In response to the COVID-19 crisis and current social distancing mandates, mental health professionals everywhere are using Telehealth services to safely provide continuity of care for their clients. Government officials and health care entities are establishing emergency policies regarding the use of Telehealth during this unprecedented time.
Although Telehealth has been around since NASA started using it to provide care to astronauts in the 1960’s, it has only recently become a mainstream method for healthcare delivery. Below are the most common considerations for clients who want to use Telehealth platforms throughout this crisis.
Telehealth Q&A For Clients During The Covid-19 Pandemic
Q. What is Telehealth?
A. Telehealth is the practice of providing care to clients at a distance using telecommunications technology. In other words, it is a method of treating patients using the internet and telephone. This can take the form of real-time video visits, secure email, or remotely monitoring a client’s progress.
Q. Are Telehealth and Telemedicine the same thing?
A. The terms Telehealth and Telemedicine are often used as if they were the same thing, but technically telemedicine is a subset of telehealth. Telehealth also includes non-clinical uses of telecommunications technology such as self monitoring, provider and patient education, and medical records management.
Q. Is Telehealth technology difficult to use?
A. Of course, this depends on the specific application and each person’s familiarity with technology, but in general, telehealth software is designed to be as easy to use as other familiar modern applications. Patients and providers with a basic familiarity with online apps should be able to quickly figure out how to use a telehealth application.
Q. Do therapists need special training to provide Telehealth?
A. California law doesn’t require training to provide Telehealth services. As with all psychotherapy services, it is important that the therapist is competent and knowledgeable about using technology in providing treatment. It’s also important to recognize the risks and benefits of providing Telehealth services and therapists are required to explain that to their clients.
Q. What is unique about Telehealth compared to In-Office Therapy?
A. The same ethical and legal aspects of confidentiality apply to Telehealth as In-Office Therapy. One primary difference is that the therapist is required by law to ask the client where they are physically located at the beginning of each session, whether it’s Online Therapy or Phone Therapy. This is so the therapist can notify the authorities in case of an emergency.
Q. Is Online Therapy as secure as Phone Therapy?
A. Phone Therapy may be somewhat more secure than Online Therapy. With online therapy, third-party applications potentially introduce privacy risks even when provider enable all available encryption and privacy modes when using such applications. The Office for Civil Rights (OCR) who enforces HIPAA (The Health Insurance Portability and Accountability Act) has said that Facebook Live, Twitch, TikTok, and similar video communication applications that are public facing should not be used in the provision of Telehealth by covered health care providers. Of course, there are probably other video communication applications that are also vulnerable.
Q. Is it important that the therapists providing Telehealth services be a “covered entity” under HIPAA?
A. The HIPAA guidelines only applies to organizations and providers who qualify as “covered entities.” The use of electronic technology to provide Telehealth services does’nt make a health care provider a covered entity. Because of this, therapists who aren’t covered entities don’t have to comply with HIPAA requirements. However, it’s still important for therapists using Teleheath to provide the most secure technology available to ensure client confidentiality.
Q. What are the HIPAA regulations pertaining to the provision of Telehealth?
A. While the restrictions regarding HIPAA compliance have been somewhat being eased during the COVID-19 pandemic, even clients and therapists who are not covered entities should still follow industry best-practices and utilize HIPAA compliant Telehealth platforms.
Q. Have any regulatory agencies taken action to help ensure insurance plans will reimburse for Telehealth services during the COVID-19 crisis?
A. According to the California Association of Marriage and Family Therapists (CAMFT), a number of agencies have said they are instituting mandates to secure Telehealth reimbursements. Several governmental agencies have made announcements that both clients and therapists should be reimbursed at the same rate, whether a service is provided in-person or through Telehealth. However, you should still confirm this with your insurance provider.
Q. Still, what do clients do if health care plans are not waiving certification requirements and refuse to reimburse?
A. The federal government, as well as Governor Gavin Newsom, have encouraged Telehealth and social distancing. Many states, including Calfornia, have taken it a step further with a shelter in place order. The Department of Managed Health Care and the Department of Insurance have asked all health plans to expedite or relax their pre-certification requirements. A number of mmental health organizations have reached asked Governor Newsom, the DMHC, the Department of Insurance,and the California Association of Health Plans to enforce a 60-day freeze mandating all plans to reimburse Telehealth with no pre-certification requirements.
Q. With Phone Therapy and Online Therapy how does a therapist help a client if a crisis occurs?
A. A therapist’s job is to make sure that the client is always safe. When doing Phone Therapy or Online Therapy sessions, a therapist not only gets the client’s full name, address, phone number and emergency contact information, they also ask at the beginning of every session where the client is located at that moment. That way, the therapist can help if there is an emergency and send an ambulance or the authorities.