TeleHealth Policy & Protocol Manual

Telehealth is the provision of health services via electronic means. Generally, this can be over desktop computers, laptops, tablets, and smart phones. The field has researched a variety of methods including text, chat, and video with talk. TeleMental Health is a subset of Telehealth refering to the providion of behavioral health service via electronic means.

Joyful Life Institute (JLI) currenltly offers Telemental Health video with voice using desktops and laptops. They allow therapist to make the necessary behavioral observations for effective therapy. 

There are benefits and draw backs. Online therapy is conveninet, travel-saving, & time efficient. Research has found that e-counseling is as effective as face-to face counseling. It has spurred innovative interventions that uses technology.

TeleMental Health is heavily regulated including several requirements that protect clients rights, confidentiality, and emotional safety.

Alas! It is not as simple as Skyping or Face-timing. Therapist are required to take cybersecurity, clinical, and legal percautions. Therefore, JLI uses a secure, encrypted telehealth client portal. Also, we have created telehealth policies and protocol. Learn more below.

To protect your privacy, deliver high quality clinical services, and ensure cyber security JLI provide the following policies:

1. Staff at JLI will only see clients when clients are in a state the therapist is licensed to practice. Right now that is Texas. Florida is comng soon.

2. Therapists will assess the appropriateness of each client for telehealth.

3. We will offer this service to all active clients who have completed the assessmeent.

4. The therapist will pay special attention to safety issues, assessing and intervening when appropriate.

5. Therapist must ask and clients must declare their location at the beginning of each session.

6. Therapist and client must use a desktop or laptop. Phones and tablet do not allow therapist to effectively observe behavior. 

7. Therapist and clients must conduct telemental health services in a room that is free from noise, distraction, and other people (even when doing couple and family therapy).

8. If seen as a couple, each member of the couple must join the secure video call using a separate computer or laptop.

9. Therapists and clients will not record sessions via video or audio in compliance with HIPAA regulations.

10. At the beginning of each session, clients will be asked to show therapist a 360 degree view of the room.

11. If technological issues prevent us from using the primary telemental health client poral and it is due to:

   (a) a poor or lack of internet connect, the backup for the session is a phone call. Note, insurance companies are unlikely to pay for phone sessions. The fee is your responsibility.

   (b) if the problem lies with the platform, we can switch to a back up platform.

12. Therapists and clients participating in this service must have the proper technology, bandwith, and lighting for optimum video and voice quality.

As you can see, there are some things that must be in place prior to starrting telemental health. For more details read the Telemental Health Disclosures and Informed Consent. Also, below is a checklist of prerequsites needed before you do teletherapy.

• Telemental Health must be appropriate for client and client's issue for video  therapy.
• Client must have no high risk symptoms.
• Client must be located in Texas for each online session.
• Client must have the degree of skill to seamlessly manage the computer technology (i.e., webcam, speaker, headphones, telehealth app, etc.).
• The audio-visiual and Wi-Fi must be of very good quality. Learn more about the technological specifications below.

Before you get started (below), here are a few technological issues for you to consider:

• Operating Systems: Windows® XP; Windows VistaTM; Windows® 7; Windows® 8; Mac OS X®
• Browsers: Final release versions of Internet Explorer® 7.0 or above (Windows only); Mozilla® Firefox® 15.0 or above (Windows and Mac); SafariTM 6.0 or above (Mac OS only); Google Chrome® 20.0 or above (Windows and Mac).
•  Mobile Applications: Apple iOS® 6.0 and above. AndroidTM 2.3 or above
•  Needed Software/Electronic Document Formats: Use of Adobe Acrobat Reader or equivalent for PDF files; Word program for Word files; The Adobe Reader software is available free of charge from Adobe’s website www.adobe.com
• Mobile Sending: Apple iOS® 6.0 and above. AndroidTM 2.3 or above.
• Screen Resolution: 1024 x 768 minimum
•  Enabled Security Settings: Allow per session cookies. Users accessing the Internet behind a Proxy Server must enable HTTP 1.1 settings via proxy connection.
• Webcam: Built in or free-standing webcam with 720p or higher. A webcam with 1080p resolution is preferable.
• Speaker: Audio Speaker built in. Or stand-alone speaker (preferable).
• Lighting: Lights with 500 and 1000 watts. Natural sunlight or light ring recommended.
• Pre-release (i.e. beta) versions of operating systems and browsers are not supported.

Steps:

1) Check with your mental health provider to see if you have telemental health coverage. 

2) Read the JLI Policy and Protocol for Telemental health (above).

3) Complete the TeleMental Health Interest Questionnaire. Don't have a questionnaire? Send a secure email, requesting one.

4) If you qualify, you will be sent:

   (a) the Telehealth Informed Consent. Sign and Date it.

   (b) the link to the NEW telehealth client portal. Log in and register. This is different than the secure email/online calendar client portal.

5) Schedule a 15 minute orientation of the video call platform to work out any kinks.

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