Telehealth consent continues to be a confusing area for some practitioners. KY Law requires telehealth consent. Even if it didn’t it’s a good idea to take common sense actions to ensure you have the client’s or patient’s express approval before conducting a telehealth services.
Check State Rules regularly
For interstate practice, some states still require paper documentation as demonstration that you got the client/patient’s telehealth consent, while other states do not. Speak with your legal counsel and find out the specific requirements for where your client is located at the time of service and where your practice is based. Then you’ll know whether you need paper documentation, or if a notation in the electronic health record is sufficient, or if anything else is required. Rules can change and notices are not often made to practitioners. Know the rules in the state where you and the client are at the time of service.
Explain What Clients/Patients Can Expect
Every time you meet with a client/patient over telehealth, explain what they can expect from the visit and what their rights are. KY requires the verification of client identity and location for each visit if you are a social worker. Be sure clients understand what you’re explaining and give them the option of rescheduling a face-to-face visit if they aren’t comfortable with sharing sensitive information over the phone or an internet connection. Do you use a HIPAA secure system?
Get Consent About Observers
If anyone is observing the telehealth visit, let the patient know and get their approval ahead of time. For instance, the provider might say, “My student intern is here observing this visit, her name is Sarah McClure. Do I have your telehealth consent for Sarah McClure to attend this visit?” Does this have to be in writing? Always make a note in the client’s record. Ensure the patient knows that limits of confidentiality apply to the observer.
Discuss Privacy Expectations (yours and the client)
Ensure the patient knows that they must feel comfortable with privacy on their end of the line, wherever that maybe. If they’re in a public place, make it clear that you may ask some questions that require them to share private health information, and give them the option of finding a quieter, more secluded spot or consider using headphones before you start talking about their health. Remember you must also be comfortable with their location for safety and emergency situations.
Avoid Recording the Visit
You should document the details of the telehealth visit in the medical record as you would if the patient was in front of you. But you shouldn’t create a recording of the telehealth visit. That presents far too many opportunities for PHI to escape. Does your client record you?
There is more to telehealth the using FaceTime to connect with your client. FaceTime may not even be allowed in your setting.