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Because of these two situations, and hearing of others from colleagues, I determined that it was the house, the family dynamics that was the catalyst for making these kids 'mad'. When apart from these dynamics, they had the ability to comply with the guidelines of the organizations because they were required to do so. But actually what were the psychiatrists achieving for them? They simply subdued them with drugs, required their compliance, and returned them to the exact same overbearing environment which resulted in their being hospitalized in the very first place. It became obvious that the psychiatric establishment could truly care less, for each admission added to their coffers. The family was pleased to develop a scapegoat instead of addressing the core problem and to belong to send the 'disrupted kid' to so that they might continue in their own self-interest.

There were a number of practical aspects we needed to think about in the advancement and application of such a tool, consisting of developing partnerships, privacy issues, physician engagement, and payment. The objective of this post is to explain the steps needed to carry out the practical and technical aspects of the e-consultation system, while highlighting the thinking behind each action and the lessons learned along the way. The intent is to offer a step-by-step guide that can be used in other health areas to implement a similar procedure to enhance the overall access to care.

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