In a June article for the Hawaii Psychological Association, Dr. Pat DeLeon summarized recent psychology-related events and includes the area of telepsychology. (Reprinted with permission from Dr. DeLeon.)
AN EXCITING VISION FOR THE FUTURE
Dr. Pat Deleon, former president of the APA, just wrote this article for the Hawaii Psychological Association:
The federal sector has a unique opportunity, with its considerable resources and national presence, to bring the rest of the health care world into the 21st century capitalizing upon the unprecedented developments occurring within the health information technology (HIT) environment. Is there, for example, any meaningful difference between on-site supervision and that conducted via telehealth? At the highest level, VA and DoD are committed to integrating their electronic health records. This will allow seamless care from active duty to retirement, and across-patient and family comparisons of effectiveness and need. VA visionaries Toni Zeiss and Lisa Kearney truly did an outstanding job.
“Telepsychology is knocking: The key to responsible use in our clinical work is the training of psychologists regarding the existing legal, ethical, and clinical issues involved with not only e-mail but video-chat such as Skype, Facebook, text messaging, iPhone apps, as well as a number of other technologies. Handling the barrage of new electronic services promising to make practice ‘easier’ is fraught with nuances that are difficult for the average clinician to detect. Privacy and confidentiality; licensure and other regulatory issues; patient and practitioner authentication; HIPPA requirements; appropriate online professionalism, including boundaries in social media sites; treatment ramifications of searching for patient information online; reputation management and reacting to negative reviews in online rating websites; mandated reporting of abuse or suicide and homicide intent; what to include in the informed consent discussion and document; what to include in the patient record; how online technology is likely to evolve, including the electronic health records and what they mean for psychologists – all these issues are at our doorstep. When the patient floats from one to another technology and asks that the psychologist accommodate him or her, what is the responsible psychologist to do?” (Marlene Maheu, a visionary leader in telehealth).
A Historical Perspective: Jerry Michael, former Dean of the University of Hawaii School of Public Health and Assistant Surgeon General of the U.S. Public Health Service, prophetically observed in 1968: “For broad planning purposes, we can project long-range trends in health manpower supply and demand.
I cannot emphasize too strongly that the value of any auxiliary health worker is directly proportional to the quality of his training and the quality of his supervision. Quality training and quality supervision are essential. It is also essential to determine just what jobs the workers are to do – and where – and to train them for the specific jobs. These precepts are so elementary that it is almost redundant to state them, yet we see all too many instances in which these obvious first steps have been forgotten or overlooked. The keystone in better utilization of health care facilities is improved planning, training, and education. Thus it would follow that these elements are equally crucial in the utilization of health personnel. In addition, planning aimed at the most effective use of health manpower must also be responsive to changing knowledge and social changes and to the increasing expectations of health service consumers. The scarcity of health manpower must be viewed as both a national and a local problem, and the approach to its solution must be systematic, based on sound knowledge of the makeup of the health system and with the needs of the patient identified and kept paramount.” VA, DoD, and increasingly Hawaii’s political leadership appreciate this vision. Above all else, our system must be patient-centered and no longer concerned with being highly provider comfortable.
Aloha, Pat DeLeon, former APA President – HPA – June, 2011