1. XYZ agency agrees to provide adequate and suitable space for clients to use videoconferencing equipment for teletherapy. 2. XYZ agency will adhere to the following telepsychiatry protocol: ○ The client is scheduled for the intake appointment by an XYZ agency therapist. An ABC agency therapist will provide XYZ agency a weekly copy of the schedule for client therapy appointments. ○ At the initial appointment with the ABC agency therapist, a staff member may assist the client in coordinating an appointment with a psychiatrist at XYZ agency. ○ An XYZ agency intake coordinator will fill out essential chart components, get consent for treatment, obtain signed releases, and submit paperwork for service authorizations. ○ An ABC agency therapist will complete a biopsychosocial assessment and treatment plan and provide copies to XYZ agency for upload into the electronic medical record. ○ An ABC agency therapist will provide XYZ agency a copy of treatment progress notes. ○ XYZ agency staff will provide ABC agency a copy of medication management notes. ○ XYZ agency will bill for the originating-site fee. ○ ABC agency staff will complete the required paperwork for authorizations. ○ XYZ agency staff will provide the ABC agency therapist access to medical record information. 1. In accordance with HIPAA standards, as well as all applicable state laws, ABC agency and XYZ agency will collaborate as needed to provide optimum outcomes for mutual clients. With the permission of the client, ABC agency will send XYZ agency electronic copies of documentation of each service via secured email. In instances when XYZ agency continues to provide medication management, XYZ agency will also send documentation for each service provided to consumers.
Self-Assessment Question 1 Which of the following software platforms should clinicians avoid for telemental health sessions due to lack of HIPAA compliance?
a. Adobe Connect and Cisco WebEx b. Facetime and Google Hangouts c. Skype and Microsoft Live Meeting d. Vidyo and Vsee Informed Consent and Safety Planning
A comprehensive informed consent should be reviewed and signed by the client (Lustgarten, 2017; Swenson et al., 2016). A clinician must check the jurisdiction’s requirements (i.e., the originating site or client’s location) for real versus electronic signatures for informed consent (Kramer & Luxton, 2016; Lustgarten, 2017; Swenson et al., 2016). Informed consent should include several components usually found in consents for traditional psychotherapy, including the following: Session length, scheduling information, cancellation policies, fees, record keeping, and mandatory reporting guidelines. These components are typical of most consent forms. However, telemental health consent forms may significantly differ from traditional
forms by including additional information, such as threats to confidentiality, security breaches, privacy concerns, terms, and conditions for third-party software, such as Skype and Google Hangouts, which are not currently HIPAA compliant (Lustgarten, 2017). In addition, information specific to telemental health services should include a written emergency plan, what to do in case of technological failure, how contacts between sessions will be handled, under what conditions telemental health services would no longer be appropriate, and how referrals for face-to-face services will be made (Swenson et al., 2016). Box 2 provides an example of a teletherapy consent form that is used in addition to an agency’s typical consent form.
Box 2: Consent for Treatment Using Teletherapy Client Name: I, _______________________________, agree to participate in teletherapy with a mental health provider at ABC agency. This means that: ● I authorize information about my medical and mental healthcare to be transferred electronically through an interactive video connection between ABC Agency and XYZ Agency [if a clinic-based service is offered]. ● I understand that I will be informed of the identities of all people who are present during the teletherapy session and informed of their purpose for attending the session. ● My therapist/psychiatrist has explained how the teletherapy system works and how it will be used for my treatment. ● My therapist/psychiatrist has explained how this service will differ from face-to-face sessions, including emotional reactions that may arise due to technology use. ● I understand that my therapist will not be physically present during my teletherapy session. Instead, we will see each other electronically. ● I understand that teletherapy is a newer form of treatment. Although research shows effectiveness of this mode of treatment for a variety of needs and settings, there may be potential risks that are not yet recognized. ● Potential risks include the following: (a) at times the video image may be unclear or inadequate; (b) a disruption in the connection may occur; and (c) in rare circumstances, the information may be intercepted by unauthorized persons. ● I authorize the release of information pertaining to me determined by my mental healthcare providers or by my insurance company for the purpose of processing insurance claims.
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Book Code: SWFL1825
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