Maheu -- Skype, HIPAA & Alternatives


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Dr. Marlene Maheu discusses benefits of using video conferencing (VTC) for healthcare, pros and cons for using Skype, Microsoft's new programmer's toolkit for Skype, .NET architecture; and low-cost alternatives to Skype, along with added features they offer.

She concludes with a summary of other issues clinicians need to know to be HIPAA compliant in their processes.

This program is available for 1 CEU or 1 CME, along with transcripts and an audio download of the event. Details are available here:

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 alerts about our FREE monthly webinars 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.

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Contact Dr. Maheu to speak at your next workshop or conference at:

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Maheu -- Skype, HIPAA & Alternatives

  1. 1. HIPAA-Compliant Alternatives to Skype www. teIehea| th. ORG/ webinars
  2. 2. Marlene M. Maheu, Ph. D. as interviewed by Joe Bavonese, Ph. D. Te| eMenta| Health Institute, Inc. & Uncommon Practices
  3. 3. DISCLAIMER at WHO I AM: I am a licensed psychologist. not an attorney. physician. or information technology (IT) professional. The content of my presentations covers a wide range of technical. clinical. risk management. legal and ethical issues that are in rapid flux. as MY GOAL: My goal is educational only. As a clinician. my goal is to outline the issues and alertyou to what's happening in a way to help think through the issues. help you move forward. but protect yourselves as clinicians. No warranty. guarantee. or representation is made as to the accuracy or sufficiency of the information contained in my presentation for your specific circumstance. Therefore. I assume no responsibility in connection therewith. x YOUR PART: You are encouraged to seek specific advice from your specific legal. regulatory. ethical and malpractice bodies. Get all such opinions in writing. and have yourinformed, trusted. local. legal counsel review them for theirfull significance with your particular business requirements. and the specific populations you serve. + lfy-: iIl eels l’| lle: .ti-: il’i~; . | "-lease| '~i‘-: lte»: :ttl’le ideicitifyw: -f the | "'ElII'EI'IK—. I; iil~Tl ». :|ieiits: ‘_'v“C. ~|, l lTI'EI'y' iTlel’iti-: il’i. Copyright2IJ12 TeIeMema| Health Institute, Inc. A|| righis reserved.
  4. 4. WHY USE VIDEO AS A PLATFORM FOR MENTAL HEALTH CARE? 3: 50+ years of an evidence base at Power of visual cues + Eye contact 9 telepresence + Window into the home + Aided by yet more functionality than visuals x Reimbursement copyright 2012 TeleMenta| Health Institute, Inc. A|| rights reserved.
  5. 5. The world is re—too| ing with technology copyright 2012 TeIeMental Health Institute, Inc. All rights reserved.
  6. 6. Copyright2012 Telemental Health Institute, Inc. All rights reserved .
  7. 7. is Video Teleconferencing (VTC) the same as video chat? Copyright2012 Telellltental Health Institute, Inc. All rights reserved.
  8. 8. IS VIDEO TELECOl'FEREIIC| iIGl (/ TC) EFFECTIVE? Yes Medicare & Medicaid required to pay Client satisfaction very high Provider satisfaction is high Outcomes are relatively comparable. especially for follow-up care (intakes are still a matter of state law) Literature for specialty groups is sparser. but positive (pediatrics) Also effective for supervision Can improve some ways service is rendered copyright 2012 TeIeMenta| Health Institute, Inl: .All rights reserved.
  9. 9. l I is E‘: kype a I video 2 latform or a social media 'o - _, .;-' . L) 1" . -— , -/ ‘C
  10. 10. E Is Skype HIPAA- Com pl la nt? It Skype doesn't claim HIPAA compliance — it doesn't have to - professionals do Difficult for us to know Unless a company makes a statement for which they are liable Changing quickly Microsoft Copyright2012 TeleMentaI Health Institute, Inc-. Al| rights reserved .
  11. 11. pun ‘I H '-‘4 . iII| ‘I| I?. "‘; :~/3 A IhIllllI—“gI ‘nu-nu‘ ls Skype Reliable? li. i1il"~~ It'll. then .1ejI‘_1ll'l I3 .1 | ‘.1l'l I-ell-ill l—: ..1jI.1i‘l l1~l'l-: |i _1II--| l|: lT_- T~l". I-| ||'1'. --ll T ~l'lT. llF| L. ‘-~lii~tllli~: . -; -1l'l: .Illli~i‘: l -: _1i‘i : .~~ -II _1l'i«l li~_1l'1-«ll . UII. Il‘ ~llt I'll" _1.. .1I'*—I'lr*‘: -ii I. '.IIII_II‘-' | ll'-il'I. f-fIll'lCl. |I'l'lJI --Tglill‘ -: Ilel’it: . _1l‘l-I j‘.1T. l+l'lT_: i« i'e_1-: tt-» .1-llw~j~(~~1I ~; ,1I| ' E» --II | i_1.~ .1 l-.11:l —| l| ~iliel'~g*~l'l-: . [‘I.1I'I. .1i'ivl fllll I III -1.. l'+F| 'g'~ >11‘ I- ~: .1| l'~: ~Ill»: ~; ll’i1:.1:. ~ Ill h~~-l t-I .11:t lliilli~1ll.1t. ~|, T I l"f1I_"lI: I|*‘ l| T.~l'.1T. |ll'~ ll]? .1 -: ll_1llij~l~l'i in the | - -1: 1| ~: - -lliliilihltt «T the j~_1tlei'il_ Copyright2012 TeleMentaI Health Institute, Inc-. Al| rights reserved .
  12. 12. Do you see well enough? -Image Resolution - ATA Guidelines Are you conducting an intake orfollow—up? - Most of the scientific literature described VTC as being used for follow-up care after a primary physician or other licensed professional does an intake. - Can you properly assess glassy eyes. tremors. gait disturbance. sweaty palms. body odor. other signs of poor hygiene? Copyright2012 Telemental Health institute, Inc. All rights reserved .
  13. 13. Skype does not provide an audit trail, which is a foundational HIPAA requirement ‘‘ ‘. ~- 3‘ ii . (-’ "'V‘~. _‘fj’L. ;., E I V5.35. , _,- I .5" I E: -' E‘. E3 If I 3’ / /.
  14. 14. What if you just ask consumer to sign a disclaimer? You can ask. but most courts will not support your having asked a vulnerable patientto sign away their basic U. S. rights -- such as the right to privacy.
  15. 15. What if I claim Beneficence vs. Malfeasance? - Are you in an emergency snuaflon? - Did you documentyour rationale adequately to defend yourself if something goes wrong? - Did you run your rationale by yourown local attorney? - Did you describe your rationale in writing to your licensing board. ethics boards and other colleagues? - Are you sure your malpractice carrier will cover your civil as well as regulatory risk? Get it in writing.
  16. 16. - o In «- r I F A; in , . ~. .__ I +9 . Lighting & Other A/ V Issues?
  17. 17. WHAT’S MICROSOFT DOING TO IMPROVE SKYPE’S FUNCTIONALITY? as For developers, the . NE T Framework provides a comprehensive and consistent programming model for building applications that have visually stunning user experiences and seamless and secure communication. htt : www. microsoft. com net copyright2012 TeIeMento| Health Institute, lnc. A|lrights resented
  18. 18. IMPLICATIONS OF M| CROSOFT'S ACTIONS FOR SKYPE IN MENTAL HEALTH? 3: Very positive + Future of bringing mental health care to the hip pocket is more and more of a reality
  19. 19. #1. VTC is moving to the smart device <9 ? A : ‘{7I11:S9AM
  20. 20. MHEALTH x Mobile phones are the predominant form of communication in 3”“ world countries + landlines are extremely limited + broadband lags behind in development Copyright 2012 Telelvlental Health Institute, Inc. NI rights reserved.
  21. 21. 49.7% of all Americans have a smartphone nlleiliculi. Fel, ~.; ~JJ_; n ‘ WI? ?? I ram * %€= ;i; Ljl‘v’. I J iii L‘I' all ,1 , . V‘: ' I I ' ma .1 e-; i:_. * ~ . .=: :»: -1 . ’ *- -~ r-I J Ff »; .-S-vr I -~ £1.-s z ——'-: =‘. f.'g5‘. lf~€‘~>LDl"": What does that mean for psychotherapy? lair- In: Insurance reimbursement is right around the corner. .. patients and clients will choose between you and someone else who is trained. skilled and available via technology Copyright2IJ12 TeleMenta| Health Institute, Inuxllrights reserved.
  22. 22. #2 Technology is shaping USE How long will mental health professionals remain passive?
  23. 23. #3 Technology is already a av : significant part fl: 1 of health care. I
  24. 24. Business Asscoaites and HITECH ~ All Business Associates in health care must sign an agreement statingtheiradherenceto HIPAA standards » Transactions ~ Security ~ Privacy - True for any service you hire - Billing. janitorial. computer repair. e-mail. orvideo conferencing. etc. o Nota matter of opinion 9 it is now enforced by the HITECH ACT. I
  25. 25. RE| I‘. ’IBURSEIVIEi'T? Medicare & Medicaid already pay for VTC. Many 3rd party carriers do. too. Require HIPAA compliance Designated sites Rural areas Not to the home yet. but such reimbursement is coming G et Telemedicine Reimbursement Handbook or TMl Institute course Copyright2U12 TeIeMenta| Health institute, lnc. AlIrights reserved.
  26. 26. WHICH TECHNOLOGIES TO USE? x No Guesswork Needed + HIPAA “compliant” or “compatible” + Practitioners need to be compliant, not technology + Look for documentation of compatibility with HIPAA standards
  27. 27. I N 'I' E R N E'l'-I3/-‘. E D, / TC C L/ -‘. | M I N G H I P. ’-. ’-‘. CO IVI PLI. ’- N CE Access P5Y°hIatrY Interactive Care Adobe Connect n-el Behavior Imaging Solutions IVE (Cloud) Breakthrough Lifesize (Logitech) Ca| iforniaLiveVisit MyTherapyNet CopeToday pass C°“5'~"ta Doctor SecureTelehealth C°U“5°I-Com Securevideo Conference Easyshare VC shepe” fgi ecounseling Solmte E Mental Health Center W33 G EMS VisHea| th (Visual Telehealth) GoToMeeting / See iCouch Copyright 2012 Te| eMenta| Health Institute, |nc. A|Irights reserved.
  28. 28. WHICH FEATURES DO MENTAL HEALTH PROFESSIONALS NEED TO DELIVER EFFECTIVE CARE WITH VTC? x Depends on population served + General adult + Pediatrics (room. table top + Gerontology (adaptive devices) + Correctionalfacilities Copyright 2012 Telelvlental Health Institute, Inc. All rights reserved.
  29. 29. SPECIAL MENTAL HEALTH FEATURES 9 Depend on services delivered o White board o Access desktop or web o Neuropsych testing + Supervision + Might also want secured email, instant messaging. cloud storage, etc. + Virtual reality goggles + Apps Copyright2012 Te| eMental Health Institute, Inc. All rights reserved.
  30. 30. WHAT ELSE DO HEALTHCARE PROFESSIONALS NEED TO KNOW TO BE COMPLIANT WITH HIPAA REGULATIONS TODAY? x We are mandated to use HIPAA compliant technologies and processes + Document policies x Security & privacy policies * Repairs k Staff training * Breaches. etc.
  31. 31. What can we do? Work with VTC and other technology companies ~ Organize ourselves through our professional associations - Sign our petition for a dedicated Division at the APA if you are a psychologist - Join us anyway if you are not a member Copyright 2012 TeIeMental Health institute, Inc. Allrights reserved.
  32. 32. FOR MORE INFORMATION x Te| eMenta| Health as Proposed Division of the Institute American Psychological www. te| ehea| th. ORG ASS°°Iati°“ + Look for petition in ’‘ FREE MyAPA. org + Newsletter + Linkedln Group as Paid CEs + Webinars + Courses + Certificate Program copyright 2012 TeleMentaI Health Institute, Inc. All rights reserved,
  33. 33. TI: cmIL Marlene M. Maheu, Ph. D. Te| eMenta| Health Institute, Inc. Phone: 619-255-2788 Email: mmaheu@telehealth. ORG Copyright2012 TeIeMentaI Health Institute, Inc. All rights reserved.