Regional Psychiatric Hospital (RPH) Treatment Team

TELEHEALTH CLINICAL GUIDE and CHECKLIST  

 These guidelines are applicable for the OhioMHAS Regional Psychiatric Hospitals (RPH) for conducting Telehealth events with community mental health providers.  These guidelines were developed using recommendations from the Practice Guidelines for Video-Based Online Mental Health Services May 2013, American Telemedicine Association. http://www.americantelemed.org/practice/standards/ata-standards-guidelines/practice-guidelines-for-video-based-online-mental-health-services

1. Provider (Inpatient and Community) and Patient Verifications
2. Provider and Patient Identity Verification

The name and credentials of the staff/providers and the name of the patient are to be verified prior to the beginning of each telehealth event.  Regional Psychiatric Hospital (RPH) staff will verify who is present in the room at the hospital site, and the community/remote site will be asked to do the same verification.

As appropriate, all providers and staff will provide information regarding their role in the patient’s     treatment (i.e. case manager, psychiatrist) and be able to respond to patient requests for additional information regarding their credentials.  All professional licensure rules apply.  Providers/staff should be able to verify their qualifications, licensure information, and if requested, license number.  Upon request of the patient, information regarding how/where the patient can verify credentials will be provided.

Patients shall provide their full name, and may be asked to provide additional identification information.

2. Provider and Patient Location Documentation

The RPH will act as the host site where the patient is located for these telehealth activities.  The participating community agency site shall be confirmed and documented in the patient record by the RPH staff.   All other documentation requirements for treatment are applicable.

Verification of the provider (the host site) location and patient location is critical for these reasons:  Relevant licensing laws; Emergency management protocols; Mandatory reporting; and Reimbursement (applicable to community providers at this time).

3. Contact Information Verification for Professional and Patient

It is encouraged that contact information for both provider and patient shall be verified.  As applicable, contact information can include a phone number, address, and e-mail.

1. Patient Consent and Appropriateness for Telehealth Activities

A patient’s ability to participate in the telehealth event will be assessed by the RPH treatment team prior to initiating telehealth activity.  Patients will be provided information about this treatment option, and if in agreement, will sign a consent form for telehealth treatment.  Patients right to refuse telehealth services will be reinforced.  If this occurs, other treatment options are always available.   Participation in telehealth is voluntary and can be discontinued by the patient at any point in time.

1. Informed Consent Process

The RPH staff will review the Telehealth Consent Form with the patient prior to initiating a telehealth event.   The goal of the informed consent process is that the patient understands telehealth as a treatment modality, the patient has the ability to ask questions, and the patient agrees to this form of treatment.

1. Physical Environment

The room/environment should allow for optimal visual and audio clarity, and comfort.  As with any treatment activity, information being shared is confidential.   All participants in the room shall be identified, and their involvement agreed upon by the patient.   Seating and lighting should be monitored and comfortable for the participants. To the extent possible, the patient and provider cameras should be placed at the same elevation as the eyes with the face clearly visible to the other person.  (Please reference the Telehealth Site Survey form and information).

1. Education, Training and Safety Management

 Education and Training

RPH Staff will be asked to review a brief Telehealth Training Module prior to being involved in telehealth activities. It is encouraged that all professional staff review their discipline’s definitions of “competence” prior to initiating patient care by telehealth to ensure that they maintain both technical and clinical competence.   The RPH training modules provide information about telehealth as a treatment modality, clinical documentation requirements, patient consent, confidentiality, system security, community collaboration and other pertinent information.  Each RPH may provide information regarding scheduling, technical assistance, and equipment failure/back-up planning.

2. Patient Safety

In the case of an emergency, an appropriate code shall be initiated by dialing “XXX” using the closest hospital telephone.  If the patient becomes unable to participate in the session, the community provider will be notified and the video/telehealth session will be discontinued.

1. Cultural Competency

RPH staff shall be culturally sensitive in the involvement and delivery of services to patients.   Factors to consider include awareness of the client’s language, ethnicity, race, age, gender, sexual orientation, geographical location and socioeconomic and cultural backgrounds.

If necessary, an interpreter will be provided either in person, or in a venue that is acceptable to the patient.

Clinical Checklist

Pre-Telehealth Event Checklist

1. The patient has signed the Telehealth Consent form and has an opportunity to ask questions or be provided with additional information.
2. The patient has an opportunity to request an interpreter or other support(s) to enable their maximum benefit from the telehealth activity.
3. The community agency has been made aware that treatment services provided by telehealth fall under the same rules, regulations and requirements as any treatment activity.
4. A back-up communication plan (telephone, etc.) is developed and communicated to the provider.
5. The telehealth checklist has been completed.
6. RPH staff have an emergency back-up plan, and staff roles/tasks are known.
7. RPH and community providers agree that telehealth session will not be recorded (audio or visual) or taped under any circumstances.

Telehealth Event Checklist:

1. Staff at both Host (RPH) and Remote (Community Agency) site introduce themselves, and each site is clearly identified.
2. The patient is clearly identified.
3. The patient has an option to request information about staffs’ role in their treatment, staff licensure or credentials, or other clinical information.
4. Each site will restrict access to individuals involved in the treatment team meeting.
5. RPH staff will document the treatment team meeting in the patient record.
6. RPH staff will continue to monitor the patient during the telehealth event as with any treatment intervention, and respond appropriately.

 

July 2014

Developed by the RPH Telehealth Team