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“The internet is becoming the town square for the global village of tomorrow.” -Bill Gates
Ready or not, COVID-19 has catapulted the medical and mental health community into the era of telemedicine.
In an effort to be productive (and stay relevant) during the current global shut down, this 50-something, moderately tech-savvy mental health provider just finished a distance therapy training course and lived to tell about it. Here are my top 10 takeaways:
- Check out the more than 20 different platforms that provide HIPPA compliant practice management systems, only one of which is Zoom. Many companies will perform end to end encryption, which ensures patient information is always secure. As well these platforms provide services including things like: scheduling, reminders, video conferencing, treatment plans, forms and payment collection. Do some research; many companies have a free trial period.
- Establish a clear back up plan (in advance, preferably in writing, or verbally) in case a session is interrupted by someone (who is not the client) entering the room or if the internet connection is lost. This means, does the client know what to do if you are cut off? If there is an emergency?
- It is your job as the provider to ask about the client’s physical location, privacy and any concerns about safely discussing issues while on a virtual visit. Establish this at the beginning of each session. (Use a check in check list-EVERY TIME.) Document this.
- Have a policy about emails. Most people do not know that regular emails are not secure and sharing private information that is not encrypted needs to be disucssed. Virtru is an add-on for Gmail and Microsoft users that might be helpful to use with your existing email account for privacy.
- Have written guidelines about how you use texting. Do you have these guidelines written down and signed as part of your informed consent? (This was my biggest take away: we all need informed consent outlining all of digital communication policies about video sessions, texting and social media). As well, informed consent should include the limits of all of these modalities of communication.
- Use a headset if possible (it makes the connection feel closer and is more private). Make sure your equipment works (in advance) and that both parties can see one another, meaning eye contact is critical in establishing rapport over video.
- As well, be sure your background is free of distracting clutter.
- Know the limits of telemedicine and document your rationale for using it. High risk, suicidal patients may not be suited for virtual visits.
- Check an app for legal gudiance: Epstein Becker Green 2017: Telemental Health Laws. I downloaded right away. It is an interactive app that provides current laws by state as well as current YouTube videos, Twitter posts, related to new medical/mental health laws. Accurate, current and relevant info. YOU NEED THIS APP.
- Discuss the unique boundary issues around social media in advance with patients as they relate to interacting with you through LINKEDIN, Twitter, Instagram and Facebook. This needs to be directly addressed and in writing.
As always, document decision making steps to ensure standards of care are being met and when in doubt, peer consult or seek supervision, which you already know to do.
This training course was a good reminder that as things are rapidly changing, staying abreast of current standards and laws are critical to providing ethical care.
In fact, did you see the article on the expansion of telehealth with 1135 waiver?
Learn more with the PESI.com seminar: Telehealth for Mental Health Professionals. Try using the code: TELEFREE at checkout.
