Lesson 1 Setting Up Your Video-Based Office for Telehealth.pptx
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The document provides information on setting up a video-based office for telehealth. It discusses the necessary hardware, including computers, cameras, monitors, speakers and what issues may arise. It also covers software options and how to ensure compliance with HIPAA. Additional topics covered include properly setting up the office environment, professional presentation, working with clients, emerging video technologies and their impact on telehealth, and legal and ethical considerations.
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Lesson 1 Setting Up Your Video-Based Office for Telehealth.pptx
- 1. Setting Up Your Video- Based Office for Telehealth Lesson 1
- 2. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • WHO WE ARE: We are licensed healthcare professionals, attorneys and other consultants. • TELEHEALTH GOAL: Our goal is educational only. No warranty, guarantee, or representation is made as to the accuracy or sufficiency of the information contained in our training for your specific circumstance. • YOUR PART: You are encouraged to seek practice-specific advice from your own legal, regulatory, ethical and liability authorities before offering any telehealth services or programs to consumers/clients/patients. Obtain all such opinions in writing, and have your informed, trusted, local, legal counsel review those written responses for their full significance. Disclaimer 2
- 3. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Hardware Issues Equipment you will need - computer, camera, monitor, speakers, what can go wrong and how to prevent problems. What is going on with SKYPE? How can you identify reasonable alternatives that offer you not only good video quality, but the kind of reliability you need with mental health clients and patients who rely on you to know what you are doing. This session will include "lessons learned" by professionals using VTC, and how to prevent the mistakes they've made. • Software Issues Software options - how to compare email and video platforms (companies), how to use their staff, what questions to ask to be sure that you are in compliance with HIPAA and other legal and ethical requirements; which documents to get from your vendors and why they are important; what other training you need to give your staff; how the Electronic Health Record fits into the picture. where to find HIPAA-compliant email programs and how to use them. Master Study Group: Dates & Topics 3
- 4. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Office Set-up How to set up your office for maximum professionalism: backdrop (screens), lighting, sound proofing, recording, file storage, clocks, signs, cushions and curtains and other furnishings and accessories to prepare your professional setting. Where to buy this equipment to get the highest quality for the lowest price. • Your Professionalism How and why to establish the best "telepresence" possible while using VTC. How to present yourself for maximum professionalism: how to dress, not dress and which accessories and behaviors to avoid. How to arrange your camera so as to maximize eye contact and the sense of being connected to your client or patient. Master Study Group: Dates & Topics 4
- 5. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Client Issues Working with your client to maximize your therapeutic effectiveness: introductory protocols, preparedness for mental health sessions; practice sessions, systems checks, how to use your VTC vendor to answer consumer issues, emergency availability of vendors, community champions and informed consent must-dos to minimize your risk. How to deal with clients who don't have good-enough equipment. • Bleeding-edge Video Technology and How It Will Impact Mental Health Know what's coming next, so you don't waste your time or money on technology that is already "old school." Get a glimpse into the iPhone / iPad revolution and other innovative aspects of using video teleconferencing devices to connect with clients and patients are already here. Are they safe? HIPAA compliant? Do they make sense with mental health populations? (Scroll below to see Dr. Maheu's publication list, which reflects her expertise in predicting new trends for telemental health since the mid-1990's.) Master Study Group: Dates & Topics 5
- 6. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • 5 LIVE and interactive group consultation calls to demonstrate skills / equipment options • Recordings of all group consultations, with the option to send questions ahead of time if you can't attend and given group meeting • Access to 2 foundational Telebehavioral Health Institute courses • Introduction to the Psychotechnologies • Audio & Video in TelePractice Master Study Group Features 6
- 7. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • A spreadsheet of VTC companies with URLs, HIPAA-compliance status, and various other details, such as cost, email, chat and other features for your consideration before investing in any 1 platform • Full access to the password protected TBHI Learning Lounge Community Center for 1 full year of peer interaction and support • Downloadable documents outlining ethical guidelines for VTC • Discussion of legal requirements by state licensing boards • Position papers about VTC and SKYPE from NASW and what they mean Master Study Group Features 7
- 8. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 8 Our planet is re-tooling as is psychology
- 9. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Remote doctor examines a patient’s inner ear from a remote location. 9 Patient in rural ER gets benefit of local care plus remote consultation with specialists. Traditional Telemedicine
- 11. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Table of Contents for Psychological Services, Volume: 9 Issue: 2 Regular Articles • Videoconferencing Psychotherapy: A Systematic Review • Acceptability and Cost Effectiveness of Military Telehealth Mental Health Screening • Telehealth for persons with severe functional disabilities and their caregivers: Facilitating self-care management in the home setting • A Telehealth Intervention for Veterans on Antiviral Treatment for the Hepatitis C Virus • Interactive Voice Response for Relapse Prevention Following Cognitive Behavioral Therapy for Alcohol Use Disorders: A Pilot Study • Assessing Daily Fluctuations in Posttraumatic Stress Disorder Symptoms and Substance Use With Interactive Voice Response Technology: Protocol Compliance and Reactions Question is No Longer “If” but “How” 11
- 12. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Table of Contents for Psychological Services, Volume: 9 Issue: 2 Brief Program Articles • Lessons Learned From Studies of Psychotherapy for Posttraumatic Stress Disorder via Video Teleconferencing • Tele-Pain Management: Use of video-conferencing technology in the delivery of an integrated cognitive- behavioral and physical therapy group intervention • The VA Maryland Health Care System's Telemental Health Program • Uniting Veterans across Distance through a Telephone-Based Reminiscence Group Therapy Intervention • VA Puget Sound Telemental Health Service to Rural Veterans: A Growing Program Question is No Longer “If” but “How” 12
- 13. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Table of Contents for Psychological Services, Volume: 9 Issue: 2 Brief Program Articles • Web-based, Psychosocial Treatment for Substance Use Disorders in Community Treatment Settings • The Use of Internet Technology for Psychoeducation and Support With Dementia Caregivers • Telephone-delivered Psychotherapy for Late-life Anxiety • Improving clinical outcomes in psychiatric care with touch-screen technology • Using an Online Viewing System for Parent-Child Interaction Therapy Consulting with Professionals • A Web-Based Intervention for Elementary School Teachers of Students with Attention-Deficit/Hyperactivity Disorder Question is No Longer “If” but “How” 13
- 14. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Godleski, Darkins & Peters reported in April of 2012 that hospital utilization in psychiatric populations at the Veterans Administration were decreased by an average of 25% since the use of telehealth. It is worthy of note, however, that: • This study focused on clinic-based, high-speed videoconferencing and did not include any home telehealth encounters. Mental health patients were referred for telecare by clinicians. Typically, telemental health services were provided remotely at community-based outpatient clinics by mental health providers of all disciplines located at larger parent VA hospital facilities. Equipment consisted of either room or personal desktop video conferencing units transmitting at 384 kbps or greater. Supporting Research 14
- 15. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Similarly, Backhaus and colleagues (May, 2012) reported in their abstract of a meta- analysis that: • 821 potential articles were identified, and 65 were selected for inclusion. • The results indicate that VCP is feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy. • Videoconferencing psychotherapy: A systematic review. Backhaus, Autumn; Agha, Zia; Maglione, Melissa L.; Repp, Andrea; Ross, Bridgett; Zuest, Danielle; Rice-Thorp, Natalie M.; Lohr, James; Thorp, Steven R. Psychological Services, Vol 9(2), May 2012, 111-131. doi: 10.1037/a0027924 Supporting Research 15
- 16. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Have you seen any legal or ethical codes related to hardware? 16 • If yes, which ones? • If no, where might you look for them?
- 17. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 17 All Existing Legal and Ethical Rules Apply
- 18. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 18 Which Technologies to Use? • No Guesswork Needed • HIPAA “compliant” or “compatible” (in U.S.) • Practitioners need to be compliant, not technology • Look for documentation of compatibility with HIPAA standards
- 19. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Monitors • Cameras • Microphones • Speakers • Connectivity Other Equipment 19
- 20. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Skype? 20 Question: Do you have any concerns about Skype?
- 21. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 21 Reliability • Often breaks up or drops calls Skype & HIPAA-Compliance • Skype doesn't claim HIPAA compliance
- 22. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 22 Skype does not provide an audit trail, which is a foundational HIPAA requirement
- 23. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 23 Business Associates and HITECH • All Business Associates in health care must sign an agreement stating their adherence to HIPAA standards • Not a matter of opinion - it is now enforced by the HITECH ACT
- 24. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Internet-based, VTC Companies* Claiming HIPAA Compliance 24 http://telehealth.org/video * Telebehavioral Health Institute, LLC has partnered with some of these companies and will receive a referral fee if you mention TBHI. You may also get an added discount.
- 25. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. Which HIPAA compliant policies must you have? 25 • Which areas do they need to cover? • How extensive do they need to be?
- 26. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. We are mandated to use HIPAA compliant technologies and processes • Document policies • Security & privacy policies • Repairs • Staff training • Breach plans etc. • Med Practice Fined $100,000 for HIPAA Violations • http://www.azcentral.com/business/articles/2012/04/17/20120417cardiologists-fined- internet-privacy-violations.html Our HIPAA-compliance Policies? 26
- 27. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 27 Question: Which features do you think mental health professionals need to deliver effective care with VTC?
- 28. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. • Depends on population served: • General adult • Children/Pediatrics (room, table top) • People with disabilities (adaptive devices) • Couples / groups • Incarcerated (videophones) • Patients in facilities (e.g., elderly) Which features do you think mental health professionals need to deliver effective care with VTC? 28
- 29. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 29 Special Mental Health Features Depend on services delivered White board Access desktop or web Neuropsych testing • Supervision • Might also want secured email, instant messaging, cloud storage, etc. • Virtual reality goggles • Apps
- 30. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. U.S. National Health Information Infrastructure and Telehealth 30 Electronic Health Records Client / Patient Care Delivery Systems Hospitals Long Term Care Office Visit Live Telehealth Home Care Pt-MD Messaging Urgent Care Public Health Work Telecommunications, Informatics Infrastructure
- 31. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 31 49.7% of all Americans have a smartphone (Neilson, Feb. 2012)
- 32. © 1994-2022 Telebehavioral Health Institute, LLC All Rights Reserved. 32 Young people use media an average of almost 11 hours every day of the week (*Kaiser Family Foundation, 2010) Seniors are the second largest group online (PEW, 2010)