Dr. Jim Heneghan, a child psychiatrist, used to spend 225 days of the year on the road, traveling to small New Mexico towns where his expertise is in short supply.

Today, thanks to telemedicine, Heneghan spends more than 30 hours a week caring for patients in places such as Clovis, Alamogordo, Ruidoso and Los Lunas while sitting in his office in the new Family Center on Santa Fe's south side.

He still travels to these towns once a month, in order to keep face-to-face rapport with his patients and the team of clinicians working with them. Four years ago, Zia Behavioral Health invested in telepsychiatry, which cut down Heneghan's travel time drastically.

"The technology makes it very much like the nightly news," Heneghan said. "The clarity is there and there really is no lag time."

The patient on the other end sits in front of the two-way video screen at a community health center in his or her hometown. Usually someone, such as a case manager, introduces the patient to the psychiatrist. In some sessions, treatment foster parents accompany the patient. The equipment also is used for emergency psychiatric evaluations and to connect with incarcerated or institutionalized children.

Heneghan's role is to oversee the patient's medication and clinical care, not to provide therapy. He sends the prescriptions he writes by Federal Express. He checks in with each patient once a month, asking questions about the patient's relationships with others, the patient's mood and response to medication.

"The kids really like it," Heneghan said. "When I go there in person, they say, 'Why aren't you on TV?' "

Many of his patients have been abused or neglected. Some are living at home under difficult circumstances; others are in foster care. Heneghan works closely with the school system, juvenile probation officers and the patient's treatment team.

Getting the telepsychiatry program started was tough because the state's Medicaid program was not set up to handle the billing. Heneghan said ValueOptions New Mexico, which manages the state's Medicaid program, stepped in to fix that glitch and help finance equipment costs, which in turn allowed Zia Behavioral Health to expand its telemedicine network.

"We're the fifth most rural state in the country, and we didn't get telepsychiatry until recently," said Heneghan, a founding member of Zia Behavioral Health and director of the telemedicine program.

But now, in his opinion, New Mexico has caught up — and possibly surpassed — what other states are doing in childhood telepsychiatry.

Zia's eight psychiatrists contract with various agencies around the state and also work as a private-practice group. They accept health insurance, Medicaid and private pay.

They treat adults as well as children because in much of rural New Mexico "we're the only game in town," Heneghan said.

Contact Diana Del Mauro at dianasf@juno.com.