Are you finding ratings for video conferencing services to be more time-consuming than helpful? No matter what you call it, from telepsychology to distance counseling to telepsychiatry or online therapy — choosing a video vendor can be needlessly time-intensive, confusing and frustrating.
At the TeleMental Health Institute, we regularly get questions about what clinicians often refer to as, “Skype reviews.” It has become clear to us that clinicians don’t know how to compare one video platform to another. They are confused by the different names used by scores of video vendors: web conferencing services, business conferencing services, web conferencing reviews, video chat reviews and online chat services online meeting services and yet more. Their searches lead to hundreds of listings that all promise to be the best, but fail to clarify how to help behavioral practitioners.
TMHI has been educating behavioral practitioners migrating their services to the Internet since 2009. As its founder, I’ve been teaching legal and ethical issues related to telepractice since 1994. I’ve written four textbooks in the area, developed an on-demand library of 1 and 2-hour webinars to address the leading issues (including webinars on Skype such as FREE and Low-Cost, HIPAA-Compliant Alternatives to Skype and developed two levels of online Certificate training for telemental health.
Three Easy Steps to Conducting Video Conferencing Reviews
To help our trainees, we’ve developed a comprehensive list of questions below to help you have an informed conversation with any video vendor before starting.
We suggest that you:
- 1. scan the list for those questions most relevant to your practice
- 2. develop a grid to clearly list the responses you get from each company, and then
- 3. make your choice based on how well each identified company meets your needs.
If any company give you grief about answering these questions, cross them off your list immediately. Better yet, send them the list of questions by email and see what you get back in writing…. Compare the answers you get from one company to another.
Before you dismiss the need for taking these steps, think about the last time you re-arranged the furniture in your office. How much clinical time was spent discussing the shift in your furniture? Firing a video conferencing company and switching to another is significantly more complex than simply switching your sofa from one wall to the other. Your patients will become reliant on a video conferencing platform to “frame” your entire relationship. Unfortunately, switching videoconferencing services with a caseload of behavioral clients or patients is often so daunting that many clinicians simply stay with the first vendor they chose, despite their dissatisfactions.
TMHI’s Questions to Ask When Conducting Your Own Video Conferencing Review
These below are questions that you may want to consider when comparing video vendors. Only pick the ones of relevance to your work:
- Is your system HIPAA-compliant, otherwise known as HIPAA-compatible? (If in a foreign country, does the system meet required levels of security and/or privacy in that country?)
- Do you have a training video for first-time clients/patients? Where is it located? Does that page pitch other products and services, or is it just dedicated to my clients/patients?
- What are your most frequent questions from new purchasers?
- How long have you been in business? How well funded is your company? Do you have any consumer ratings, such as the Better Business Bureau or objective 3rd party review sites? How many of your clients are telehealth services or practices?
- Do you offer a Business Associate Agreement (BAA)? (Required by federal law if you serve US citizens. See our TMHI webinar and course library for training to help you understand and be compliant with these crucial mandates.)
- Do you offer the ability to record my sessions? If yes, where are those recordings stored? For how long? Extra fees? Who will have access to the files?
- Can more than one party connect with me (i.e., if different family members want to connect from 3-4 different locations)?
- Can I broadcast out to a group? (This is called “1-many.”) If yes, will I be able to see the faces of people in the group? If yes, how many can I “tile” on my screen? Will they have voice enabled as well?
- Can I show my desktop to my client/patient? (This is not always a good idea because you might click the wrong file and expose information that is not in the best interest of your client/patient. If this feature is present, how will I see what is being shown?
- Are you mobile compatible? Can I use my mobile device to work with my client or patient? Are there limitations to using such a device?
- Do you offer an internal calendar feature for me to use for scheduling? What is the granularity of that feature? Can I launch my video session from within that calendar?
- Are you set up to work with Electronic Health Records (EHRs)? If yes, which one(s)? Extra fees?
- Do you offer an internal, HIPAA-compliant email service that allows me to communicate with clients/patients securely between sessions? Or do I need to get another service to securely send and receive secured email? (See TMHI list of such email vendors.)
- Do you offer an internal, HIPAA-compliant text-messaging service for my use in a session? (Often used to type numbers or other detailed instructions for clients/patients who may not have understood. See TMHI list of text-messaging vendors.)
- Who will have access to my patient files? How is your staff screened for people with past felony convictions, for example?
- What is your policy regarding subpoenas? Will you contact me if you get subpoenaed to hand over my records and/or files? How much prior notice will I be given?
- Have you ever been reported for a HIPAA violation? Been sued? Do you carry liability insurance? With which company? Limits of benefits? Can I see a copy of the facesheet?
- How many clicks are required by a client/patient to get started with your system the first time? (WebRTX?)
- What type of training do you offer me? Do you provide forms for me to use with my clients/patients?
- Do you provide audit trails? How do they work? How can I access them? How often? Is there a charge for access?
- Do you provide breach notification tools, and if so how do they work? Will I be sent an email? If yes, how long after an event will it take for me to be notified?
- Do you provide a virtual waiting room for clients to sit and wait before I pop into the treatment room?
- Can I decorate or “brand” my office or waiting room to make it look like my own (i.e., include my logo, insert images, change colors, etc.)?
- Do you provide technical support during my contact hours with clients or patients (i.e., for when the system goes down)? How do I reach them? What is their average response lag?
- What is the average time needed for a response from your technical support team if I have a problem with your system?
- What’s the quality of your connection? What % of the time is your signal choppy? What’s your video “lag?” (Listen for %s and not a statement like, “Oh, we’re the best.”)
- What has been the company’s “downtime” in the last 3 months? In the last year? What is the industry standard for downtime?
- Do you offer real-time technical support if your system fails in a live session with a patient or client?
- What is your process for making system-wide changes based on customer complaints or suggestions? How often do you make such changes?
- Does your system allow me to ask questions of my clients/patients for them to answer in writing prior to my session with them?
Lastly, call their customer service line and see who answers. If you reach an answering service, how long it takes to get a response? Similarly, if you send an email, see how many business days it takes to get an answer. Remember, if you are in a session with a difficult client or patient and the system goes down, how long do you want to wait before your new video conferencing company to get back to you?
More Resources for You
If you want to see a list of video conferencing companies that TMHI has found, see TMHI’s list of video conferencing platforms here. If you want more personalized help selecting your HIPAA-compliant platform or are the point person for a group of clinicians seeking broader video conferencing consultation, see our consulting options or fees for brief consults.
Also, if you’d rate our list of questions by giving us a few stars below, we’d be grateful! (Bookmark this site for updates, and sign up for our free weekly newsletters to keep abreast of what’s happening in telemental health.) Please comment below if you think of any other “crucial” questions to add to our list.