Telemental Health: Logistical Considerations

1. Assess the various facets of telehealth care needs of your patients and those of your practice
2. Develop a detailed, strategic plan
   • Developing a telebehavioral health strategy

1. 1. Questions to ask before determining a platform:
      • Is the platform/tele application easily accessed and utilized by providers/staff AND patients/caregivers?
      • What type of technology does your patient have access to?
      • Do they own a smart phone or another device that can help them to connect with you, and do they know how to use them?
   2. Next, obtain a Business Associate Agreement (BAA)
      • Required by all entities to have a signed contract with any business associate who may come into contact with PHI
   3. Train providers and support staff on how to use platform
      • Consider identifying a super user within your practice to aid patients with access/trouble shooting platform
   4. Consider offering a practice “session” for clients (logging in, adjusting volume, screen, transferring call/hand off to scheduler (if applicable), signing off)

Resources

1. • Administrative logistics: Resources from Center for Connected Health Policy (CCH)
   • AMA Telehealth Implementation Playbook

Overall Tips for Building Your Program

• Clearly define telehealth interventions and the context in which they are implemented
• Explore in more detail what types of visits and conditions are and are not appropriate for telehealth
• Select appropriate outcomes—those that are clinically important and linked to the intervention, instead of those that are most easily measured

Other Aspects of the Process to Consider in Advance:

• Scheduling
• Charting
• E-prescribing
• Consents – include separate consent to treat via tele health/virtual platform
  • Obtaining Informed Consent
  • Medicaid & Medicare Consent Requirements
  • Easy to understand consent form (attached)
• Accessing patient records
• Intake documents
  • How will your practice send/receive? Electronically, via an encrypted EHR? Mail to/from patient? Is in-person pick-up/drop off available?
  • Telehealth Intake & Screening: Key Roles of Setting and Diagnosis

Resources

• AAFP Toolkit: A Toolkit for Building and Growing a Sustainable Telehealth Program in Your Practice
• APA Telepsychiatry Toolkit
• Teaching Patients about Telehealth Toolkit
• ATA’s Quick-Start Guide to Telehealth During a Crisishttps (free access after filling out online form)
• Center for Telehealth Innovation, Education, and Research

Resources to include with intake packet:
Telehealth and Patient Safety

Safety Tips:

• Establish escalation protocols
• Encourage pre-charting of upcoming patient visits
• Quality assurance plan: hold patient huddles, discuss with others on the team
• Tutorials of telehealth basics

Crisis Resources:

• NAMI: What to Do in a Crisis
• Locate essential community services: 211
• National Helplines:
  800-662-HELP (4357)
  988 Suicide and Crisis Lifeline

• Establish how to reconnect if you are disconnected
• Always document the patient’s physical location
• Have a back up plan (for example, if video doesn’t work, to use audio)

Help for providers: Well-being in the virtual health environment

Learn more about telehealh fatigue including ways to prevent and reduce strain. For example:

• Take Breaks
• Talk to someone
• Switch up your schedule

Tips for camera use

• Hide or minimize your face
• Be aware of your time
• Get comfortable