they have used our product and why they prefer it over a PC-based system. (The images here were captured using the ViaTV Phone's "Snapshot" feature.)

"I don't use the videophone for a first visit with a patient, only for follow-ups," states Dr. Stamati. "High functioning patients appreciate the regular and frequent face-to-face contact. Severely demented patients are brought into the room where the ViaTV is set up and I observe them while talking to the nurse. If the patient were to come to the hospital, they would have to be transported and there would be scant reporting on their behavior since I last saw them. With the videophone, I can talk to the right person: the nurse that sees the patient everyday."

Dean Strahm, assistant administrator at the Apostolic Christian Nursing Home, says, "ViaTV has saved us a lot of trips to Topeka. It's real simple to use. It does three important things: 1. keeps us in close contact with a psychiatrist (they are not readily available in rural areas) 2. keeps the patient in close and frequent contact with a psychiatrist, and 3. when a resident becomes a patient in the psych unit in Topeka, a spouse or friend here can talk to and see them."

Strahm believes they are saving Medicare a good deal of money when they don't have to admit one of their residents to a psychiatric hospital because ViaTV Phones are providing a healthcare conduit between psychiatrist and patient. "That can be a thousand dollars a day savings."

For the past few months, Dr. Stamati has been a telepsychiatry leader and champion, as the only psychiatrist involved in the pilot project, but Reid reports that the program is being expanded and additional psychiatrists will be participating.

"Home healthcare is going to be more prevalent as POTS (plain old telephone system) video conferencing continues to improve," said Reid who has been trying to change the attitudes of psychiatrists who look at telemedicine as new and different and who are not sure they want to get involved with it. "But we are winning the battle and the war as we address clinicians' legitimate concerns. The technology benefits the patients. Instead of a doctor seeing a patient once a month, they can see their patient at least once a week. Clinicians are more able to monitor behavior and detect deterioration in a patient's condition."

"The big issue with telemedicine and telepsychiatry is how do you make it pay for itself. We have to be able to justify the economic issues as well as the quality of care issues. 8x8 de-emphasizes the cost benefit ratio remarkably," states Reid. "At a time when reimbursement for telepsychiatry services is still patchy at best, the affordable price of the ViaTV Phone takes the technology costs completely out of the picture."

Before acquiring ViaTV Phones, Reid said they tried to employ a PC-based videophone but had many problems with the video and audio qualities. Also problematic was that most of the nursing home staff lacked computer training and were intimidated by PC-based video conferencing.

"This is the first product that we actually could put in a patient's home. If they can answer a phone and turn on the TV, we can provide them with behavioral healthcare in their home. I'm very excited because we've been waiting a long time for a product this good. I saw my first demonstration of POTS video in 1990 and it was a done by a charlatan. Now, we're here. It's a reality...ViaTV Phones are definitely adequate for almost all telepsychiatry applications."