Lesson 5 Setting Up Your Video-Based Office for Telehealth.pptx

Slide deck for Lesson 5 Setting Up Your Video-Based Office for Telehealth course in Telehealth.org

1. Setting Up Your Video-Based Office for Telehealth Lesson 5

2. Questions to date?

3. Questions about client/patient education?

4. 4 OCPM: Online Clinical Practice Management Step 1: Training Step 2: Referrals Step 3: Patient Education Step 4: Legalities Step 5: Assessment Step 6: Direct Care Step 7: Reimbursement

5. 5 Clients will want to connect with you by both computer and telephone... What is your policy? Do you have that policy in writing on your website? Where else does it need to be? What is your social media policy?

6. American Medical Association. (2000). Guidelines for Patient-Physician Electronic Mail American Counseling Association. (1999) (2005). 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. (1997). APA Statement on Services by Telephone, Teleconferencing, and Internet, A statement by the Ethics Committee of the American Psychological Association American Psychological Association. (2010). Ethical principles of psychologists and code of conduct American Telemedicine Association. (2009). Evidence-Based Practice for Telemental Health Existing TeleMental Health Guidelines 6

7. American Telemedicine Association. (2009). Practice Guidelines for Videoconferencing-Based Telemental Health 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 Medical 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 Existing TeleMental Health Guidelines 7

8. National Association of Social Workers. (1999) (2008). Code of Ethics National Board for Certified Counselors and Center for Credentialing and Education, (2001). The Practice of Internet Counseling. (2001) New Zealand Psychological Psychologists Board (2011). Draft Guidelines: Psychology services delivered via the internet and other electronic media  Ohio Psychological Association. (2010). Telepsychology Guidelines Winkler, M., Flanagin , A., Chi-Lum, B., White, J., Andrews, K., Kennett, R., DeAngelis, C. & Musacchio , R. (2000). Guidelines for medical and health information sites on the Internet. Journal of the American Medical Association, March 22/29, 283(12), pp. 1600-1606 Existing TeleMental Health Guidelines 8

9. Has there been an emergency in your environment today? Is there anyone in your room or within ear-shot today? (Agree on pass signals or phrases) Is there anything else I might notice and find of interest if I were in the same room with you today? Initial Protocol 9

10. 10 Nursing Homes

11. 11 Schools

12. 12 Rural Hospitals

13. 13 Hospitals

14. 14 Home Health

15. 15 Correctional Facilities

16. 16 Military & Veteran’s Administration

17. Which other questions would you ask of the specific population you serve? Initial Protocol 17

18. Email / Texting Social networking File exchange Computer repair Clinical records Insurance Reports Lateness / Missed sessions Non-compliance / Avoidance OCPM Step 3: Patient Education 18

19. A.12.a. Benefits and Limitations Counselors inform clients of the benefits and limitations of using information technology applications in the counseling process and in business / billing procedures. Such technologies include, but are not limited to, computer hardware and software, telephones, the World Wide Web, the Internet, online assessment instruments and other communication devices. ACA Code of Ethics (2005) 19

20. A.12.g. Technology and Informed Consent As part of the process of establishing informed consent, counselors do the following: 1. Address issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications. 2. Inform clients of all colleagues, supervisors, and employees, such as Informational Technology (IT) administrators, who might have authorized or unauthorized access to electronic transmissions. ACA Code of Ethics (2005) 20

21. 21 American Psychological Association Telepsychology Guidelines (Open for Comment Until Late October, 2012) Assess client fully, and in-person assessment is advised Be aware of client’s local resources for both emergency and discharge planning Document everything Receive professional training (document that, too)

22. 22 ATA Guidelines - Emergency Emergency protocols shall be created and agreed upon with clear explanation of roles & responsibilities in emergencies Develop your own standard, initial protocols

23. Know the local resources Some liability risks can be overcome buy having another licensed professional in the room to follow specific instructions by the specialist Local Community Emergency Backup 23

24. How can you learn and document the local resources for your clients/patients? How will you keep them handy?

25. 25 Practice Model: Patient Consent Agreement 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

26. Describe the specific roles of any consultant or local referring practitioner and who will have ultimate authority over the patient’s treatment Discuss whether patient information will be stored in a computerized database Discuss issues of jurisdiction Provide written procedures for various types of follow-up when patient does not appear for remote consultation Patient Consent Agreement 26

27. Firearms in the home? Drug and alcohol in the home (for the substance abuse) Pay attention to the other standards and guidelines that are in existence – Australian guidelines Assessment Issues 27

28. Describe how deficiencies electronic equipment could possibly cause interference with diagnosis or treatment Make provision for non-receipt of email, delayed receipt, problems with servers, or unannounced changes in the schedule of email communications Mention how easily human error could lead to incorrectly delivered messages Patient Consent Agreement 28

29. 29 Patient Consent Agreement Allow patients to prohibit use of identifiable images or information by researchers or other, unidentified entities Allow patients the opportunity to prohibit identifiable medical information or images from appearing in any electronic medium

30. 30 ATA Videoconferencing Guidelines - 2009 Audio and visual privacy Don’t allow other people to enter room Ability to view written or drawn material Patient needs to give express permission before having other clinicians or guests participate Everyone in the exam room will be identified to all participants prior to starting the session

31. 31 ATA Guidelines - Policies Continuous training Release of information and informed consent Identifying all required patient information for a referral/consultation Ensuring privacy and confidentiality Intake procedures and screening

32. 32 ATA Guidelines - Emergencies 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

33. 33 What if They see Too Much of You or Your Home?

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