What is TeleHealth?
“Telemental health” means, in short, "the delivery of health care services or consultations while the client is at an originating site and the licensed health care provider is at a distant site" and includes "real-time two-way interactive audio, and visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, that facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a client's health care."
MINN. STAT. § 256B.0625(3b)(d)
Services delivered via TeleHealth rely on a number of electronic, often Internet-based, technology tools. These tools can include videoconferencing software, email, text messaging, virtual environments, specialized mobile health (“mHealth”) apps, and others.
Benefits and Risks of TeleHealth services:
The client may receive services at times or in places where the service may not otherwise be available.
The client may receive services in a fashion more convenient and less prone to delays than in-person meetings.
Clients may receive services when they are otherwise unable to travel to the service provider’s office.
The unique characteristics of telehealth media may also help some people make improved progress on health goals that may not have been otherwise achievable without telehealth.
Receiving services via telehealth potential risks:
Telehealth services can be impacted by technical failures, may introduce risks to your privacy, and may reduce your service provider’s ability to directly intervene in crises or emergencies.
Internet connections and cloud services could cease working or become too unstable to use
Cloud-based service personnel, IT assistants, and malicious actors (“hackers”) may have the ability to access your private information that is transmitted or stored in the process of telehealth-based service delivery.
Computer or smartphone hardware can have sudden failures or run out of power, or local power services can go out.
Interruptions may disrupt services at important moments, and your provider may be unable to reach you quickly or using the most effective tools. Your provider may also be unable to help you in-person.
There may be additional benefits and risks to telehealth services that arise from the lack of in-person contact or presence, the distance between you and your provider at the time of service, and the technological tools used to deliver services. Your provider will assess these potential benefits and risks, sometimes in collaboration with you, as your relationship progresses.
Your Telehealth Environment
You will be responsible for creating a safe and confidential space during sessions. You should use a space that is free of other people. It should also be difficult or impossible for people outside the space to see or hear your interactions with your provider during the session. You need access doxy.me from a laptop or tablet or smartphone with a webcam during the session. Otherwise, you will need access to a phone. If you are unsure of how to do this, please ask your provider for assistance.
Back-Up Communication Plan
Before or during our first telehealth session, we will have a plan for backup communications in case of technology failures and a plan for responding to emergencies and mental health crises. A common option is simply an accessible phone number.
Our Contingency Plan
As a recipient of telehealth-based services, you will need to participate in ensuring safety during and emotional or psychological health crises, medical emergencies, and sessions that you have with your therapist.
Your therapist will require you to designate an emergency contact. By doing so, you grant us permission for to communicate with this person(s) about your care during emergencies.
Your therapist will also create a plan with you to do during emotional or psychological health crises, and a plan for how to keep your space safe during sessions. It is important that you engage with your therapist in the creation of these plans and that you follow them when you need to.
Assessing Telehealth’s Fit for You
Although it is evident in the literature, service delivery via telehealth is not a good fit for every person, and for many it is a very good fit. You and your therapist will continuously assess if working via telehealth is appropriate for you. If it is not appropriate, your therapist will help you find in-person providers with whom to continue services.
Please talk to your therapist if you find the telehealth media distracts from the services being provided, if the medium causes trouble focusing on your services, or if there are any other reasons why the telehealth medium seems to be causing problems in receiving services. As with any question or concern regarding your care, bringing your concerns to your therapist is often a part of the process.
You also have a right to stop receiving services by telehealth at any time without prejudice. If your therapist also provides services over the phone or in-person and you are reasonably able to access those services, you will not be prevented from accessing those services if you choose to stop using telehealth.
If you are not an adult, we need the permission of your parent or legal guardian (and their contact information) for you to participate in telehealth sessions.
You should confirm with your insurance company that the video sessions will be reimbursed; if they are not reimbursed, you are responsible for full payment.
As your therapist, we may determine that due to certain circumstances, telehealth is no longer appropriate and that we should resume our sessions in-person.
Your Security and Privacy
Except where otherwise noted, your therapist employs software and hardware tools that adhere to security best practices and applicable legal standards for the purposes of protecting your privacy and ensuring that records of your health care services are not lost or damaged. More information on our record-keeping system is included in the Communication Policies.
As with all things in telehealth, however, you also have a role to play in maintaining your security. Please use reasonable security protocols to protect the privacy of your own health care information. For example: when communicating with your therapist, use devices and service accounts that are protected by unique passwords that only you know. Also, use the secure tools that your provider has supplied for communications.
Recordings
Please do not record video or audio sessions without your therapist’s consent. Making recordings can quickly and easily compromise your privacy and should be done so with great care. Your therapist will not record video or audio sessions without your express consent.
To determine whether telehealth is a good option for you, consider these factors:
Do you, the client, have access to a reliable and secure telehealth platform, and are you able to use it?
Is the next phase in your care feasible for continuing remotely, or does it require face-to-face contact?
Online therapy preparation
As of March 17, 2020 the Office for Civil Rights informed practitioners that they have relaxed requirements to utilize only HIPPA compliant methods of communication, in an effort to allow clients and practitioners to stay connected during this time. It states, “Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple Face Time, Zoom, or Skype, to provide telehealth without risk that the Office of Civil Rights might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
We want to share that we will use an application called doxy.me for online sessions. It is completely secure and HIPAA-compliant. Below is the link to the doxy.me website. NOTE: We will be using the upgraded version, not the free service first mentioned on the website.
If for any reason you would prefer to have a phone session or an in-person session instead of a video session. Some insurances will only pay for sessions that are both audio AND visual in nature. These policies are in flux.
In most cases, insurance processing will continue uninterrupted as before. Please do not hesitate to ask questions. It is advised, however, that you contact your insurance provider first to verify they cover teletherapy. Some insurances have limitations or requirements on what they will allow. If insurance does not cover, you would need to pay the full session fee.
Please contact the Parkdale Therapy Group, LLC via email or phone if you have any questions or concerns at all – we are happy to go over any of this information with you at any time.
This period will come to pass and we have the opportunity to move through this period together!
Also included is an informed consent form required for telehealth.
Warmly,
Parkdale Therapy Group, LLC