Ned workwise-week 3 508

1. New Ethical Dilemmas
Developing Professional
Competency in the Digital Age
Christina Boyd, LSCSW, LCAC
Gary Wareham, MA, LPC, LAC

2. Texting, Email,
Videoconferencing-HIPAA and
42 CFR Part II
Week #3

3. Quick Reminder on Expectations
Be Be here for sessions (present in body AND mind!)
Have Have camera and microphone on during sessions
Minimize Minimize Distractions
Participate in each session (CE credit is dependent on commenting
Participate in verbally or on chat)
Complete Complete Learning Activities
Learn Learn something each session!

4. Agenda-
Week #3
• Check in
Welcome
• Review Learning Activity
• Email
• Texting
Presentation • Videoconferencing
• Competency in the world of
COVID-19
• Preview of next week
• Learning Activity-Social Media
Summary
Policies
• Questions

5. What is one thing that you have
been excited about learning
from this series so far?
Please type in the chat or unmute to
speak!

6. Learning Activity
Learning Activity
What did you find out?
What does your Profession say about
technology you use in your practice?
Social media? Email? Texting?

7. So what’s the

8. Emailing
Clients

9. Security of Email
Emails are stored at multiple locations: the
sender's computer; your Internet Service
Provider's (ISP) server; & the receiver's computer
Deleting an email from your inbox doesn't mean
there aren't multiple other copies still out there
Emails are also vastly easier for employers and
law enforcement to access than phone records
Finally, due to their digital nature, they can be
stored for very long periods of time

10. ‘Email is not like
mailing a sealed
letter or package. It’s
more like sending a
postcard – people
are not supposed to
read it while in
transit, but it passes
through many hands,
& one can never be
sure that someone is
not reading it
illegally.’ (AMA, 2010-13)
Ms. Wendy Woods
% Mountain Plains
Reno, NV
Addiction Technology Transfer Center

11. HIPAA New Rule
Regarding Email• Privacy Rule allows providers to communicate
electronically with patients
• Reasonable safeguards
• Checking email for accuracy
• Sending an email alert
• Limiting the amount or type of information
disclosed
• Must be compliant with 45 CFR Part 164 Subpart C
• Health care providers can provide email reminders to
patients if they consent
• Patients can initiate email communications with
providers using emailU.S. 2008

12. Re-Targeting

13. Advertisement and emailing

14. Do you or your staff TEXT
Clients?
Do you or your staff
TEXT clients?

15. How many of you are using text to
communicate with clients?
If you are, how many are using
their own cell phones to do that?
Polling Question

16. More than one third
of cell phone users
MORE THAN ONE-THIRD OF CELL PHONE USERS:
• have sent a text message to the
wrong person (38%)
• report that a text they sent was
misunderstood by the reader
(37%)
(http://www.saurageresearch.com/key-findings-novemberdecember-2009/)
Saurage 2009

17. Text Messages
can be saved,
sent to an email
account, and
posted online all
without the
other
person’s
permission or
knowledge
Text Messages
can be saved,
sent to an email
account, and
posted online all
without the other
person’s
permission or
knowledge

18. Confidentiality

19. Text Message
Transmission
Process

20. (American Academy of Orthopaedic Surgeons, August 2012-
(Brooks2013 )
“Traditional Short Message Service (SMS) text
messaging is non-secure and non-compliant with
safety and privacy regulations under the HIPAA.
Messages containing ePHI can be read by anyone,
forwarded to anyone, remain unencrypted on
telecommunication providers’ servers, and stay
forever on sender’s and receiver’s phones.”

21. Cell phone providers

22. A Video conference in real life
22
https://www.youtube.com/watch?v=JMOOG7rWTPg

23. Video Conferencing Checklist
Create a background free of distractions (doors, floors, ceilings out of view) Ensure
clear space around your head and torso, nothing that looks like it is emerging from
your body!
Lighting should be good to add to clarity, poor lighting creates a grainy picture. Try LED
Daylight bulbs if possible. Lamps in front of you can help to create crisp lighting.
Avoid Virtual Backgrounds! Unless you have extremely high-quality equipment, it can
be very distracting every time you move.
Do not attend meetings on camera from your bed! Avoid beds and bathrooms being in
the video frame. This can be interpreted as inappropriate and cause others to be
uncomfortable 23

24. Practice, Practice, practice
Centering self in middle of frame. You should see your entire head
and part of your torso. There should be about 2 fingers of space
above your head.
You should be looking directly at the camera on your screen, not
down or up at the camera. You can use a box or something under
your computer or raise or lower your chair to achieve this
Sound should be clear and free of echo. Try using headphones to
reduce echo and improve clarity. You can also put up fabric (pillow,
blanket) directly behind the camera to reduce e24cho

25. W
What to do
ear situation appropriate attire. If you would not wear something to an in-person meeting, do not wear it on
video. Wear pants!
Find a space with no pets or People, ask others in the home to remain out of your area while you are on video
Check room lighting, including windows and sunlight, adjusting as needed
Check possible phones that might ring or make noise (e.g. landlines, cellphones, receiving email or text alerts)
Check your audio (e.g. headset, mic on computer/platform) and video camera on platform
If you do have a door to the room you are using, make sure it is shut to ensure that others in the house cannot
hear your discussion.
25
Place “Quiet Please” sign on door to alert others in the home that you are on a conference call

26. Looking
at
Camera &
Improved
Lighting
Looking
Down at
Screen &
Poor
lighting
26

27. Can you spot the difference?
Which looks more professional?

28. Ethics of Technological
Competence
Technological competence:
ability to create and use a
particular field
of technology effectively, which
is gained through extensive
experimentation and learning in
its research, development and
employment in production
• (Fai & von Tunzelmann, 2001)

29. July 2017-New Technology
Standards for Social Work
Starting to see more
Guidance!

30. Safe
Practices

31. Just because we CAN,
SHOULD we?
Let’s TAKE A
Closer
LOOK….

32. Some things to consider:
• The Office of Civil Rights (OCR) has indicated they will exercise
enforcement discretion and waive penalties for HIPAA violations against
health care providers that serve patients in good faith through FaceTime
or Skype
• The Substance Abuse and Mental Health Services Administration
(SAMHSA) is providing guidance and resources for treating patients with
mental health and substance use disorders on its COVID-19 webpage.
• On March 19, the Substance Abuse and Mental Health Services
Administration (SAMHSA) released guidance on 42 CFR Part 2 to ensure
that substance use disorder treatment services are uninterrupted during
this public health emergency
APA-2020

33. “Clients should know that electronic
communications are generally not secure
methods of communication and there is a risk
that one's privacy/confidentiality could be
compromised with their use"
(Neace , 2011)

34. Curbside
Nevada
https://nvdoctors.org/wp-
content/uploads/Curbside-Nevada-flyer.pdf

35. Sneak Peek at Next
Week ….
Social Media-
Potential Ethical
Pitfalls

36. Learning Activity
Week #3
Social Media
Read the Article
Consider Questions
Activity utilizing your own
screen shot
Be prepared to discuss next
week!

37. Acknowledgments
APA 2020. https://www.psychiatry.org/psychiatrists/covid-19-coronavirus/practice-guidance-for-covid-19
Brooks, A. (2013). Healthcare Texting in a HIPAA-Compliant Environment. American Academy of Orthopaedic
Surgeons. Retrieved from http://www.aaos.org/news/aaosnow/aug12/managing5.asp
Fai & von Tunzelmann, 2001. Industry-specific competencies and converging technological systems: evidence from
patents. Structural Change and Economic Dynamics. Volume 12. Issue 2, July 2001, Pages 141-170.
Neace. R. T. (2011). Yes, u shud b txting cits! [Web log message]. Retrieved from http://my.counseling.oi-
g/2011/05/09/yes-u-shudb-txtng-clts/
U.S. Department of Health & Human Service. (2008). Does the HIPAA Privacy Rule Permit Health Care Providers
to Use E-Mail to Discuss Health Issues and Treatment with Their Patients? HHS.gov. Retrieved from
http://www.hhs.gov/ocr/privacy/hipaa/faq/health_information_technology/570.html
Saurage Marketing Research. (2009). Key Findings – November/December. Retrieved from
http://www.saurageresearch.com/key-findings-novemberdecember-2009
/