14 Essential Informed Consent Elements
marlenemaheu
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82 slides
May 12, 2020
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About This Presentation
14 Essential Telemental Health Informed Consent Elements (2 Hour Webinar)
For full webinar, visit https://telehealth.org/webinar/job/
At the Telebehavioral Health Institute, you can earn CE hours while you learn. You can benefit from our webinars, our individual course modules or full Certificati...
Slide Content
Telebehavioral Health
Institute, Inc.
Marlene M. Maheu, PhD
Executive Director
619-255-2788
‘Copyright © 2017 Telebehavioral Health institute Al rights reserved.
Institute, Inc.
Marlene M. Maheu, PhD
Executive Director
619-255-2788
‘Copyright © 2017 Telebehavioral Health institute Al rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
TBH INSTITUTE
Consultation
Training
Staffing
Credentialing
www.Telehealth.org
INSTITUTE
TBH INSTITUTE
Consultation
Training
Staffing
Credentialing
www.Telehealth.org
TELEBEHAVIORAL HEALTH
INSTITUTE
WHO | AM: | am a licensed MFT and psychologist, not an attorney, physician,
marketing or information technology (IT) professional.
MY GOALS: | hope to inspire you. | will outline the issues in an educational
format and alert you to what's happening to help you think through the issues.
No warranty, guarantee, or representation is made as to the accuracy or
sufficiency of the information contained in my presentation for your specific
circumstance. | assume no responsibility in connection with your choices.
YOUR PART: Seek documented training for “competence.” Seek written
approval from your legal, regulatory, ethical and malpractice bodies before
offering any online services or programs to consumers. Have your informed,
trusted, local, clinical and legal consultants review all written responses from
the authorities for their full significance.
‘Copyright 2017 Telab Heath Institute Al rights reserved.
INSTITUTE
WHO | AM: | am a licensed MFT and psychologist, not an attorney, physician,
marketing or information technology (IT) professional.
MY GOALS: | hope to inspire you. | will outline the issues in an educational
format and alert you to what's happening to help you think through the issues.
No warranty, guarantee, or representation is made as to the accuracy or
sufficiency of the information contained in my presentation for your specific
circumstance. | assume no responsibility in connection with your choices.
YOUR PART: Seek documented training for “competence.” Seek written
approval from your legal, regulatory, ethical and malpractice bodies before
offering any online services or programs to consumers. Have your informed,
trusted, local, clinical and legal consultants review all written responses from
the authorities for their full significance.
‘Copyright 2017 Telab Heath Institute Al rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Today's Plan
o You may want to tum off your cell phone, keep away
from email & keep others out of your office
o Slides and the recording of this training are available in
the TBHI Training Center
o You will have access to them both for 6 months from
your date of registration
o Toward the end, I'll take your questions toward the end
of class, but please send them as they occur to you. | will
take them on a “first-come, first-served" basis.
© Our eLearning system allows you to take notes,
participate in our HUB Community Forum to ask questions
and participate in related discussions.
Institute All ights reserved,
INSTITUTE
Today's Plan
o You may want to tum off your cell phone, keep away
from email & keep others out of your office
o Slides and the recording of this training are available in
the TBHI Training Center
o You will have access to them both for 6 months from
your date of registration
o Toward the end, I'll take your questions toward the end
of class, but please send them as they occur to you. | will
take them on a “first-come, first-served" basis.
© Our eLearning system allows you to take notes,
participate in our HUB Community Forum to ask questions
and participate in related discussions.
Institute All ights reserved,
TELEBEHAVIORAL HEALTH
INSTITUTE
Name at least 5 issues addressed by published
professional association standards and guidelines
for telemental health that can be handled most
easily and efficiently through an informed consent
process and electronic document
List at least 5 documentation-specific
requirements that can be addressed by a proper
informed consent process
Intelligently discuss how to handle employers who
minimize your concerns about informed consent
INSTITUTE
Name at least 5 issues addressed by published
professional association standards and guidelines
for telemental health that can be handled most
easily and efficiently through an informed consent
process and electronic document
List at least 5 documentation-specific
requirements that can be addressed by a proper
informed consent process
Intelligently discuss how to handle employers who
minimize your concerns about informed consent
TELEBEHAVIORAL HEALTH
INSTITUTE
Informed
Consent
Legal
Issue
Ethical
Issue
Copyright 2017
INSTITUTE
Informed
Consent
Legal
Issue
Ethical
Issue
Copyright 2017
INSTITUTE
Informed Consent Discussion VS
Document
oRepresents a "meeting of the minds”
- Information is influenced by many factors,
including:
> Client/Patient's capacity for absorbing information
» Time Limits
» Clinician's schedule
- Subject matter is often complex and technical
- Clinician thinks she is speaking English
- Client/Patient may be under stress (or may assert
so later)
- Mental illness
Informed Consent Discussion VS
Document
oRepresents a "meeting of the minds”
- Information is influenced by many factors,
including:
> Client/Patient's capacity for absorbing information
» Time Limits
» Clinician's schedule
- Subject matter is often complex and technical
- Clinician thinks she is speaking English
- Client/Patient may be under stress (or may assert
so later)
- Mental illness
INSTITUTE
Informed Consent Discussion VS
Document
oDocument only serves as important
evidence of discussion
oDocument is usually only an addendum
added to your regular informed consent
oAll standard informed consent elements
apply
oJust add telemental health elements
Informed Consent Discussion VS
Document
oDocument only serves as important
evidence of discussion
oDocument is usually only an addendum
added to your regular informed consent
oAll standard informed consent elements
apply
oJust add telemental health elements
Specific statuses govern
informed consent in
telehealth
Who's state law controls?
Solution: assume that the
law of the client/patient's
location will most likely be
applied
More conservative
approach is to determine
the law in both your and
your client/patient's state
and follow mandates of the
more stringent law
TELEBEHAVIORAL HEALTH
INSTITUTE
informed consent in
telehealth
Who's state law controls?
Solution: assume that the
law of the client/patient's
location will most likely be
applied
More conservative
approach is to determine
the law in both your and
your client/patient's state
and follow mandates of the
more stringent law
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
AB 415 - Telehealth Advancement Act
AB 415 changes telehealth's additional written patient
consent requirement to verbal consent.
O Providers found that the written consent form
stigmatized the use of telehealth, and created an
unnecessary barrier to care.
© AB 415 replaces the written consent with a verbal
consent. This establishes parity between services
rovided in person and those provided via
elehealth. (Must be documented.)
http://cchpca.org/telehealth-advancement-act
INSTITUTE
AB 415 - Telehealth Advancement Act
AB 415 changes telehealth's additional written patient
consent requirement to verbal consent.
O Providers found that the written consent form
stigmatized the use of telehealth, and created an
unnecessary barrier to care.
© AB 415 replaces the written consent with a verbal
consent. This establishes parity between services
rovided in person and those provided via
elehealth. (Must be documented.)
http://cchpca.org/telehealth-advancement-act
TELEBEHAVIORAL HEALTH
INSTITUTE
Australian Psychological Society. (2004). Guidelines for Providing
Psychological Services and Products on the Internet
British Psychological Society. (2009). The Provision of Psychological Services
via the Internet and Other Non -direct Means
Canadian Psychological Association. (2006). Ethical Guidelines for
Psychologists Providing Psychological Services via Electronic Media
Federation of State V edical Boards of the United States, Inc., Report of the
Special Committee on Professional Conduct and Ethics. (2002). Model
guidelines for the appropriate use of the Internet in medical practice
National Association of Social Workers. (2008). Code of Ethics
National Board for Certified Counselors and Center for Credentialing and
Education. NBCC Provision of Distance Professional Services (2012)
New Zealand Psychological Psychologists Board (2011). Draft Guidelines:
Psychology services delivered via the internet and other electronic media
Ohio Psychological Association. (2010). Telepsychology Guidelines
http://telehealth.org/ethical-statements/
‘Copyright 2017 Telab th institute All rights reserved.
INSTITUTE
Australian Psychological Society. (2004). Guidelines for Providing
Psychological Services and Products on the Internet
British Psychological Society. (2009). The Provision of Psychological Services
via the Internet and Other Non -direct Means
Canadian Psychological Association. (2006). Ethical Guidelines for
Psychologists Providing Psychological Services via Electronic Media
Federation of State V edical Boards of the United States, Inc., Report of the
Special Committee on Professional Conduct and Ethics. (2002). Model
guidelines for the appropriate use of the Internet in medical practice
National Association of Social Workers. (2008). Code of Ethics
National Board for Certified Counselors and Center for Credentialing and
Education. NBCC Provision of Distance Professional Services (2012)
New Zealand Psychological Psychologists Board (2011). Draft Guidelines:
Psychology services delivered via the internet and other electronic media
Ohio Psychological Association. (2010). Telepsychology Guidelines
http://telehealth.org/ethical-statements/
‘Copyright 2017 Telab th institute All rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
American Counseling Association. (2014). ACA Code of Ethics
American Mental Health Counselors Association. (2000). Code of Ethics of
the American Mental Health Counselors Association, Principle 14, Internet
On -Line Counseling
American Psychological Association. (2010). Ethical principles of
psychologists and code of conduct
American Psychological Association (2013). Guidelines for the Practice of
Telepsychology
American Telemedicine Association. (2009). Evidence -Based Practice for
Telemental Health
American Telemedicine Association. (2009). Practice Guidelines for
Videoconferencing-Based Telemental Health
American Telemedicine Association (ATA). (2013). Practice Guidelines for
Video -Based Online Mental Health Services
http://telehealth.org/ethical-statements/
Copyright & 2017 Telab Heath Institute Al rights reserved.
INSTITUTE
American Counseling Association. (2014). ACA Code of Ethics
American Mental Health Counselors Association. (2000). Code of Ethics of
the American Mental Health Counselors Association, Principle 14, Internet
On -Line Counseling
American Psychological Association. (2010). Ethical principles of
psychologists and code of conduct
American Psychological Association (2013). Guidelines for the Practice of
Telepsychology
American Telemedicine Association. (2009). Evidence -Based Practice for
Telemental Health
American Telemedicine Association. (2009). Practice Guidelines for
Videoconferencing-Based Telemental Health
American Telemedicine Association (ATA). (2013). Practice Guidelines for
Video -Based Online Mental Health Services
http://telehealth.org/ethical-statements/
Copyright & 2017 Telab Heath Institute Al rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Behavioral Telehealth Best Practices Checklist
Derived from APA sidelines, 2013
Maheu Mn Agnoletti, Phe
Thisbest practices and documentation checklistis derived from aTeleMental Healthinstitute review of2013
American Pry chological Association and American Telemedicine Association's Guidelines *
2013 APA & ATAGuideline Similarities
iudginent in any specific
Beth documents recommend
Adherence to local, state ficensing lswrsinterjuisdicrional practice, mandatory reporting), federal laws
(6-4 HIPAA and HITECH) Sethical codes of profession
of practitioner (adequate professional and technical knowledge and skills, etc)
Casefuland ongoing assessment
Emergency planning
Privacy, security and confidentiality and risk management
Documentation
2013 APA & ATA Guideline Differences
APA Written for Psychologists ATA Written for All TelementalHeakhProviders
Global perspective Specific penpective
Scope email telephone, social networking and video Scope real-time, videoconferencing via personal computers
Copyright a Heath Institute Al rights reserved.
INSTITUTE
Behavioral Telehealth Best Practices Checklist
Derived from APA sidelines, 2013
Maheu Mn Agnoletti, Phe
Thisbest practices and documentation checklistis derived from aTeleMental Healthinstitute review of2013
American Pry chological Association and American Telemedicine Association's Guidelines *
2013 APA & ATAGuideline Similarities
iudginent in any specific
Beth documents recommend
Adherence to local, state ficensing lswrsinterjuisdicrional practice, mandatory reporting), federal laws
(6-4 HIPAA and HITECH) Sethical codes of profession
of practitioner (adequate professional and technical knowledge and skills, etc)
Casefuland ongoing assessment
Emergency planning
Privacy, security and confidentiality and risk management
Documentation
2013 APA & ATA Guideline Differences
APA Written for Psychologists ATA Written for All TelementalHeakhProviders
Global perspective Specific penpective
Scope email telephone, social networking and video Scope real-time, videoconferencing via personal computers
Copyright a Heath Institute Al rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Name at least 5 issues addressed
by published professional
association standards and
guidelines for telemental health
that can be handled most easily
and efficiently through an
informed consent process and
electronic document
lebehovierol Heath Institute Allrights reserved.
INSTITUTE
Name at least 5 issues addressed
by published professional
association standards and
guidelines for telemental health
that can be handled most easily
and efficiently through an
informed consent process and
electronic document
lebehovierol Heath Institute Allrights reserved.
List at least 5
documentation-specific
requirements that can
be addressed by a
proper informed
consent process
TELEBEHAVIORAL HEALTH
INSTITUTE
‘Copyright & 2017 Telebehavierat Heath Insttute Allrights reserved.
documentation-specific
requirements that can
be addressed by a
proper informed
consent process
TELEBEHAVIORAL HEALTH
INSTITUTE
‘Copyright & 2017 Telebehavierat Heath Insttute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Intelligently discuss
how to handle
employers who
minimize your conc
about informed
consent
‘Copyright & 2017 Telebehavierat Heath Insttute Allrights reserved.
INSTITUTE
Intelligently discuss
how to handle
employers who
minimize your conc
about informed
consent
‘Copyright & 2017 Telebehavierat Heath Insttute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Date
Diagnosis
Outline of
intervention
INSTITUTE
Date
Diagnosis
Outline of
intervention
TELEBEHAVIORAL HEALTH
INSTITUTE
4. Document how you
are in compliance
with
state/provincial
law
OWhat are you licensed
to practice?
OName the states,
provinces or countries
lute Allrights reserved,
INSTITUTE
4. Document how you
are in compliance
with
state/provincial
law
OWhat are you licensed
to practice?
OName the states,
provinces or countries
lute Allrights reserved,
Discuss
legal/regulatory
mandates for all
jurisdictions
involved (clinician's
& client's/patient's
location at time of
contact)
TELEBEHAVIORAL HEALTH
INSTITUTE
legal/regulatory
mandates for all
jurisdictions
involved (clinician's
& client's/patient's
location at time of
contact)
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
5. Describe how
you keep records
secure (i.e., in
compliance
with...)
INSTITUTE
5. Describe how
you keep records
secure (i.e., in
compliance
with...)
TELEBEHAVIORAL HEALTH
INSTITUTE
ae Counseling Association “Code of Ethics”
H.5. Record
H.5.a. Records
Counselors maintain electronic records in accordance
with relevant laws and statuses. Counselors inform
clients on how records are maintained electronically.
This includes, but i is not limited to, the type
encryp rity assigned to the records, and
O al storage of transaction records
is fied iarse lhe
http://www.counseling.org/Resources/aca-code-of-
ethics.pdf
ath Institute. Allrighis reserved.
INSTITUTE
ae Counseling Association “Code of Ethics”
H.5. Record
H.5.a. Records
Counselors maintain electronic records in accordance
with relevant laws and statuses. Counselors inform
clients on how records are maintained electronically.
This includes, but i is not limited to, the type
encryp rity assigned to the records, and
O al storage of transaction records
is fied iarse lhe
http://www.counseling.org/Resources/aca-code-of-
ethics.pdf
ath Institute. Allrighis reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
6. Identify and
record
client/patient
preferences
regarding
technology,
treatment,
arrangements
INSTITUTE
6. Identify and
record
client/patient
preferences
regarding
technology,
treatment,
arrangements
7. Allow patients to
prohibit use of
identifiable images or
information by
researchers or other,
unidentified entities.
8. Allow patients the
opportunity to prohibit |
identifiable medical
information or images
from appearing in any
electronic medium
TELEBEHAVIORAL HEALTH
INSTITUTE
prohibit use of
identifiable images or
information by
researchers or other,
unidentified entities.
8. Allow patients the
opportunity to prohibit |
identifiable medical
information or images
from appearing in any
electronic medium
TELEBEHAVIORAL HEALTH
INSTITUTE
9. Consider
mentioning
multicultural, diversity,
socio-economic and
your policies for such. 4
10. Consider
mentioning linguistic
issues [e.g., is it
advisable to test
verbal or auditory
language skills?)
TELEBEHAVIORAL HEALTH
INSTITUTE
mentioning
multicultural, diversity,
socio-economic and
your policies for such. 4
10. Consider
mentioning linguistic
issues [e.g., is it
advisable to test
verbal or auditory
language skills?)
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
11. Obtain information regarding
medical and psychiatric services that
are nearby to make appropriate
referrals.
12. Obtain name and contact
information for the patient’s medical
provider during a crisis situation.
a. Send letter as you would with local
clients upon intake.
INSTITUTE
11. Obtain information regarding
medical and psychiatric services that
are nearby to make appropriate
referrals.
12. Obtain name and contact
information for the patient’s medical
provider during a crisis situation.
a. Send letter as you would with local
clients upon intake.
Consider other
individual
characteristics
(e.g., medical
status, psychiatric
stability,
physical/cognitive
disability, personal
preferences)
TELEBEHAVIORAL HEALTH
INSTITUTE
individual
characteristics
(e.g., medical
status, psychiatric
stability,
physical/cognitive
disability, personal
preferences)
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
Describe why your
choice of technology
(i.e., Skype or alternative
video, text messaging,
email) needs to be
reflected in your informed WN
consent process.
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
INSTITUTE
Describe why your
choice of technology
(i.e., Skype or alternative
video, text messaging,
email) needs to be
reflected in your informed WN
consent process.
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
13. Outline the risks and
benefits of treatments
chosen is standard
elements of IC.
14. Name technologies
used (video, email, Text,
apps, social media, etc.)
15. Risks and benefits of
all technologies used is
normal protocol for TBHI.
TELEBEHAVIORAL HEALTH
INSTITUTE
benefits of treatments
chosen is standard
elements of IC.
14. Name technologies
used (video, email, Text,
apps, social media, etc.)
15. Risks and benefits of
all technologies used is
normal protocol for TBHI.
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
Document verbal informed
consent prior to treatment
(risks/benefits of chose
technology; limits to
confidentiality; access,
disclosure & storage of
data; boundaries;
procedures for responding
to e-communications)
ith Institute All ights reserved,
INSTITUTE
Document verbal informed
consent prior to treatment
(risks/benefits of chose
technology; limits to
confidentiality; access,
disclosure & storage of
data; boundaries;
procedures for responding
to e-communications)
ith Institute All ights reserved,
TELEBEHAVIORAL HEALTH
INSTITUTE
Consider accessibility of
technology &
client’s/patient’s and
practitioner's technical
competence
Copyright © 2017
INSTITUTE
Consider accessibility of
technology &
client’s/patient’s and
practitioner's technical
competence
Copyright © 2017
TELEBEHAVIORAL HEALTH
INSTITUTE
Outline how to
easily address email
and text messaging
in your informed
consent process
jehavieral Heath Institute All rights reserved.
INSTITUTE
Outline how to
easily address email
and text messaging
in your informed
consent process
jehavieral Heath Institute All rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Email and Text Messaging
o*l use the abc system to secure email”
o*l do not require the use of a secure
email program, but our email exchanges
can be intercepted, sent to the wrong
address, hacked, impersonated, and
response times may take xxxx hours, days
or weeks.”
INSTITUTE
Email and Text Messaging
o*l use the abc system to secure email”
o*l do not require the use of a secure
email program, but our email exchanges
can be intercepted, sent to the wrong
address, hacked, impersonated, and
response times may take xxxx hours, days
or weeks.”
16. Must rely on information
provided by the
client/patient and by any
on-site practitioners or
other sources.
17. Potential problems
could arise with electronic
transmission in
telepractice:
1. Distortion, delays
interceptions, interruptions
TELEBEHAVIORAL HEALTH
INSTITUTE
provided by the
client/patient and by any
on-site practitioners or
other sources.
17. Potential problems
could arise with electronic
transmission in
telepractice:
1. Distortion, delays
interceptions, interruptions
TELEBEHAVIORAL HEALTH
INSTITUTE
TELEBEHAVIORAL HEALTH
INSTITUTE
18. Describe how deficiencies electronic
equipment could possibly cause
interference with diagnosis or treatment.
19. Make provision for non-receipt or email,
delayed receipt, problems with servers, or
unannounced changes in the schedule of
email communications.
20. Mention how easily human error could
lead to incorrectly delivered messages or
other unforeseen events.
‘Copyright 2017 Tela! Heath Institute Al rights reserved.
INSTITUTE
18. Describe how deficiencies electronic
equipment could possibly cause
interference with diagnosis or treatment.
19. Make provision for non-receipt or email,
delayed receipt, problems with servers, or
unannounced changes in the schedule of
email communications.
20. Mention how easily human error could
lead to incorrectly delivered messages or
other unforeseen events.
‘Copyright 2017 Tela! Heath Institute Al rights reserved.
Il TELEBEHAVIORAL HEALTH |p
INSTITUTE
Informed Consent
Documentation Basics
21, Risks and benefits of
competing approaches
a. Including no service
20. Emergency Plan
including names and
contact information for
local, trusted person(s)
to be contacted at the
discretion of the
clinician.
Copyright & 2017 Telabehaviorat Heath institute Allrights reserved.
INSTITUTE
Informed Consent
Documentation Basics
21, Risks and benefits of
competing approaches
a. Including no service
20. Emergency Plan
including names and
contact information for
local, trusted person(s)
to be contacted at the
discretion of the
clinician.
Copyright & 2017 Telabehaviorat Heath institute Allrights reserved.
How can you learn
and document the
local resources for
your client/patients®
How will you keep
them handy at every
contact?
‘Copyright & 2017 1
TELEBEHAVIORAL HEALTH
INSTITUTE
Heath Institute Al rights reserved.
and document the
local resources for
your client/patients®
How will you keep
them handy at every
contact?
‘Copyright & 2017 1
TELEBEHAVIORAL HEALTH
INSTITUTE
Heath Institute Al rights reserved.
How should you use
your informed
consent process as an
aid to planning for
and addressing
emergencies?
TELEBEHAVIORAL HEALTH
INSTITUTE
7 Telebehavieral Health institute All rights reserved,
your informed
consent process as an
aid to planning for
and addressing
emergencies?
TELEBEHAVIORAL HEALTH
INSTITUTE
7 Telebehavieral Health institute All rights reserved,
TELEBEHAVIORAL HEALTH
INSTITUTE
Provide and discuss clear €
emergency plan with .
written instructions (e.g., Ni
suicide, homocide, abuse, | /
other)
Institute All ights reserved,
INSTITUTE
Provide and discuss clear €
emergency plan with .
written instructions (e.g., Ni
suicide, homocide, abuse, | /
other)
Institute All ights reserved,
TELEBEHAVIORAL HEALTH
INSTITUTE
O Identify yourself and your geographic location
O Ask your client/patient to do the same
O Audio/video check (e.g., Do you hear & see me clearly?)
O Is there anyone in your room or within earshot today?
(Agree on safety code words, signals or phrases)
O Is there anything else | might notice and find of interest if |
were in the same room with you today?
O Has there been an emergency in your environment
today?
O Is there anything else | should know about before we
begin talking today?
INSTITUTE
O Identify yourself and your geographic location
O Ask your client/patient to do the same
O Audio/video check (e.g., Do you hear & see me clearly?)
O Is there anyone in your room or within earshot today?
(Agree on safety code words, signals or phrases)
O Is there anything else | might notice and find of interest if |
were in the same room with you today?
O Has there been an emergency in your environment
today?
O Is there anything else | should know about before we
begin talking today?
INSTITUTE
Document Your Opening
Protocol
OVerify patient location and contact information
O Important not only for emergencies but also for state
licensure requirements
O Obtain direct phone number for emergency
services for the location of patients
OTest the non-emergency number for that area in order
to verify that the emergency number is correct
OScan your room with your camera and ask patient
to do the same
Document Your Opening
Protocol
OVerify patient location and contact information
O Important not only for emergencies but also for state
licensure requirements
O Obtain direct phone number for emergency
services for the location of patients
OTest the non-emergency number for that area in order
to verify that the emergency number is correct
OScan your room with your camera and ask patient
to do the same
23. Confidentiality and limits
thereof as related to mandated
reporting (suicide, homicide,
abuse)
24. Fees, if any
25. Statement similar to:
a. My questions have been
answered to my satisfaction in
language | understand
b. As of the time of my signing, all
blanks have been filled in
TELEBEHAVIORAL HEALTH
INSTITUTE
tute All ights reserved,
thereof as related to mandated
reporting (suicide, homicide,
abuse)
24. Fees, if any
25. Statement similar to:
a. My questions have been
answered to my satisfaction in
language | understand
b. As of the time of my signing, all
blanks have been filled in
TELEBEHAVIORAL HEALTH
INSTITUTE
tute All ights reserved,
26. Some risks may not yet
be unknown
27. No physical exam
28. Identify both the
clinician's &
client's/patient's physical
location and an
agreement that the
client/patient will notify
you of any changes.
TELEBEHAVIORAL HEALTH
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be unknown
27. No physical exam
28. Identify both the
clinician's &
client's/patient's physical
location and an
agreement that the
client/patient will notify
you of any changes.
TELEBEHAVIORAL HEALTH
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TELEBEHAVIORAL HEALTH
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29. Discuss the technical requirements with
the patient prior to initiating treatment
30. Consider the level of technology
experience of the patient (train if needed)
31. Document a back-up plan if the video
connection is lost
a. Telephone - landlines are best, but cell phones
are better than nothing
b. Document this plan (“I will call you, please stay
off the phone”)
lute Allrights reserved,
INSTITUTE
29. Discuss the technical requirements with
the patient prior to initiating treatment
30. Consider the level of technology
experience of the patient (train if needed)
31. Document a back-up plan if the video
connection is lost
a. Telephone - landlines are best, but cell phones
are better than nothing
b. Document this plan (“I will call you, please stay
off the phone”)
lute Allrights reserved,
TELEBEHAVIORAL HEALTH
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Safety Issues to Consider
Documenting IC
32. Identify the use of a local collaborator such as a family
member or close friend of a patient
. Enter name and contact information into informed consent
document
. Stipulate under which conditions these people will be
contacted
. Outline emergency procedures and when collaborator will
be notified
. Clearly define expected roles and responsibilities of local
collaborators
. Consider discussing these issues with family members directly
ith Institute All ights reserved,
INSTITUTE
Safety Issues to Consider
Documenting IC
32. Identify the use of a local collaborator such as a family
member or close friend of a patient
. Enter name and contact information into informed consent
document
. Stipulate under which conditions these people will be
contacted
. Outline emergency procedures and when collaborator will
be notified
. Clearly define expected roles and responsibilities of local
collaborators
. Consider discussing these issues with family members directly
ith Institute All ights reserved,
TELEBEHAVIORAL HEALTH
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Safety Issues to Consider
Documenting IC
Q Local collaborator can be helpful for:
Providing information about the patient's history
Monitoring mood and behavior
Assisting with treatment planning and coordination
Coordination with local 911 service when needed
Provide an additional mechanism for contacting
patients if a connection becomes lost
Provide on-site technical assistance
Provide support to a patient during emergency
situations
INSTITUTE
Safety Issues to Consider
Documenting IC
Q Local collaborator can be helpful for:
Providing information about the patient's history
Monitoring mood and behavior
Assisting with treatment planning and coordination
Coordination with local 911 service when needed
Provide an additional mechanism for contacting
patients if a connection becomes lost
Provide on-site technical assistance
Provide support to a patient during emergency
situations
INSTITUTE
Safety Issues to Consider
Documenting IC
Q Assess when using a local collaborator may not be
advisable:
o Safety of local collaborators must be carefully
considered - may be best to rely on trained 911
responders
Be cognizant of potential deleterious effect of
disclosures made during emergency management
on patient confidentiality and relationships,
especially in small communities
Safety Issues to Consider
Documenting IC
Q Assess when using a local collaborator may not be
advisable:
o Safety of local collaborators must be carefully
considered - may be best to rely on trained 911
responders
Be cognizant of potential deleterious effect of
disclosures made during emergency management
on patient confidentiality and relationships,
especially in small communities
Safety Issues to Consider
Documenting IC
Q Is there access to firearms in
home-based care?
o Discuss firearm ownership, safety,
and culture of firearms
o Beprepared to negotiate firearm
disposition with patients and
consider involvement of family
members when appropriate
o Use of trigger safety lock devices is
an option
Q Is there alcohol in the home of
the alcoholic patient?
Copyright & 2017 Telabehaviorat Heath institute Allrights reserved.
Documenting IC
Q Is there access to firearms in
home-based care?
o Discuss firearm ownership, safety,
and culture of firearms
o Beprepared to negotiate firearm
disposition with patients and
consider involvement of family
members when appropriate
o Use of trigger safety lock devices is
an option
Q Is there alcohol in the home of
the alcoholic patient?
Copyright & 2017 Telabehaviorat Heath institute Allrights reserved.
Duty to report/warn
Suicide
Homicide
Abuse reporting
Inform
clients/patients of
your remote
policies in writing
TELEBEHAVIORAL HEALTH
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‘Copyright & 2017 1
Heath Institute Al rights reserved.
Suicide
Homicide
Abuse reporting
Inform
clients/patients of
your remote
policies in writing
TELEBEHAVIORAL HEALTH
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‘Copyright & 2017 1
Heath Institute Al rights reserved.
Consider who might be
listening
Manage or other factors
that can impact on the
efficacy of intervention
(e.g., reluctances to
communicate caused by
people or events?
Code words and phrases
or signals
Disconnection from
contact by claiming an
unavoidable problem on
your end
Copyright 2017 Telabehavierat Heath Insttute Al nights reserved.
listening
Manage or other factors
that can impact on the
efficacy of intervention
(e.g., reluctances to
communicate caused by
people or events?
Code words and phrases
or signals
Disconnection from
contact by claiming an
unavoidable problem on
your end
Copyright 2017 Telabehavierat Heath Insttute Al nights reserved.
TELEBEHAVIORAL HEALTH
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California State Law
(v) Failing to comply with the
child abuse reporting
requirements of Section
11166 of the Penal Code.
(w) Failing to comply with
the elder and adult
dependent abuse reporting
requirements of Section
15630 of the Welfare and
Institutions Code. CA Business
and Professionals Code Sections
(4989.54 (cont.)
INSTITUTE
California State Law
(v) Failing to comply with the
child abuse reporting
requirements of Section
11166 of the Penal Code.
(w) Failing to comply with
the elder and adult
dependent abuse reporting
requirements of Section
15630 of the Welfare and
Institutions Code. CA Business
and Professionals Code Sections
(4989.54 (cont.)
A patient site assessment
shall be undertaken,
including obtaining
information on local
regulations & emergency
resources, and
identification of potential
local collaborators to
help with emergencies.
TELEBEHAVIORAL HEALTH
INSTITUTE
shall be undertaken,
including obtaining
information on local
regulations & emergency
resources, and
identification of potential
local collaborators to
help with emergencies.
TELEBEHAVIORAL HEALTH
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Some liability risks can be
overcome by having
another licenses
professional in the room
to follow specific
instructions by the
specialist.
Know the local resources
‘Copyright & 2017 Tel
TELEBEHAVIORAL HEALTH
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rol Heath Institute Allrighis reserved,
overcome by having
another licenses
professional in the room
to follow specific
instructions by the
specialist.
Know the local resources
‘Copyright & 2017 Tel
TELEBEHAVIORAL HEALTH
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rol Heath Institute Allrighis reserved,
TELEBEHAVIORAL HEALTH
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How will you handle? What's not OK?
O Not willing to
handle
O Am willing but
need resources
O Not sure
INSTITUTE
How will you handle? What's not OK?
O Not willing to
handle
O Am willing but
need resources
O Not sure
TELEBEHAVIORAL HEALTH
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Mistakes with Suicide or
Homicide Threats
o Failing properly trained to work with distant populations
(understanding norms of populations)
© Failing to fully identify individual upon intake and at every session
(opening protocol)
o Failing to identify local collaborators upon intake who can
intervene when needed
e Failing to identify and have releases to contact local emergency
resources
© Failing to have proper releases in place to work with those referral
sources
© Failing to have proper SOP to deal with resources (when, who,
etc.)
Institute All ights reserved,
INSTITUTE
Mistakes with Suicide or
Homicide Threats
o Failing properly trained to work with distant populations
(understanding norms of populations)
© Failing to fully identify individual upon intake and at every session
(opening protocol)
o Failing to identify local collaborators upon intake who can
intervene when needed
e Failing to identify and have releases to contact local emergency
resources
© Failing to have proper releases in place to work with those referral
sources
© Failing to have proper SOP to deal with resources (when, who,
etc.)
Institute All ights reserved,
TELEBEHAVIORAL HEALTH
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Discuss the purpose of
remote contact.
Inform patients of who
will have access to their
email address, phone
number, or any other
contact information.
Inform the patient of who
else might contact the
patient on your behalf.
Copyright & 2017 Telebel ith Institute All ights reserved,
INSTITUTE
Discuss the purpose of
remote contact.
Inform patients of who
will have access to their
email address, phone
number, or any other
contact information.
Inform the patient of who
else might contact the
patient on your behalf.
Copyright & 2017 Telebel ith Institute All ights reserved,
TELEBEHAVIORAL HEALTH
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Patient Consent Agreement
oDescribe the specific roles of any consultant or
local referring practitioner and who will have
ultimate authority over the patient’s treatment.
oDiscuss whether patient information will be
stored in a computerized database.
oProvide written procedures for various types of
follow-up when patient does not appear for
remote consultation.
INSTITUTE
Patient Consent Agreement
oDescribe the specific roles of any consultant or
local referring practitioner and who will have
ultimate authority over the patient’s treatment.
oDiscuss whether patient information will be
stored in a computerized database.
oProvide written procedures for various types of
follow-up when patient does not appear for
remote consultation.
TELEBEHAVIORAL HEALTH
Discuss the method
& procedures for
data & information
storage, which info
will be stored, how
info will be stored
transmission, disposal
of malware, cookies,
etc.
behaviors! Heath Institute All ights reserved.
Discuss the method
& procedures for
data & information
storage, which info
will be stored, how
info will be stored
transmission, disposal
of malware, cookies,
etc.
behaviors! Heath Institute All ights reserved.
TELEBEHAVIORAL HEALTH
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How do privacy and
security laws
(HIPAA/HITECH Act in
the US) impact what
you put in your informed
consent process?
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INSTITUTE
How do privacy and
security laws
(HIPAA/HITECH Act in
the US) impact what
you put in your informed
consent process?
‘Copyright & 2017 Telebehavierat Heath Insttute Allrights reserved.
33. Your status as a HIPAA
covered entity
34. How you conduct a
risk-analysis of technology
35. If in US, cross
reference your HIPAA
Notice of Privacy
Practices (NPP), which
you must have on your
website and in-person
office.
TELEBEHAVIORAL HEALTH
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covered entity
34. How you conduct a
risk-analysis of technology
35. If in US, cross
reference your HIPAA
Notice of Privacy
Practices (NPP), which
you must have on your
website and in-person
office.
TELEBEHAVIORAL HEALTH
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TELEBEHAVIORAL HEALTH
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What do you need to
include in your informed
consent document
when your client is in an
unsupervised setting,
such as their home?
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Heath institute Allrights reserved.
INSTITUTE
What do you need to
include in your informed
consent document
when your client is in an
unsupervised setting,
such as their home?
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Q Service to the home is not just about access
o Scientific evidence base to the home is much
thinner, less reliable than traditional telehealth
Many more uncontrolled variables
Different laws are in play
Credentialing and reimbursement are different
Depending on whom is being served and the
treatment plan, you may want to mention this
added risk in your IC
INSTITUTE
Q Service to the home is not just about access
o Scientific evidence base to the home is much
thinner, less reliable than traditional telehealth
Many more uncontrolled variables
Different laws are in play
Credentialing and reimbursement are different
Depending on whom is being served and the
treatment plan, you may want to mention this
added risk in your IC
TELEBEHAVIORAL HEALTH
INSTITUTE
Plan ahead -- clients/patients may see too much of you or your home/office
Copyright & 2017 Telabehaviorat Heath Institute Allrights reserved.
INSTITUTE
Plan ahead -- clients/patients may see too much of you or your home/office
Copyright & 2017 Telabehaviorat Heath Institute Allrights reserved.
TELEBEHAVIORAL HEALTH
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Q Professional boundaries
Q Secure end points
o Notify family and
friends
Sign on door
Lock door
Initial protocols
“Talk to me about
anything that happens
because of the
technology if it upsets or
alarms you"
INSTITUTE
Q Professional boundaries
Q Secure end points
o Notify family and
friends
Sign on door
Lock door
Initial protocols
“Talk to me about
anything that happens
because of the
technology if it upsets or
alarms you"
TELEBEHAVIORAL HEALTH
INSTITUTE
U Be aware of and
comply with all
jurisdictional issues
Q Know and follow all
federal and state laws
that are relevant to your
work
(Make sure you are currently
licensed or registered and
follow the laws of the state of
your client/patient at the
time of the contact - this is
not rocket science)
LA
INSTITUTE
U Be aware of and
comply with all
jurisdictional issues
Q Know and follow all
federal and state laws
that are relevant to your
work
(Make sure you are currently
licensed or registered and
follow the laws of the state of
your client/patient at the
time of the contact - this is
not rocket science)
LA
TELEBEHAVIORAL HEALTH
INSTITUTE
forthe California HealthCare Faundas
iHealthBeat u
Reporting Toennolsay
Andy a Subzcrtber?
FES Features aa
eer! Thursday, March 21, 2083, = es
RES States Not Keeping Up With © sna
bare Telehealth Advances LES
Duta Pete: 13 Taina
by Rebecca Veely telthBest Contributing Reporter
Special Reports Bh ce
Moat Popular contain, according ia a recent comprehenaha repea an baw ai 50 || N vistos
Sales oversee the uae of technology to dels health ace ramately Digg à
eves
Ma | 02100 states are alike in how teleheath is defines and requisted, | RELATED STORES HealthBeat
Sf EE | ccaráng tthe repo y the Center o Conmectes ath Paty,
aa Hs M 3eeitance group bazea in Sacramento, Cat Be
u Fins
Register now
"General apsahing, the policies am regulation thet govern
telat te no ape op a mis lel day aia | 09/42/3033 | mern |
Mamie MOST POPULAR ARTICLES
LE) MSIE SET TUE MEN TNT ESS A venus CRE
suber in expected to rach neaity 1.3 lion by 2017 — à realy six fle
increas ores 2012. secerdimg to a report by IMS Rreworch rabos
dan Surin à
Van Alves pus
2 The main dis of teloheath are cxpected to be tocosal rules a
FROM TIE FOUNDATION including hosptalpenclvos for 30 day resdms=ion= and demand eee
‘Scanning the'Teiehealtlh from prvaters, payers and patients, accardıng tothe MAS Research ui
Horton report Eli mens of
‘The Canter or Connecteg AS
NeomPoncynssreiessea CCHP Report Mighlig Heeres)
250 cate sean ot
us Tre fopce sheds light on telahoali lay related to Mache an nt aa
Mesos caes clnec an 1 potcy wees, including eimDurzement, conser
\tmeroves quai and aed an 11 poicy arena 2 5:
Improves UNE mico tocaion,eruine presenting and licensure. The repon wil be
= Continua updated ata new website schedided to launch In March mir online Kern
Oe EEE
{cial mediate research
Surenaaing decisions, Row
olas ike vet com : ie most praminant fers of ewer
Samgare win waatnal wah ea sates paying for ve doo
{ies for hospi! cues
+ Feny-tour tates have some form of telsheaith rainbursoment
‘Copyright & 2017 Telebehavierat Heath Institute Allrights reserved.
INSTITUTE
forthe California HealthCare Faundas
iHealthBeat u
Reporting Toennolsay
Andy a Subzcrtber?
FES Features aa
eer! Thursday, March 21, 2083, = es
RES States Not Keeping Up With © sna
bare Telehealth Advances LES
Duta Pete: 13 Taina
by Rebecca Veely telthBest Contributing Reporter
Special Reports Bh ce
Moat Popular contain, according ia a recent comprehenaha repea an baw ai 50 || N vistos
Sales oversee the uae of technology to dels health ace ramately Digg à
eves
Ma | 02100 states are alike in how teleheath is defines and requisted, | RELATED STORES HealthBeat
Sf EE | ccaráng tthe repo y the Center o Conmectes ath Paty,
aa Hs M 3eeitance group bazea in Sacramento, Cat Be
u Fins
Register now
"General apsahing, the policies am regulation thet govern
telat te no ape op a mis lel day aia | 09/42/3033 | mern |
Mamie MOST POPULAR ARTICLES
LE) MSIE SET TUE MEN TNT ESS A venus CRE
suber in expected to rach neaity 1.3 lion by 2017 — à realy six fle
increas ores 2012. secerdimg to a report by IMS Rreworch rabos
dan Surin à
Van Alves pus
2 The main dis of teloheath are cxpected to be tocosal rules a
FROM TIE FOUNDATION including hosptalpenclvos for 30 day resdms=ion= and demand eee
‘Scanning the'Teiehealtlh from prvaters, payers and patients, accardıng tothe MAS Research ui
Horton report Eli mens of
‘The Canter or Connecteg AS
NeomPoncynssreiessea CCHP Report Mighlig Heeres)
250 cate sean ot
us Tre fopce sheds light on telahoali lay related to Mache an nt aa
Mesos caes clnec an 1 potcy wees, including eimDurzement, conser
\tmeroves quai and aed an 11 poicy arena 2 5:
Improves UNE mico tocaion,eruine presenting and licensure. The repon wil be
= Continua updated ata new website schedided to launch In March mir online Kern
Oe EEE
{cial mediate research
Surenaaing decisions, Row
olas ike vet com : ie most praminant fers of ewer
Samgare win waatnal wah ea sates paying for ve doo
{ies for hospi! cues
+ Feny-tour tates have some form of telsheaith rainbursoment
‘Copyright & 2017 Telebehavierat Heath Institute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Content | Easter | ce
À BOARD OF PSYC HOL OGY
Information on Telepsychology
From tee o tee the Boars becomes amare of aces cr nformaton tha wand De we nal and mA a Kern paye REIN and the consumers of
Parchagca series nsx case, e Dar vd aero Brg Is forma to ers an consume, provided ne necessary auhoreanons fr
In ROSA of. ans EDAD. et ste ts node A A sole COOL EOS poe,
Te folowing nfermaton regarding telepsychology has Deen excerpted wit the permission ofthe primary author rom "Regulation of Tesepsychology A Survey
of Sime Attorneys Generar by Gerry Koocher & Eisabein Moray Professional Psychology: Research and Practice, October, 2000, vol 31, sue #5,
pages 509.508.
QUICK HITS
Board Meeengs
Oortimung Educar 1D 1 Bette engapny m me remote cewvery of mental Neath serves va elector means, practDoners Should caretuny assess meu competence 1o er
Decision Pending and ‘me parte services and consider te Imaatons of eftcacy and eflectveness that may be a function of remate gemesy
‘Opportunies for Puan 2 Practioners should consul wth thes profession Katty Insurance carrer to ascertain weasmer mo planned services wif be covered. losaty. a wetien
Parscpañon cortmation from a representative of Ine carer shuld be ottaned
Examnasons 3 Practtoners are adised to seek commutation rom coleagues and lo provide allclents mi clear mien guidelines regarding planned emergency
Expert Witness Recruament practices (6.9. SucKje risk situations).
PAs 4 Because no unorm standards of practee exist al this me, thouptet wien plans that refect careful consultation wen coeagues may sufice o
Faas ee Te Soc Mange protrsuensitam nme event Of am aero ora
Bor 5 Acareha statement on imitations cf covticentiaty should be developed and provided fo cients atthe start of the professonal restos. The
Statement shousd nom cients oe standard amitabons (e 9 cha abuse reporting mandates) any stae-specierequeements. and CANONS about
Privacy problems wh bread: as! conversations (6. overmeard wireless phone conversations or Captured internet Hanımssons)
66. Cinicians show moroughiy inform cents of what hey Can expect in terms Of services offered, UAH SEVCOS (0.9. meegENKy or
Sign Up for Our Ema List aychopnamacology coverage). access o the pracstoner emergency coverage. an SAT issues.
Tara parses are Dies for services offered via esetrent means. practioners must cleartyicicate that tact en Deng forms I a hird-party payer who
= IS unsupporbre of elecronk serve cetvery 15 wrongly led fo Beleve thal the serves look place n VD as opposed 10 00-ne. fraud charges may
RELATED LINKS many bo ta.
TH ight ofthe survey Gata Gblaned ES research the authors GE he OO regarding Sepa hOngy
eee Veriteaton
Heath Institute. Allrighis res
INSTITUTE
Content | Easter | ce
À BOARD OF PSYC HOL OGY
Information on Telepsychology
From tee o tee the Boars becomes amare of aces cr nformaton tha wand De we nal and mA a Kern paye REIN and the consumers of
Parchagca series nsx case, e Dar vd aero Brg Is forma to ers an consume, provided ne necessary auhoreanons fr
In ROSA of. ans EDAD. et ste ts node A A sole COOL EOS poe,
Te folowing nfermaton regarding telepsychology has Deen excerpted wit the permission ofthe primary author rom "Regulation of Tesepsychology A Survey
of Sime Attorneys Generar by Gerry Koocher & Eisabein Moray Professional Psychology: Research and Practice, October, 2000, vol 31, sue #5,
pages 509.508.
QUICK HITS
Board Meeengs
Oortimung Educar 1D 1 Bette engapny m me remote cewvery of mental Neath serves va elector means, practDoners Should caretuny assess meu competence 1o er
Decision Pending and ‘me parte services and consider te Imaatons of eftcacy and eflectveness that may be a function of remate gemesy
‘Opportunies for Puan 2 Practioners should consul wth thes profession Katty Insurance carrer to ascertain weasmer mo planned services wif be covered. losaty. a wetien
Parscpañon cortmation from a representative of Ine carer shuld be ottaned
Examnasons 3 Practtoners are adised to seek commutation rom coleagues and lo provide allclents mi clear mien guidelines regarding planned emergency
Expert Witness Recruament practices (6.9. SucKje risk situations).
PAs 4 Because no unorm standards of practee exist al this me, thouptet wien plans that refect careful consultation wen coeagues may sufice o
Faas ee Te Soc Mange protrsuensitam nme event Of am aero ora
Bor 5 Acareha statement on imitations cf covticentiaty should be developed and provided fo cients atthe start of the professonal restos. The
Statement shousd nom cients oe standard amitabons (e 9 cha abuse reporting mandates) any stae-specierequeements. and CANONS about
Privacy problems wh bread: as! conversations (6. overmeard wireless phone conversations or Captured internet Hanımssons)
66. Cinicians show moroughiy inform cents of what hey Can expect in terms Of services offered, UAH SEVCOS (0.9. meegENKy or
Sign Up for Our Ema List aychopnamacology coverage). access o the pracstoner emergency coverage. an SAT issues.
Tara parses are Dies for services offered via esetrent means. practioners must cleartyicicate that tact en Deng forms I a hird-party payer who
= IS unsupporbre of elecronk serve cetvery 15 wrongly led fo Beleve thal the serves look place n VD as opposed 10 00-ne. fraud charges may
RELATED LINKS many bo ta.
TH ight ofthe survey Gata Gblaned ES research the authors GE he OO regarding Sepa hOngy
eee Veriteaton
Heath Institute. Allrighis res
TELEBEHAVIORAL HEALTH
INSTITUTE
What must you do if you
violate your client or
patient's privacy and what
might you tell them in your
IC process to prepare
them for such an
occurrence?
7 Telebehavieral Health institute All rights reserved,
INSTITUTE
What must you do if you
violate your client or
patient's privacy and what
might you tell them in your
IC process to prepare
them for such an
occurrence?
7 Telebehavieral Health institute All rights reserved,
36. Specify your
procedure for notifying
clients/patients of a
breach of security or
privacy
a. (e.g., Letter via surface
mail; purchase a year of
credit checking
TELEBEHAVIORAL HEALTH
INSTITUTE
procedure for notifying
clients/patients of a
breach of security or
privacy
a. (e.g., Letter via surface
mail; purchase a year of
credit checking
TELEBEHAVIORAL HEALTH
INSTITUTE
37. Include a social
media policy
Do you want
clients/patients to be
leaving suicide
messages on your
Facebook page?
Have and addendum
to your informed
consent
TELEBEHAVIORAL HEALTH
INSTITUTE
media policy
Do you want
clients/patients to be
leaving suicide
messages on your
Facebook page?
Have and addendum
to your informed
consent
TELEBEHAVIORAL HEALTH
INSTITUTE
How can you
document that your
informed consent an
ongoing process in
your treatment plan?
TELEBEHAVIORAL HEALTH
INSTITUTE
7 Telebehavieral Health institute All rights reserved,
document that your
informed consent an
ongoing process in
your treatment plan?
TELEBEHAVIORAL HEALTH
INSTITUTE
7 Telebehavieral Health institute All rights reserved,
TELEBEHAVIORAL HEALTH
INSTITUTE
Informed Consent is Dynamic,
Not Static
Q Informed Consent is Ongoing Process
o If connection is broken, document time of break,
topic and resumption of service
= Document any additional agreements made at these
times
o Use the opening protocol to register any changes to
previous agreements (e.g., “l'm in the back of a
restaurant in Chinatown”)
INSTITUTE
Informed Consent is Dynamic,
Not Static
Q Informed Consent is Ongoing Process
o If connection is broken, document time of break,
topic and resumption of service
= Document any additional agreements made at these
times
o Use the opening protocol to register any changes to
previous agreements (e.g., “l'm in the back of a
restaurant in Chinatown”)
TELEBEHAVIORAL HEALTH
INSTITUTE
What should you
mention in your
informed consent when
you work from your
home or other non-
traditional setting?
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
INSTITUTE
What should you
mention in your
informed consent when
you work from your
home or other non-
traditional setting?
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
IC and Working from Your
Home
Q Your statement of licensure status is usually all you
need to do in the IC process/document
o Your location is only relevant to the extent your licensing
boards makes it relevant. For most boards, they:
= Can insists that you are located in your state of licensure at
the time of the contact
= Can and often do insist that you are licensed wherever the
client/patient is at the time of contact
INSTITUTE
IC and Working from Your
Home
Q Your statement of licensure status is usually all you
need to do in the IC process/document
o Your location is only relevant to the extent your licensing
boards makes it relevant. For most boards, they:
= Can insists that you are located in your state of licensure at
the time of the contact
= Can and often do insist that you are licensed wherever the
client/patient is at the time of contact
TELEBEHAVIORAL HEALTH
INSTITUTE
Intelligently discuss how
to handle employers
who minimize your
concerns about
informed consent.
‘Copyright & 2017 Telebehi Heath institute Allrights reserved.
INSTITUTE
Intelligently discuss how
to handle employers
who minimize your
concerns about
informed consent.
‘Copyright & 2017 Telebehi Heath institute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Online Employer Questions
A Who on your team has clinical expertise?
o What are their credentials in distance counseling or
telemental health?
o Do you have any clinical research supporting what you
do?
Q Who bills insurance for services through your system?
How?
A How do | conduct informed consent on your system?
Q How do | know where someone is geographically
when they contact me? Do | have to ask them?
INSTITUTE
Online Employer Questions
A Who on your team has clinical expertise?
o What are their credentials in distance counseling or
telemental health?
o Do you have any clinical research supporting what you
do?
Q Who bills insurance for services through your system?
How?
A How do | conduct informed consent on your system?
Q How do | know where someone is geographically
when they contact me? Do | have to ask them?
TELEBEHAVIORAL HEALTH
INSTITUTE
Online Employer Questions
Q Do you prefer “audit trails" and “breach notification
tools”?
Will you give me a Business Associates Agreement (BAA)
for the technology you are offering to me?
Who will see my client/patient PHI? What is their
training?
Will you sign a BAA for me?
Q How else do you protect me as a clinician?
Q What type of agreement do you ask consumers to
sign before they connect with me, if any?
INSTITUTE
Online Employer Questions
Q Do you prefer “audit trails" and “breach notification
tools”?
Will you give me a Business Associates Agreement (BAA)
for the technology you are offering to me?
Who will see my client/patient PHI? What is their
training?
Will you sign a BAA for me?
Q How else do you protect me as a clinician?
Q What type of agreement do you ask consumers to
sign before they connect with me, if any?
TELEBEHAVIORAL HEALTH
INSTITUTE
When and how can you
appropriately obtain
informed consent when
soliciting email contact
from unknown, potential
clients/patients in an online
directory service?
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
INSTITUTE
When and how can you
appropriately obtain
informed consent when
soliciting email contact
from unknown, potential
clients/patients in an online
directory service?
‘Copyright & 2017 Telebehi
Heath institute Allrights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
ACA Code of Ethics
O B.1.b. Respect for Privacy
Counselors respect t f prospective and current
clients. Counselors request pivote information from clients
only when itis beneficial to the counseling process.
O B.1.c. Respect for SA EU
Counselors prote
and current clients. Counselors disclose information ane
with appropriate consent or with sound legal or ethical
justification.
(American Counseling Association, 2014)
Copyright © 20 Heath Institute Al rights reserved.
INSTITUTE
ACA Code of Ethics
O B.1.b. Respect for Privacy
Counselors respect t f prospective and current
clients. Counselors request pivote information from clients
only when itis beneficial to the counseling process.
O B.1.c. Respect for SA EU
Counselors prote
and current clients. Counselors disclose information ane
with appropriate consent or with sound legal or ethical
justification.
(American Counseling Association, 2014)
Copyright © 20 Heath Institute Al rights reserved.
TELEBEHAVIORAL HEALTH
INSTITUTE
Working with Online Directories
1. Send prospective clients/patients to a secure form on
your website
o Secure your website by buying a security license for $100 - $100
per year
. Reply to email
2
3. Delete original message to you
4. Apply “minimal necessary” rule, welcome
client/patient, ask for a phone conversation as their
next step
. Apply “beneficence over malfeasance” rule; give
them the help they seek or appropriate referrals
INSTITUTE
Working with Online Directories
1. Send prospective clients/patients to a secure form on
your website
o Secure your website by buying a security license for $100 - $100
per year
. Reply to email
2
3. Delete original message to you
4. Apply “minimal necessary” rule, welcome
client/patient, ask for a phone conversation as their
next step
. Apply “beneficence over malfeasance” rule; give
them the help they seek or appropriate referrals
TELEBEHAVIORAL HEALTH
INSTITUTE
Questions/Discussion?
INSTITUTE
Questions/Discussion?
INSTITUTE
Telebehavioral Health Institute,
Inc.
Send email to: Thank Gb
Visit website: | {
www.telehealth.org
Telebehavioral Health Institute,
Inc.
Send email to: Thank Gb
Visit website: | {
www.telehealth.org
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