Psychology Technology

Telemedicine For Everyone

Telemedicine For Everyone
Woman holding phone to ear, looking at a laptop, and sitting at a table with a large window behind her)
Did you know: Telemedicine and telemental health access is available to you. Have you tried it? Photo Credit: free for commercial use.

If you live in a large city, it’s likely you have already had your first experience with telemedicine.

Suppose on Day Seven of a nasty cold or flu, you decide it’s time to see your doctor. You call up your medical practitioner’s office and request an appointment. In smaller stand-alone practices, you would speak to a receptionist or scheduler, and you would be offered an appointment with your doctor based on his/her availability. In larger multiple-practitioner offices, you might be offered the option of seeing a different doctor other than your primary doctor if you wished to be seen sooner. Yet by phone, you’ve been triaged and placed into the schedule.

Most medical centers began using telephonic triage nurses to help patients get effective medical care in a timely manner, and also keep those who actually did not need to see their doctor from spreading colds and flus to others in a waiting room. Seattle is no exception, and I had the opportunity to work as a Telephonic Triage Nurse in 2011 and 2012. I am happy to report that I learned a lot about the effectiveness of telemedicine during that time!

Telemedicine, particularly in behavioral health settings, is an exciting option for those seeking counseling therapy. Yet perhaps you wonder, as I do, why more people aren’t using it more. Less than two percent of the inquires I receive from potential clients include a request for telemental counseling services (that is, sessions provided over an Internet connection using a HIPAA compatible video conferencing platform, or services provided over the phone).

Until last month, that is. I received an unprecedented number of inquiries about access to counseling sessions either by phone or by video conferencing. And I actually think this is very good news. Read on to find out why.

Why Aren’t More People Using Telemental Health Services? 

Based on what I’m reading about how people are using telemedicine and telemental health services, here are the reasons why people might not be using them as much as you’d think:

  1. They think F2F is better than video or phone communication, with “better” measured by the practitioners ability to see them with their own eyes.
  2. They think they might not get the help they need, i.e. something might get missed.
  3. They think the video component it might be too difficult to set up, especially for older clients or for clients in rural settings.
  4. They perceive it as less effective, and therefore it should cost less than a F2F visit
  5. They like the perceived value of spending time in a private office or medical setting.
  6. They are afraid that sessions held over the Internet or phone may not be confidential.
  7. They enjoy the special feeling of being in the room with another person, and having that person’s attention to their wellbeing.
  8. Those who wish to use their health insurance to cover the visits don’t look into whether they can get coverage for telemental health.

The ‘Real’ State of the Telemedicine and Telemental Health

Just like ATM’s and banking, telemedicine and telemental health services are being integrated into how we do medicine. It is not going away; it will simply increase in access over time.

As businesses have expanded to using video and phone conferencing as a communication tool, so medicine and behavioral health is being sanctioned and financially funded at the government level to help practitioners provide services to make them more accessible.

When we think of the word “accessibility,” it’s natural to consider the needs of the disabled in accessing health care. Additionally, accessibility can also be considered for those who have healthcare needs while balancing childcare, work, self-care,  commuting time, and their partner’s schedule. While not disabled, a parent who is the primary parent of a sick child and who works outside of the home may have difficulty finding time to come to an office on the other side of the city. However, if that parent could access her provider via an Internet connection and get the healthcare she needed, would this not also be a good, win-win solution?

The ‘real’ state of telemedicine and telemental health is that it is available, and has been available, for most Americans for the last five years, and the portals that provide safe, HIPAA compatible platforms have been well vetted. When providers are taught how to use these technologies safely, including telephonic triage, telephonic medicine, and Internet counseling sessions, it becomes clear that the reason why they aren’t being accessed more isn’t because they haven’t been deemed safe.

I think the main challenge is that it’s still new, and it’s not ubiquitous. You don’t hear about your friends saying, “Yeah, I just had a session with my therapist over the Internet, and I really feel a lot better.” 

Why You Should Try Telemental Sessions

Based on my brief assessment (above), here are some compelling reasons why I think you should give telemental sessions (whether over the phone or video) a try:

  1. You can host the session in the privacy of your own home.
  2. You can show your therapist how you live, not just tell him or her.
  3. You can include a family member in a session.
  4. You eliminate the anxiety and physical stress of commuting to the practitioner’s office.
  5. If given permission to do so, you can host your call or video chat at your workplace in a private office, and thus reduce the time needed to be away from your work if you’re in a particularly busy work season.
  6. As long as the camera used to capture a video conversation includes the person from head to waist, and the room is well lit with few obscuring shadows, the practitioner should be able to read body language as if you are sharing the same room.
  7. If you are ill, you won’t spread your illness to others due to coming in contact with others on the way to your practitioner’s office.

Telemental Health Sessions with Seattle Direct Counseling

Through my work with clients at SDC, I’ve been listening to what it is that people say that they need. I believe that the majority of people who seek counseling services are initially willing to come to our office. And then “life” happens: you get busy, you become ill or a family member becomes ill, you experience a job change, or you re-locate your home further away.

Currently, ten percent of my clients convert their sessions to telehealth sessions 50% to 100% of the time. About twenty percent of new clients are asking about telehealth options, because they are planning ahead for increasingly busy schedules or changes while leveraging consistent sessions to get the most out of their time.

In order to meet the increased need, I’m going to be offering telemedicine only sessions on two Mondays in October, October 10 and October 24, as a trial for those wishing to try it out. Those who wish to try it for the first time will still need to sign my registration forms as new clients; if you are a current client, you will be given an additional form pertaining to the use of telephonic sessions and video counseling sessions.

These October sessions on Monday will follow a different fee scale and will not be billed to health insurance . You can see the fee scale on my Fee Schedule page for those dates.

If you are interested in knowing more about how to set up for an Internet-based counseling session, click here for more information.


By Imei Hsu

Imei Hsu is a mental health counselor, active retired RN, AIP Coach and PN1-NC, writer, triathlete and arts promoter in the Seattle area and through online services. With 30+ years in healthcare (22+ years in mental health), Imei has a commitment to helping people discover insight into their health, relationships, and connecting. She is the owner of Seattle Direct Counseling and the blog, a presenter and speaker on a variety of psychological topics, and a positive force on the Internet. She launched her personal project, My Allergy Advocate, in 2018. Imei is a two-time Ironman Finisher (Mont-Tremblant 2016, Ironman Canada 2018); she also finished her first ultramarathon in 2017 and has gone on to race the 100K distance while preparing for 100 Mile trail races and a backyard ultra. You can find her running everywhere and eating all the thingz, watching movies, camping under the stars, and cooking real food.

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