How to Develop a Telehealth Policy for Your Practice (+ Policy Checklist!)

Do you have the necessary policies in place to protect your clients and practice?

In the wake of COVID-19, all industries have had to adjust the way they operate. In healthcare, practitioners have turned to emerging technology solutions in order to keep up with the growing demand for services and to keep clients, staff and practitioners safe. The rapid adoption of Telehealth has helped to expand access to healthcare at a time when traditional in-person visits had to be avoided due to the significantly increased risk in communities.

Telehealth options have expanded to not only include texts, phone calls, image forwarding, and video visits but also online client portals and remote monitoring. Using Telehealth solutions, a greater number of suspected and positive COVID-19 patients can quarantine in the safety of their homes without forgoing care, freeing up healthcare resources for those that need them the most. In addition, clients suffering from non-COVID afflictions can seek treatment without entering vulnerable environments. On the provider side, Telehealth is helping keep practitioners and staff healthy while helping them manage their clients and lessen the backlog of future demand for services once the pandemic has decreased.

Due to the haste of the adoption of this technology, many practices have been left vulnerable; practices were not prepared and had to scramble to alter their business model and, understandably, their immediate thought was to ensure their clients got the care they needed. Now that this technology is settling into the new “norm”, it’s time to look at your practice’s policies and procedures to keep the business side of your practice running smoothly and ensure that you are compliant while focusing on quality health care for your clients.

5 Top Inclusions for Your Telehealth Policy

1. Client Consent

Consent is collected from clients prior to Telehealth sessions to ensure all clients understand what Telehealth is, what their rights are and what to do if they no longer want to participate in Telehealth. The best option to collect the client’s consent is to be sent via online forms at the time of the booking. Before conducting a Telehealth consultation, practitioners should ensure clients understand how the consultation will proceed.

This could include:

• Providing the client with plain language information about Telehealth
• Informing clients of the other available care options
• Informing clients of any out-of-pocket charges for Telehealth consultations, compared to other available options
• Indicating the length of the Telehealth consultation
• If the use of Telehealth is practitioner-driven, giving the client context for their use of Telehealth if possible to help the client feel more comfortable

Practitioners should be satisfied that clients have consented to participate in the Telehealth consultation. In cases where the client does not have the capacity to give consent, consent should be obtained in the same way as in a face-to-face consultation. The clinician may have to arrange for consent to be given by a family member or friend who has the requisite legal authority (for example, enduring guardianship) to give consent on the client’s behalf.

In cases where a recording is to be used for education or assessment purposes, the client should be informed of this and give consent to how the recording is to be used. A client’s verbal consent to the recording of the consultation and how the recording is to be used should be given at the start of the Telehealth consultation and recorded.

2. Privacy and Confidentiality

Telehealth consultations should be private and confidential, and practitioners should have processes in place to facilitate this as per standard face-to-face consultations. The client’s privacy and confidentiality should be maintained at all times. Some procedures practitioners should use to manage risks to privacy and confidentiality include:

• Having a system to ensure that there are no interruptions at both the clinician and client ends of the consultation
• Ensuring clients participating in the Telehealth consultation from home do so in a quiet room where they will not be disturbed
• Alerting other staff at their practice location that they are conducting a Telehealth consultation and asking not to be disturbed
• If a consultation is to be recorded, storing the recording securely and ensuring privacy and confidentiality are maintained
• When choosing video conferencing hardware and software for Telehealth, consider the security features of the Telehealth system to ensure the technology used facilitates privacy and confidentiality
• Maintaining appropriate storage of all reports provided for, or generated from, the Telehealth consultation
• If there is a valid and clinically appropriate reason for the recording of a consultation, fully informing the client and receiving their consent

3. The Technology

The basic requirement of Telehealth is the transfer of audio and or visual data in real time between the practitioner and the client. To conduct Telehealth consultations, Telehealth-specific hardware or software is not necessary as some consumer-based products can be used effectively. The choice to use particular technologies rests with individual practitioners or practices and is dependent on context.

The information and communications technology used for Telehealth should be fit for the clinical purpose of the consultation.

Specifically:

• The equipment is reliable and works well over the locally available network and bandwidth
• The equipment is compatible with the equipment used by the client
• The equipment and network are secure, and privacy and confidentiality during the consultation can be ensured
• The equipment is of a high enough quality to facilitate good communication between all participants and accurate transfer of clinical information.

4. The Risks

When providing Telehealth services to clients, it’s important to identify risks and hazards that may have a negative impact on the safety and confidentiality of the client and to provide for the implementation of safeguards and contingency plans to prevent harm.

Practitioners should conduct a risk analysis to determine the likelihood and magnitude of foreseeable problems. Practitioners should be mindful of the limitations of the technology being used and have procedures in place for detecting, diagnosing and fixing equipment problems.

When selecting Telehealth technologies, practitioners should consider the availability of technical support services during the times the equipment will be operating. Practitioners should be mindful when choosing Telehealth technology solutions that some consumer-based products do not offer support services.

Practitioners should ensure they have a backup plan in cases of equipment or connectivity failure, which is proportionate to the consequences of failure. For non-urgent consultations, rescheduling or completing the consultation by telephone may be sufficient. If urgent medical assistance is likely to be provided by Telehealth, practices might consider installing an uninterruptible power supply and a second source of connectivity.

5. The Experience

Practitioners and clients need to be comfortable and in surroundings that enable good communication. The Telehealth consult, either voice only or voice and video needs to be conducted in a private quiet space. Remember this consult is in place of a face-to-face consultation, and all privacy and confidentiality legislation and laws apply.

Telehealth Policy Recap

Once you’ve drawn up your Telehealth Policy, review the checklist below to make sure you haven’t missed anything important.

Telehealth Policy Checklist

• Do practitioners make it clear that appointments are via Telehealth?
• Have you provided training and troubleshooting information?
• Have you set up online payment via Stripe ahead of the appointment?
• Do your clients know why you want to use Telehealth?
• Do you have a plan in place to prevent interruptions?
• Do you have a backup in place in case there are connection issues?
• Is your team clear on the client consent needed for Telehealth consultations and recordings?
• Have you communicated any extra costs the client may incur?

A Telehealth policy is one of the documents that need to be defined in any health practice that offers virtual consults. They’re a reference document for your team and a handy resource for onboarding clients that have never used Telehealth before.

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