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Apa 2012 Chronic Illness & Disability


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Dr. Maheu offers a legal and ethical outline for practicing telepsychology with patients who are chronically ill or disabled. …

Dr. Maheu offers a legal and ethical outline for practicing telepsychology with patients who are chronically ill or disabled.

The above event is sponsored by the TeleMental Health Institute, Inc. We are the premier professional training site for professionals seeking training in telehealth. Our courses are offered in a state-of-the-art, 100% online learning environment that is fully mobile compatible. Professional training is now available from your desktop of mobile device, 24/7, at your home or office.

To receive our FREE monthly newsletter related to telemental health, telecounseling, online therapy, telepsychology or telepsychiatry and telenursing, send an email to: You will also receive notices of our bonuses and discounts for professional training for CEUs and CMEs.

See other offerings at
Send questions or comments to us at
Contact Dr. Maheu to speak at your next workshop or conference at:

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  • 1. APA Expanding Telehealth Service Models to Underserved Populations with Chronic Illness and Disability August, 2012 Marlene M. Maheu, Ph. D. TeleMentaI Health Institute, Inc.
  • 2. I r‘ I ‘~’. ‘ I _, / . /_ , / / , I ; / We Are Re-tooling
  • 3. APA Proposed Society for Technology & Psychology TELECOM M UHCATIONS Email; Interactive Voice Response, l7.emoteSensiIIg. Social Media -‘ire! -ass. S. Traininghchnology. TelephonesIe. g., rnHeaIth. Mobile Phones. Tm Practice '-'*‘= *%‘“e""‘“*° Science Conferencing: . COl5Pl. TTll. G HEALTH ":3: ILFORMATICS METHODOLOGES Bigbata; Lolllrfllléd‘-’DC3|JS 0| _ _ Ie. g.. IIZD-103, Decision Making ,3 '“? €'"€°~ ‘°["| °"$‘1' . §.Suppon, Datahlining; Z’-”; ”'a"_°'", $_: 'g'l' Health and Personal Health ' . ""’_ ET‘: ', ' ' "3, "° ’5 Records, Electronic Data & "‘""'°'a"""'"'g"‘"‘: e5 _ < ~ . » . Microcomputers‘ Natural ""‘H‘l’a. ‘.‘; .‘. ”n'i". .‘r. ;l. '.‘l‘. .*f"" Develo p me nt Lane-an Prvéessinzu E; . -A ' Robotics, Llseriomputer changes, HIP-. .-. , . _ | Mmmm°"5mrage_-A & Inrerfa<es»e. g.. Lomputer Retrieval, ’ lnteroperabilitv V-“ion T'3cH“g' Ham“ Interfacesi Education Public Interest OTHERTECHHOLOGIES Biotechnology; t-Lg. Biofeedback, Bio: -an singl, Planotechnology. Nanomediclne Cc-wright -jcjn2L‘I. I.2 IN Marlene M. Maheu, PhD and Erica. ’-‘. Abel PhD
  • 4. Video Teleconferencing (VTC)
  • 5. Copyright 2012 Telelllental Health ln: titute. lnct All rights resery-ad.
  • 6. squ- Wearable Computers (Glasses)
  • 7. "I? 'I "*~7 as l3i‘i= "E Random People vampres Animals Robots Vehicles ’: "I-‘I-. x'»:1Iii~, '.. A'. 'e. er. ' " l l V Eli ‘ lug" Jll» ‘i J r :7 It % ll *« ( Choose This Avatar ) r . 'l Ir~. I'a-.1-t» ti. u. R‘14l-i-I113I! Ji-E? l'E}3!. -ttl-I-Iirtl. -£vI2?4=I‘I:2J, l~J914%-r= .rIs: iEiI-l ~. ‘.
  • 8. 6% lR"C3 Personavl liobots Group mit media lab Home Welcome to the Personal Robots Group , . gafi ‘ °‘O , / . — ¢51""". "a. '.'¥. _/é |
  • 9. All Existing Legal and Ethical Rules Applv
  • 10. Dc/ mi (inch! of Corisunici‘ / lffrr/ is -GOV Board of Behavioral Sciences 't—*, IONSUMER RELATED TOPICS Filing a Complaint Complaint Process Pubflc Disclosure Enforcement Documents and Publications Enforcement Statistics Board P0llCl8S /53$ IUICK HITS av What's New » Board Meetings » Customer Satisfaction Survey i Consumer Comfla-int Fonn '«> Department of Consumer Affairs >» Frequently Asked Questions Online License Venhcation Pending Decisions and Opportunities lot Public Participation > Recommended Links i Statutes and Regulations . —. Q-ikcr-nl-an I net inn-llinunn rat nniil {If V “i '_ .1 ‘- g f‘ ‘, ’T: ~r ’ it-r. iiii. i=Li, li»iii. iii4 I i. 3.i-iii»! It-iqir-an : '-iniwiJiiitiirrtririni-i . . . _. C°'l51!¥“€1'.1!‘f9"ll‘lti. °!l. R. °8““1l! l8.9l“i9¢ P$! '°l19‘h°‘? ‘.PY. Notice to Calllomio Consumers Regarding Psychotherapy on the lnlemet The Board of Behavioral Sciences (BBS) would like to make the following recommendations to California consumers who choose to seek therapy or counseling over the Internet lfldMdU3lS who provide psychotherapy or counseling. either in person, by telephone‘ or om the lntemel‘ are required by law to be l| C9fIS9d Licensing requirements vary by state Individuals who prrmde psychotherapy or counseling to persons in Calrfomia are required to be licensed in Calrloinia Such licensure permits the consumer to pursue recourse against the licensee should the consumer believe that the licensee engaged in unprofessional conduct Be a cautious consumer when seeking therapy over the lmemet. or by any other means. by doing the following I Verify that the practitioner has a current and valid license in the State of California i Be sure you understand the fee that you will be charged for the semces to be rendered and that you hilly understand how and to whom the fee is to be paid i Be sure you are satisfied with the methods used to ensure your communications with and by the therapist will be confidential « Be sure you are aware of the nsks and benefits of doing therapy, over the Internet or by any other means. so you can make an infonned choice about the therapy or counseling to be proiided I Accordrrig to Business and Professions Code -ti fr , ' 1 prior to the delivery of health care via teleheallh the health care provider at the orig-nating site shall verba‘ly inform the patient that Ieleliealth may be used and obtain verbal consent from the patient for this use The verbal consent shall be documented in the patient's medical record, All laws regarding the confidentiality of health care information and a patients nght to his or her medical information shall apply to ieleheath interactions Business and Prolesslons Code Section 2290.5 (3) For purposes of this division, the following definitions shall apply (1) ‘Asynchronous store and forward‘ means the transmission of a patients medical inlonnatiori from an originating site to the health care provider at a iistant site without the presence of the patient (2) ‘Distant site’ means a site where a health care provider who provides health care semces is located while pioiiding these services via a telecommunications system (3) ‘Health care provider‘ means a person who is licensed under this division (4) ‘Originating site‘ means a site where a patient is located at the time health care SellC€S are provided its a telecommunications system or where the asynchronous store and forward semce originates (5) ‘Synchronous interaction‘ means a real-time interaction between a patient and a heatth care provider located at a distant site (6) 'Telehealih' means the mode of deliwnng health care services and pubfic health via information and communication technologies to facilitate the diagnosis‘ consultations mi-. n~i. .r .44.; -~o. .u. PRIA at-. ..-uuuiuu and FA" N. -m-m. .i-. .i M -. .. -mM. r'. - but-ii-5. a. .. iiiimra nu . i.r. ..i . . -to mi. IIIIII-I"oI| A arfln um chi. but-iiui aunt . w.. .A. . . .- -. i -. .r. i-i-mo . -.1. V W‘ I‘ SearchBBS lift
  • 11. + (w) Failing to comply with OCPM Step 3: Legal Issues Duty to Report / Duty to Warn California State Law <* (v) Failing to comply with the child abuse reporting requirements of Section 11166 of the Penal Code. the elder and adult dependent abuse reporting requirements of Section 15630 of the Welfare and Institutions Code. CA Business and Professions Code Sections 4989.54 (cont. ) ‘ll
  • 12. -Z opv right 2012 Te Ielile mal Health in stitute, Inc. All rights reserved .
  • 13. x 1% | sSkype / Reliable? .4’ g 6 y _‘ Tiles & pixelates 1 ' Audio gets tinny * Echoes Consumers might see you and hear you, without your awareness — Can take still shots of you , , No pan/ zoom ‘ capabilities D. r.ops. ..calJs. .witl. .mou. t.. -z ‘p : 1155.52? 5 ' / ll, » ? ? i'? '‘~‘ . ‘)‘. —I"’ " . a 4t" u . __. .a t ‘r o ; n
  • 14. Security Threat: Skype does not provide an audit trail, which is a pivotal HIPAA requirement . ' “‘ 1, :2 ,3 i ‘ ' l ‘~“‘*~'~. H‘ ‘C: E3 F’ I / ’ . rs ~ “ I ' if / . 4 I . - '. ., _ . .
  • 15. ls Skype a video platform or a social media platform? Copyright 2012 Tulalvlnmi Health lnnnnn, lnc. AIl riymrlsarvd.
  • 16. OCPM Step 3 Legal Issues: Which Technologies to Use? ° No Guesswork Needed — H| PAA”compliant” or mPMc°""°"°’" 1/compatible" heme, " — Practitioners need to '5"°°P? r?g‘~°m°'k be compliant, not 8. Mom: technology — Look for documentation of compatibility with HIPAA standards
  • 17. Internet-based, VTC Companies* Claiming HIPAA Compliance ' Access Pwchiatry - Interactive Care - Adobe Connect , [Tel ° Behavior Imaging Solutions , NE ( Cloud) ' Breakthrough ° Lifesize (Logitech) ° Brighter Day Health , My-rheram/ Net ° C. a|iforniaLiveVisit , Pass ° Copfloday 0 Revation ° Comun a Doctor ° Secure Telehealth ° C°""5°"c°m ~ Secure Video Conference ° EasyShare VC , Shepe" fgi ' eC'°""5e“"g ~ Sm art House Calls ° F. Mental Health Center , Soltrite ° ForefrontTelecare , Via? ’ ’ GEMS - VisHealth (Visual Telehealthl - GoToMeeting , Vsee - iCouch ° See more at www. teIehea| th. org[video 0 TMH Institute has partnered with some ofthese companies and will receive .3 referralfee if you mention TMHI, You may also get an added disfiount Copyright 2012 Telflvlental Health | nstitute, Inc. -’-. I| rights reserved.
  • 18. Licensure Requirements We need to be licensed in our state(s)to practice mental health Common: We need to be licensed in the state of residency of the patient (e. g., Florida, Texas, Utah, Vermont) Also Possible: Both laws may exist
  • 19. Question I'm ok if my malpractice carrier says they cover me online, right? Copvright 2012 Telel-rlental Health Institute. Inc. All rights reserved.
  • 20. l/ lalpractice ° Do they cover you for both regulatory and civil infractions? — If not, why not? ° Write to your malpractice carrier and ask them to clearly tell you what will happen if you get in trouble ° Consider that a lawsuit can involve a year or two of your life, without pay
  • 21. Existing Te| eMenta| Health Guidelines °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-Une 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 Telemeclicine Association. (2009). Evidence-Basecl Practice for Telemental Health °American Telemedicine Association. (2009). Practice Guidelines for Videoconferencing-Basecl 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 -«. -'ia the Internet and Other Non-direct Means ° Canadian Psychological Association. (2006). Ethical Guidelines for Psychologists Providing Psychological Services yia Electronic Media ' Federation of State Medical Boards of the United States, Inc. . Report of the Special Committee on Professional Conduct and Ethics. (2002) lvloclel guidelines for the appropriate use of the Internet in medical practice ° 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. -Z2001) ° New Zealand Psychological Psychologists Board (2011). Draft Guidelines: Psychology services cleliyerecl via the Internet and other electronic media ' Ohio Psychological Association. £2010) Telc-psychology Guidelines - WiI1k| ei'. M. Flanagin, Chi-Lum. B. . White. J. . Anclrews. l~‘Z. . Kennett. R. . De/ Angelis. C. 8} lylusacchio. R (20003 tfmiclelines for medical and health information sites on the Internet. _: '«: -u. ".': c:. " . :;_, v*'t, "'. c‘ . A.'ne. 'i. .a. ". . "v.7et/ ."ct: .";3.: : 16CN)~1t3I)6 : 'it: t:'. ::. u March 22.«‘29.28?»l12‘~ pp.
  • 22. -5. “ . '. - ‘ . ,' _l V. .. . ' W, . s ,4. _ , ‘» “ so u _ = v — * 5 _ ‘ - . - J l i“. _ V ‘ 1!. 5- __ $| "‘l. ; p J . -.-I)-'»‘ Q‘ , '1 “" ' f A . & 'o. ;'I‘' . ..' ssw‘ . , [ . e x V ‘ _ _ . , I . V. ~~_‘. ‘ , s. I’ z - 4 ‘fig , ‘ , — 1‘ I X ‘ 1 v-. . , ’ _. o V A. _ , Vi , wt 4.. a r’ , , : ''' l . - _ Jf if (— A J 1 4,. Boundaries of Competence C opv right 2 D12 Te lelvlental Health Institute, Inc. -‘-. ll rights re served.
  • 23. American Psychological Association, Ethical Principles & Standards (2002) fe" . . [E * Psychologists must be aware of multicultural and diversity issues.
  • 24. Nursing Homes
  • 25. Rural Hospitals
  • 26. Hospitals
  • 27. Home Health
  • 28. Corrections Facilities
  • 29. Military & Veteran's Administration
  • 30. Australian Psychological Society [2011 revision of Internet Guidelines) ° Research-based protocols — 1.6 ”Psycho/ ogists using the internet to provide a psychologica/ service should be aware of the extent to which therapeutic interventions via the internet are supported by research or may be contra—indicated . ... " Copyright 2012 TA. |eJvlental Health Institute. Inc. -'-. ll rights reserved.
  • 31. Service to the Home: Migration Model -* Start with your current clients * Select those who are reliable, have good support systems and with whom you have a good working relationship * Consider their diagnosis * Take the time to prepare them * Plan in-person sessions at regular intervals * Do not work through their secretaries or others
  • 32. American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) s 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 ‘ Emergency protocols shall be created with clear explanation of roles & responsibilities in emergencies
  • 33. American Telemedicine Association Videoconferencing Guidelines—- Emergencies (2009) 0 Determine Outside ' Be fanllllar lOCal emergency coverage civil commitment regulations and have arrangements where possible to work with local staff to initiate/ assist with civil commitments - Establish guidelines for determining at what point other staff and resources should be recruited to help manage emergencies
  • 34. American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) ~ Be aware of the impact of remote care on provider's perception of control (or lack thereof) over the clinical interaction, and how this might impact provider's management. = Be aware of safety issues with patients displaying strong affective or behavioral states upon conclusion of a session, and how patients may then interact with remote site inhabitants
  • 35. 49.7% of all Americans have a smartphone (Neilson, Feb.2012) l i -3:1 _ -. .. ». . t—: a.: -1 ; . i §—; ;:%. :§, ° ‘ 2 ~. . T y ‘ T. A-3" Copv right 2012 Telelclemal Health Institute. Inc. All rights re sewed.
  • 36. 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
  • 37. International Conference Series on Disability, Virtual Reality and Associated Technologies ‘~‘-r "l? =!"‘*-3l'= if‘3 Sitiiint, i'f"l' ‘. l’1l. a‘ ; €'l‘i3'C‘llKi3ll-ll jZ: int'= 'eri«: -:« Navigation 2012 Home Confer-: -rice T12-: -mes Topics Conference Organisation Programme Programm-: « Outline l‘>? ‘,‘r1Cl*? 1 13:-Err-2-AlairtJc$~‘: L‘t K9’, -not-: -2 Alrra l. l-arians Podsurn Presentations Registration Regstratiori Details 9"‘ International Conference on Rgggsgiagion Rm Disability. Virtual Reality and Associated Technologies Registraliori Form Laval, France Venue 8. Locale Information september1o¢12y 2012 Conference Venue Accommodation Fzestatiranzs 8. Sets (Standard rates applv after July 22) Call for Papers Full (Feb 29) CLOSED
  • 38. "It would be strange, and embarrassing, if clinical psychologists, supposedly sophisticated methodologically and quantitatively trained, were to lag behind internal medicine, investment analysis, and factory operations control in accepting the computer revolution. " - Paul Meehl, 1987 Please sign our petition: WWW. StQ-El Q8 . netg SOCIETY FOR U r TECHNOLOGY AND {J I PSYCHOLOGY
  • 39. Questions? Thank Marlene M. Maheu, Ph. D. Te| eMenta| Health Institute, Inc. Phone: 619-255-2788 Email: mmaheu@telehea| th. ORG Copyright 2012 Telelvlental Health Institute, Inc. All rights reserved.