The Florida legislature has passed Chapter 2019-137, Laws of Florida. Signed into law by the governor and effective July 1, 2019, Chapter 2019-137 clarifies the definitions for healthcare providers who use or plan on using telehealth services in Florida, as well as the steps needed to provide ethical, legal, and competent services within the state. The full text of Chapter 2019-137 can be downloaded on the home page.
It is now mandatory for practitioners who are licensed out-of-state and do NOT hold an additional Florida license to be registered with the state in order to perform telehealth services for patients located in Florida. (Licensed Florida providers are already allowed to practice telehealth with patients, and they would be able to see them face-to-face.)
JAMIA recently published their study on the US Department of Veteran Affairs (VA) initiative to bring telehealth to Veterans in serious need of healthcare and with barriers to accessing care. Eighty-six VA facilities provided tablets with telehealth capabilities to 6,745 patients.
In January 2019, the International Society for Telemedicine & eHealth published an article by Nathaniel Lacktman, Esq. and Dr. Neil Nerwich entitled, “Teleconsultation Services for the Mobile Workforce- Considerations and Guidelines for the Provision of Global Services in Compliance with Regulations and Best Practice Clinical Standards of Care.” The International Society for Telemedicine & EHealth (ISfTeH), founded in 2011, is a “nongovernmental and not-for-profit society that services primarily as the umbrella association for national Telemedicine and eHealth organizations,” advising on international standards and best practices for telemedicine.
As of December 2018, the Federal Communication Commission (FCC) has adopted an official ruling that text messages will be considered an informational service (such as emails) versus a telecommunication service (such as telephone calls). Click here for the ruling. This distinction is highly relevant, as communications classified as “telecommunication services” must be transmitted by cellular carriers and are not permitted to be blocked or altered, whereas informational services can be.
As text messaging has grown in popularity over the last decade, texts have carried an ambiguous status; this ambiguity has allowed cellular carriers to make independent decisions regarding transmission, with many carriers defaulting to handle texts as informational services. For the December ruling, the FCC took into consideration that cellular providers have already been filtering text messages (in an effort to minimize spam) and that allowing all texts to go through could burden consumers.
In Opinion 19-02, the Office of Inspector General declares its support for allowing drug manufacturers to temporarily loan smartphones to low-income patients who are prescribed antipsychotic digital medications. A sensor is embedded in the medication and, once taken, transmits a signal to a patch worn by the patient. The patch records the ingestion of medication, rest, and activity levels and uploads the data to a smartphone app via Bluetooth. The patient has the ability to add more detailed information (moods, sleep quality) to the app, and then the app syncs with secure, cloud-based data banks.
Telehealth is a constantly evolving mode of healthcare, and there are numerous aspects of the field in need of clarification so that statutes, policies, and practices follow the same guidelines. Telehealth is not a type of health care, rather it is the manner in which care is given. As the standards for that care become more defined and the use of this mode more prevalent, so will the need for caregivers who are adequately trained and licensed to deliver telehealth.
In 2016, the State of Florida created the Telehealth Advisory Council in order to survey, research and recommend changes to telehealth in order to better serve those living in the state. The increase in both access and use of telehealth will also require an increase in health care practitioners offering telehealth services.
Vendor Management and Video Chatting Clients
HIPAA compliance for telebehavioral health professionals is essential to running your business in the digital age.
According to HIPAA regulation, telebehavioral health professionals must be fully HIPAA compliant in order to avoid serious violations and government fines.
BA and Vendor Management
One of the most common mistakes healthcare professionals can make is improper vendor management. The HIPAA rules here affect telebehavioral health professionals in particular because of the electronic and digital mediums by which care is given.
Telemental health is defined as the provision of behavioral or mental healthcare when the clinician and the client are in different locations at the time of services. Behavioral health services provided when the client and clinician are in the same location are often referred to as "face-to-face", "on-site", "in-person" or "in-office" sessions.
Telehealth is changing the way that patients can access health care, but when new technology meets decades-old federal regulations, tensions will necessarily arise.
When it comes to the intersection between telehealth and HIPAA regulation, there are many common misconceptions about how to run a telehealth practice while maintaining compliance with federal privacy and security standards.
Before we dive into some of the particularities of HIPAA as they apply to telehealth professionals, let's look at some of the basics of HIPAA regulation.
How necessary is professional liability insurance? What if I own my own business? If there is a breach of client data, am I covered?
To answer these questions and more, we asked for help from CPH and Associates, a professional liability insurance agency specialized in the mental health field since 2001. Below, CPH shares some common questions they hear from their insureds in relation to malpractice insurance and telehealth specifically.
In this video interview, Ray Barrett of the Telehealth Certification Institute sits down with internationally known cognitive-behavioral researcher and psychiatrist, Dr. Jesse Wright. During the interview, Dr. Wright shares how his decades of research experience have helped validate the clinical power of computerized cognitive behavioral therapy (CCBT). Dr. Wright emphasizes that computer-assisted therapy is not about eliminating the person in the process, but “use computer programs to help build skills, teach some of the basic concepts, rehearse patients, help them do…homework or action plans, and do some of the routine things that cognitive therapists often have to do.”
Dr. Wright started researching the potential of using computer-assisted technology or multimedia as a hybrid therapy model in the 90s, so there are numerous articles and studies that point to the effectiveness of CCBT. In fact, Dr. Wright found that the remission rates were “more than double in people who received computer-assisted cognitive therapy” compared to treatment as usual.
Therapists are rapidly turning to telehealth as a flexible way to conduct their telemental health sessions, but sometimes the client’s strong aversion to technology is the first barrier that needs to be addressed. According to the Community Living Campaign, access, training, and equipment are the three pillars of technology literacy. Without them, clients may not have the digital literacy skills they need to engage fully in their telemental health session. In this article, you’ll find practical tips to close the tech gap between you and your client!
As a digital advocacy group, The National Digital Inclusion Alliance suggests that you first identify your client’s level of skillfulness with technology and what they’ll need to succeed. Once you’ve nailed down the barriers, you can assess your readiness to coach the client through the skill acquisition process. This could involve navigating a ZOOM log-in screen, adjusting a client’s microphone, or configuring the client’s speaker.
These are four easy-to-remember questions that can keep you on track when developing a client-centered technology plan: