For our peace of mind and the well-being of the loved ones who might rely on our earning potential, telehealth risk management needs to be on our radar 24/7.
1. Telehealth Risk Management: Licensure. We’ve got to be properly licensed. This issue is in such flux that it behooves you to keep informed by keeping in contact with your own licensing board(s) above all other sources of information. They may require you to be licensed where you live and where the client/patient is at the time of contact with you. Licensure can involve regulations about the types of notes you take; where you keep them; how much you charge for your work; how you collect late fees; what you call yourself; whether you need to report suspicion of homicide (Tarasoff) cases; mandated reporting; how you handle suicide threats; and dozens of other crucial issues that can differ from region to region.
2. Telehealth Risk Management: Research. The first point we would like to review here is that following proven intervention strategies for specified patient populations and/or conditions are required by most professional association’s ethical codes and local licensing regulations. In other words, the ethical, professional will restrict the application of direct treatment by telephone (or by text) to situations where positive results have been formally published in the scientific literature, and not just blithely follow unwitting colleagues who brag about making substantial profits while in their jammies and working online. Should we ignore ethical mandates and licensing laws, and set aside research on scientific findings to make a fast and easy dollar? As cumbersome as it may seem, we, as professionals, are required to await the literature or proceed only with caution, supervision, and as much training as we can manage (or document).
3. Telehealth Risk Management: Appropriate Intake, Treatment & Termination Procedures. Different countries, states, and provinces have different requirements for how they want their licensees to handle intakes, assessment, routine care, referrals, suicide, homicide, mandating reporting, other types of abuse (e.g., sexual abuse by another health care professional), and termination. Different disciplines also have different requirements. If you are a licensed professional, it is your job to not only know what your jurisdiction requires but also all the requirements of the jurisdictions you enter with any form of technology (video, email, text messages, etc.). You also need to keep updated with any changes in this as all other related practice issues. Fortunately, this is not as bad as it may seem at first glance. There are many free and regularly updated resources to help you.
4. Telehealth Risk Management: Documentation. States differ with regard not only to informed consent but also documentation requirements for intakes, progress notes, and termination notes, as well as for telehealth. Be sure to comply with not only your own state of licensure but also that of any state you enter, even if it is for just a little while. If you register or become licensed by a foreign state, as you should, they will most likely make sure that you understand their rules. Whatever you do, document as if your practice depends on it. That’s all the time we have to address such issues in this course, but we’ll give you additional checklists to follow on the next page to help you organize yourself for other aspects of risk management.