In episode 50 of Menninger's Mind Dive podcast, Jay Shore, MD, a pioneer in telepsychiatry, offers an in-depth perspective on the journey from the early days of telehealth to the present and where he sees it going with new technology such as AI. The COVID-19 pandemic highlighted the need for and adaptability of telehealth services, pushing the boundaries of traditional psychiatric care and redefining what patient/clinician relationships look like in the 21st century. 
For Dr. Shore, telehealth began as a response to the need for mental health services in underserved and hard to reach populations, such as rural townships and Native American communities. Initially, the focus was on replicating the in-person psychiatric experience through video conferencing. However, the recent global health crisis has accelerated the use and availability of telehealth services, proving that remote sessions can be as effective as face-to-face interactions when conducted with careful consideration and adaptation to the virtual medium.  
Dr. Shore discusses the nuances of virtual health relationships, including the unique sense of security some patients may feel during virtual sessions. A therapy session in a patient's personal space brings new dynamics into play, offering therapists unexpected insights into their patients' lives while also challenging them to maintain professional boundaries. 
The rapid rise in virtual services during the pandemic revealed a gap in preparation, with many clinicians adapting hastily without formal training. Given his decades of experience, Dr. Shore emphasizes the importance of acquiring a solid foundation in telehealth practices to ensure quality care and the effective use of technology.  
“Each patient has a range of technologies and the challenge to be a great clinician now is to know the boundaries, strengths and weaknesses of each medium, and correctly applying them to your patient to render the best care,” said Dr. Shore. 
Looking towards the future, Dr. Shore envisions a world where artificial intelligence and advanced technologies like micro expression analysis and biomarker detection such as heart rate and blood pressure monitoring could further transform the practice of telepsychiatry. Innovative technology promises to enhance a therapist's ability to understand and respond to a patient's needs more accurately but raises questions about privacy and the importance of preserving the human connection at the core of therapy. 
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