Telehealth legal issues are complicated, fraught with exceptions and in telecommunications, still unfolding. Also, many practitioners either fear them or do not understand telehealth legalities.
Telehealth Informed Consent
Let’s begin with telehealth informed consent, the ongoing agreement, we make with our clients about the process of treatment. Not to be confused with a document, informed consent is a process — a meeting of the minds between the clinician and the client/patient. The document merely serves as written proof that the meeting of the minds occurred.
Legal requirements for the contents of such agreements are defined differently by various states, provinces, and countries. Ethical requirements can also differ from discipline to discipline. Therefore, it is important that clinicians will be informed and in full compliance with all relevant legal and ethical requirements for different states and disciplines served.
For example, Georgia’s Composite Board stipulates:
Prior to the delivery of TeleMental Health services by a licensee via technology-assisted media, the licensee at the distant site shall inform the client that TeleMental Health services via technology-assisted media will be used, and the licensee shall obtain verbal and written consent from the client for this use. The verbal and written consent shall be documented in the client’s record. Consent must include disclosure of the use of any third party vendor such as a record keeping, billing service or legal counsel.
On the other hand, other states, provinces, or countries do not mention telehealth, telemental health, or informed consent for telemental health at all.
Discuss telehealth informed consent issues with patients before formally engaging in treatment. Repeat as needed.
Regardless of whether or not it is explicitly stated in a state’s business and practice code, all professional associations require informed consent to be an ethical standard, therefore inclusive but surpassing state or federal law. It is incumbent on clinicians to discuss a variety of technology-related issues with patients before formally engaging in treatment. Beyond this is how technology can help clinicians and patients deal with privacy and telehealth informed consent issues efficiently and effectively with a minimal diversion from the therapy itself.
We should point out, however, that discussion with a patient about informed consent is in itself already part of treatment. It is an important opportunity to define the therapeutic relationship, its boundaries, and to set appropriate expectations. Furthermore, the need for mentioning informed consent may repeatedly arise during various sessions. Often, a simple notation in the client/patient record is adequate to reflect new issues that arise on an ongoing, dynamic, and the informed consent process.
TBHI Best Practices and Informed Consent Professional Training
Need specific information about telehealth informed consent? See TBHI’s “Legal/Ethical Issues II: Best Practices & Informed Consent” professional training to bring you up to speed with the legal and ethical requirements for telehealth informed consent. TBHI’s professional training is available online 24/7 for your convenience.