In the digital age, telemental health services have become increasingly prevalent, offering a convenient and effective means of therapy. As a behavioral health provider, it is crucial to consider not only the safeguarding of your clients' mental well-being but also their information security. This article explores the responsibilities of behavioral health providers in informing clients about protecting their data while using telehealth services.
Understanding Telemental Health Security
Telemental health sessions involve a complex ecosystem comprising technology at the clinician's site, the client's location, and cloud-based services. Several laws, including the Health Insurance Portability and Accountability Act (HIPAA), mandate robust security measures and policies to protect electronic patient information. Furthermore, clinicians must choose cloud services with reasonable data security assurance. State licensing boards often require behavioral health providers to inform their clients of the risks associated with telemental health services, aligning with professional codes of ethics.
Client Responsibility vs. Provider Accountability
Regulations do not offer explicit recommendations on whether providers must educate clients on protecting their privacy, prompting essential questions about the allocation of responsibility. From a legal and ethical perspective, should clients shoulder the responsibility of securing their information, or is it the provider's duty to ensure clients are well-informed? Is it realistic to expect clients to independently evaluate and mitigate potential risks?
Providers choose and configure much of the telecommunication technology for telemental health sessions, including video conferencing platforms and client portals. Clients often assume that clinicians have taken the necessary precautions to safeguard their private information. Therefore, it is only logical for providers to inform their clients of any risks associated with the chosen technology and how to mitigate them.
Client-Owned Technology and Security Measures
The notion of providers educating clients about common security measures for their devices and online activities can be a subject of debate. To draw an analogy with in-person sessions, if a provider is aware that patients frequently park in a no-parking zone near their office or if there's a concealed step that might pose a tripping hazard, they would typically caution their clients about these risks. Conversely, they wouldn't advise clients to check the oil level in their vehicles or scrutinize the quality of their shoes before coming to the office. Consequently, the question arises of whether basic IT security measures are considered common knowledge for clients.
The American Telemedicine Association addressed these questions in their August 2009 Practice Guidelines for Video-Based Online Mental Health Services document. They emphasized the importance of professionals educating patients about the potential risks of data inadvertently being stored on clients' devices and offered guidance on how best to protect privacy. In many of our telemental health courses, we recommend that clinicians provide clients with essential information on protecting their own privacy.
Recent Resources for Client Education
On October 17, 2023, the Department of Health and Human Services published the "Telehealth Privacy and Security Tips for Patients" resource document created by the Office for Civil Rights (OCR). This comprehensive guide covers various aspects of telehealth security. Providers can adapt and modify this resource to suit the specific needs of their services. Additionally, in our "Preparing For a Video Meeting" article, clients can find resources to prepare for telehealth sessions beyond security measures.
While behavioral health providers may not be legally or ethically bound to educate their clients on security measures related to their own technology, doing so can contribute to preventing harm and fostering a confidential therapeutic environment. Ultimately, promoting client awareness and data security is integral to delivering high-quality telemental health services.