Original Research Telepsychiatry for Inpatient Consultations at a Separate Campus of an Academic Medical Center Jeffrey DeVido, MD, 1 Anna Glezer, MD, 1 Linda Branagan, PhD, 2 Alvin Lau, MD, 1 and James A. Bourgeois, OD, MD 1 1 Department of Psychiatry and 2 Telehealth Resource Center, University of California, San Francisco, San Francisco, California. Abstract Background: Many hospitals do not have regular access to psychiatry consult services. This is well understood as a common shortage at nonacademic community hospitals (es- pecially in rural environments, and may also be a problem at noncontiguously located smaller hospitals that are affiliated with academic medical centers in urban settings. The authors sought to deliver timely inpatient psychiatric consultation– liaison services via telemedicine to a local but physically separated hospital affiliated with an academic medical cen- ter. Materials and Methods: The authors collaborated with an office dedicated to the advancement of telemedicine tech- nology at their academic medical center. They developed a telemedicine-based care model to deliver inpatient consultation– liaison psychiatry consultations to an affiliated (but physi- cally separate) small academic hospital that did not have its own on-site consultation–liaison psychiatry team. Results: The au- thors were able to successfully complete 30 consultations, each within 24 h. Only 1 patient was ultimately unwilling to partic- ipate in the telemedicine interview. As consultations were accomplished on same day as request, patient length of stay was unaffected. Conclusions: This pilot study suggests that tele- medicine is a viable model for inpatient consultation–liaison psychiatry services to hospitals without on-site psychiatry resources and represents a viable alternative model of service delivery. Key words: telepsychiatry, inpatient psychiatry consulta- tions, consultation-liaison psychiatry Introduction T elemedicine has been an important technical and system advance for the provision of specialty medical care to populations in rural and other low-density communities where there is minimal or no access to local specialty care. Telemedicine for psychiatric care to rural primary care clinics has been embraced by patients and physicians as a solution to this specialty access problem. Advances in security, image and audio integrity, and stability of transmission have led to telemedicine systems that are re- liable, secure, and acceptable to all parties as an alternative model of care delivery that is sustainable and in some com- munities is ‘‘the new normal’’ for rural psychiatric care. 1 Hilty et al. 1 reviewed the various models for telepsychiatry service to rural primary care. Beyond video-based physician– patient sessions, other technological advances that have been applied to telemedicine to rural primary care include secure messaging (e-mail) linking patients and clinicians, as well as Internet-based technologies. In a more wide-ranging review, Hilty et al. 2 recently reviewed the published literature on telemental health and found it to be effective across an array of populations (child, adult, geriatric, ethnic) and for disorders in many settings (emergency, primary care, home health). The authors further found that telemental health was comparable to in-person care. With at least 36% of U.S. Veterans Health Administration (VHA)–enrolled veterans residing in rural regions, 3 the VHA has been particularly keen to use telepsychiatry services to expand psychiatric specialists’ reach. Deen et al. 4 recently reviewed telepsychiatric services offered by the VHA from 2006 to 2010 and noted a significant increase in all tele- psychiatric encounters during this period. The majority of these VHA encounters were for medication management and medication management with psychotherapy; however, the authors also highlighted a significant trend toward increased individual and group psychotherapy encounters. Diagnostically, interactive video has proven to be appli- cable to wide range of psychiatric disorders. Grubbs et al. 5 found that in fiscal year 2012, 1.5% (n = approximately 180,000) of all VHA mental health encounters were performed via interactive video and that anxiety, depression, and post- traumatic stress disorder were more commonly evaluated via interactive video than diagnoses of alcohol, drug, or psychotic disorders. Other studies have shown that interactive video can be effectively used in the evaluation and treatment of alcohol use disorders, 6 as well as psychotic disorders. 7 In addition, Godleski et al. 8 demonstrated the viability of interactive video in evaluating suicide risk. DOI: 10.1089/tmj.2015.0125 ª MARY ANN LIEBERT, INC.  VOL. 22 NO. 7  JULY 2016 TELEMEDICINE and e-HEALTH 1