The American Psychological Association (APA) Office for Legal and Regulatory Affairs recently published a Practitioner Pointer, describing  risks for practitioners using Skype to deliver psychological services. The APA’s risk analysis is primarily based on requirements outlined by the Health Insurance Portability and Accountability Act (HIPAA).
The APA document identified these problems with Skype when used for telehealth:

1. Lack of  Business Associate Agreements (BAA)
2. Lack of audit controls to monitor who is accessing ePHI..
3. Lack of breach notification tools to alert users of unauthorized disclosures or access to ePHI.

Not limited only to Skype, the APA’s pointer concludes with this statement if you choose to use Skype or similar web-based platforms:

  If you opt to use Skype to communicate with patients, be aware of the risk that HIPAA rules may be violated.
The APA’s statement follows in the footsteps made by the National Association of Social Workers (NASW) in 2011 and 2012, in their description of risks associated with Skype. (Available only to NASW members behind an NASW login):

• Social Workers and Skype: Part I (November 2011)
• Social Workers and Skype—Part II, Telemental Health Law (April 2012)

Other Relevant Resources:

1. WEBINAR (with 1 CE if needed): To Skype or Not To Skype? Free And Low-Cost Alternatives
2. WEBINAR (with 1 CE if needed): Skype and Related Practices Found Unacceptable by Oklahoma Medical Board
3. ARTICLE: Telepsychiatry: The Perils of Using Skype | Psychiatric Times
4. ARTICLE: Is Skype HIPAA-Compliant?
5. ARTICLE: HIPAA and Telehealth (PDF, 1.60MB)
6. LIST: More than 50 HIPAA-Compliant Video Platforms