ATA Practice Guidelines for Video-based Online Mental Health Services • “The guidelines pertain to telemental health conducted

between two parties, and do not address concerns related to multipoint videoconferencing.

• These guidelines include telemental health services when the initiating, receiving, or both sites are using a personal computer with a webcam or a mobile communications device (e.g., “smart phone”, laptop, or tablet) with two-way camera capability.

• These guidelines do not address communications between professionals and clients or patients via texting, e-mail, chatting, social network sites, online “coaching” or other non-mental health services.”

(ATA, May 2013)

Clinical GuidelinesProfessional and Patient Identity and Location

• Provider and Patient Identity Verification• Provider and Patient Location Documentation• Verification of provider and patient location is Critical for 4 reasons:

Compliance with relevant licensing laws; emergency management protocol is

dependent upon where the patient receives services; mandatory reporting and related ethical requirements; and in some cases provider payment amounts are tied to location.

Clinical GuidelinesProfessional and Patient Identity and Location

• Contact Information Verification for Professional and Patient

• Verification of Expectations Regarding Contact Between Sessions

Clinical Guidelines: Patient Appropriateness for Videoconferencing-based Telemental Health

To date, no studies have identified any patient subgroup that does not benefit from, or is harmed by, mental healthcare provided through remote videoconferencing.

(Day, 2002; O’Reilly et al., 2007 & Ruskin et al., 2004)

Clinical Guidelines: Patient Appropriateness for Videoconferencing-based Telemental Health

Considerations for the appropriateness of Videoconferencing in settings where professional

staff are not immediately available

• Patient expectations & level of comfort• Patient takes an active & cooperative role• Patient’s organizational & cognitive capacities

Clinical Guidelines: Patient Appropriateness for Videoconferencing-based Telemental Health

Other considerations:• Patient is responsible for equipment set-up,

maintenance of computer settings and privacy at his or her site along with technology competency

• Geographic distance to nearest emergency medical facility, patient’s support system and medical status

Clinical Guidelines: Informed Consent

• Conducted with patient in real-time• Follow local, regional and national laws• Provider documents consent in medical record• Information included is same as in-person• Key topics include: confidentiality, emergency

plan, how patient information is documented and stored, technical failure, contact between sessions

Clinical Guidelines: Physical Environment

• Aim to provide comparable professional specifications of a standard services room

• Ensure privacy• If other people are present, announce their

presence• Seating, lighting, camera positioning

Clinical Guidelines: Communication & Collaboration with Patient’s Treatment Team

Optimal clinical management of patients depends on coordination of care between

a multidisciplinary treatment team

Clinical Guidelines: Emergency Management

1. Education and Training2. Jurisdictional Mental Health Involuntary

Hospitalization Laws3. Patient Safety in a Setting with Immediately Available

Professionals4. Patient Safety in a Setting without Immediately

Available Professionals5. Patient Support & Uncooperative Patients6. Transportation7. Local Emergency Personnel

Technical Guidelines

• Video Conferencing Application• Device Characteristics• Connectivity• Privacy

Administrative Guidelines

• Qualification and Training of Professionals• Documentation and Record Keeping• Payment and Billing