Considering adding telemedicine visits to your psychiatry practice? Telepsychiatry is a rising trend, as more and more psychiatrists and patients realize the power of connecting securely over live video – no matter their location.
But where do you start? Even after you’ve found the perfect telemedicine platform for your practice, there are some basic guidelines you’ll need to implement to get your telemedicine program up and running. Luckily, the American Telemedicine Association has created some key recommendations for Telepsychiatry. Here are the 8 most important takeaways you should know.
1. Gather professional and patient identity and location.
Before your patient’s first telemedicine appointment, make sure you have all their contact information, such as telephone, mail, and email. If you’re using a telemedicine software/app, most of this will already be gathered when you and your patient create accounts. You should also confirm and document yours and your patient’s locations at the time of the visit to make sure you’re following the licensing laws in both jurisdictions and are able to set up an emergency management plan.
2. Determine whether your patient can handle and benefit from telemedicine appointments.
While most patients like and will benefit from telemedicine, it may not be the best option for all. Use your clinical judgement to decide the appropriateness of telemedicine for each patient. Consider the patient’s history of cooperativeness with safety issues, such as substance abuse or violent or self-injurious behavior. Evaluate also whether the patient is equipped to use the technology and remain engaged during a virtual visit.
3. Get informed consent.
Most states require psychiatrists to get a patient’s informed consent (verbal or written) before beginning a telemedicine appointment. In California, for example, the Telehealth Act of 2011 requires that patients give verbal consent.
To get a patient’s consent, review with them general expectations and guidelines for virtual visits — including structure and timing of visits, how records are kept, scheduling, patient privacy, potential risks, confidentiality, mandatory reporting, and billing. You should also share any technical requirements for telemedicine (what devices they’ll need, minimum bandwidth connection). Whether you share this information verbally or in written form, make sure your patient understands the requirements.
Need an example Telepsychiatry patient consent form? Here’s a great example from Arizona Online Psychiatry. For more examples, check for any state requirements and google “telepsychiatry patient informed consent form.”
4. Create an acceptable physical environment for the appointment.
While the beauty of telemedicine is that you can deliver healthcare from just about anywhere, you should still try and simulate an office environment whenever possible. Having a quiet, well-lit, and private space, will help the appointment go smoothly and reassure your patient that the conversation is completely confidential.
5. Have an emergency management plan in place.
Patient safety is critical for any situation — but especially for Telepsychiatry. Be sure to develop an emergency plan if something goes wrong, or if your patient needs immediate attention. If your patient is doing the visit from a host facility, have guidelines in place to coordinate with staff at the host facility. Always have an emergency contact (family, friend, neighbor) information on hand as a back-up.
6. Use quality videoconferencing equipment and applications.
This one’s pretty straightforward. Both you and your patients need to have adequate equipment to do a visit. Most telemedicine apps just require a good-quality camera, microphone, and a computer or mobile device. But you may want to recommend a webcam and microphone in some cases. Here’s a list of affordable, high-quality webcams and microphones.
Also, make sure to check that both you and your patient have a secure, reliable internet connection. Check your telemedicine software vendor’s bandwidth requirements and then have patients’ check their connection using speedtest.net. If the telemedicine vendor is like eVisit, they should have a self-check built into their platform to automatically test for any technical issues.
7. Have a backup plan for technology glitches.
Even with the right equipment and a great telemedicine platform, there’s always potential for a technical glitch. Have a back-up plan if something happens and make sure to communicate that to the patient. Keep the number for your telemedicine vendor’s support team on hand if you need to troubleshoot. You should also have the patient’s telephone number available so you can hop on the phone if you can’t get video up and running.
8. Take all precautions to ensure privacy of the appointment.
You already know ensuring patient privacy is critical. So how can you make sure to keep telepsychiatry appointments completely secure?
Most telemedicine vendors will tell you their security measures, and they’re obviously required to be HIPAA compliant. Patient information should always be password protected. If any patient data is stored on your computer or mobile device, you should know how to remotely disable or wipe the device if anything happens.
If you store any patient sessions or other personal health information online or at a third-party location—or in other words, not on your or your patient’s device—that location needs to be secure and only accessible to authorized users. That goes for the live session and for any recordings you might make.
Adopting telemedicine into your mental health practice is a big step for you and your patients. As long as you have these guidelines down, you should be in business!
What do you wish you knew when you started using telepsychiatry in your practice?
Let us know in the comments section!
