How to Implement Telehealth Safety Measures
There are a number of telehealth safety measures we have put in place at Online.Physio to protect both our patients and ourselves.
I have listed them here so that you can keep them in mind if you are setting up your own telehealth service.
Maintaining the quality and credibility of digital practice is the responsibility of all allied health professionals.
A reputable telehealth culture will improve our collective funding opportunities with insurers, compensable bodies and commercial entities.
Just remember, it is your responsibility to work out if there are any telehealth specific regulations or restrictions for your own profession, state, territory or country.
I have identified three main categories of telehealth safety measures required for digital practice:
Telehealth Safety Measures – 3 Categories:
- Legal, insurance, disclaimers
- Records, technology, gadgets
1) LEGAL, INSURANCE, DISCLAIMERS
We had Website Terms and Conditions of Use, and Terms and Conditions of Purchase professionally developed by a lawyer
When we were first launching Online.Physio, I communicated with an IP lawyer regarding the Terms and Conditions for the site.
She was able to professionally write up Terms and Conditions of Use, and Terms and Conditions of Purchase, tailored to our service.
So to the degree to which the law will allow, we are indemnified.
We are now able to link to, or refer to, these conditions as required.
An example of this is if we are answering injury based enquiries to our website:
Indemnity Insurance Clause
Does your Indemnity insurance cover you for online consultations?
When I started doing teleconsultations, I called my insurer to ask about coverage, and they said that they weren’t covered as standard.
In order to obtain a clause covering telehealth on my Indemnity insurance, I prepared a list of our safety features for them. It was like a brief version of this very list.
Insurers are solely concerned about mitigating risk, and this list helped my Insurer to feel comfortable adding a clause to cover me for online consultations.
Physiotherapists are required to meet all standard professional requirements
All our Physiotherapists are required to meet all normal professional registration and regulatory requirements.
- Continuing professional development
- Code of conduct
- Recency of practice
- Advertising guidelines
2) RECORDS, TECHNOLOGY, GADGETS
There is a 100% record of all video calls, reports, messages, images and emails involved in the consultation process
The beauty of technology is that it allows us to record everything, even our video calls.
This is great for a number of reasons:
- It is medico legally safe
- We don’t have to write up notes after the fact
- Our patients have full access to all of the information that we have shared with them
All our records, including all the different file types of information generated from digital practice, are stored in a secure practice management system.
All physical gadgets and cloud-based software used for the consultation process are secure
With technology and gadgets come security, and we are only as strong as our weakest link.
For example, if we use a secure cloud based messaging software, but it is open on our computer and others can access it, we have just created a huge hole in our secure record keeping practices.
We ensure that all gadgets used for consultations or patient information are:
- Password protected
- Noone else has the password or has their fingerprint registered
- Set to lock after a short time interval
All of our cloud based systems are also password protected.
Where possible, we set people up as individual users so that we can control their level of access.
If we have to share a login with other team members, we use Lastpass, so that no one else actually knows the password.
We will not treat patients we feel are not suitable for the online format, and will refer them to the appropriate service instead
The first thing we receive from patients at the start of a consultation is a completed subjective assessment form.
This completed form gives us a very clear picture of whether the patient is suitable for a) Physiotherapy, and b) the telehealth format.
If we do not feel they are suitable, we will let them know, refund their consultation fee in full, and tell them which health service we feel that they should follow up with.
Injury Specific Disclaimers Are Present
At certain stages in our assessment process, we have a written record of the required warnings for the patient.
For anyone presenting with calf pain, for example, we need to rule out a dangerous DVT.
We therefore include a phrase ‘If your calf is red, hot and swollen, consult a medical doctor immediately’.
Any objective testing is performed conservatively and with the patient’s safety in mind
If we are asking a patient to do physical movements on their own, we ensure that we have a clear picture of their overall mobility and physical capacity first.
- We give the patient some guidelines on preparing their environment for safety
- The patient is advised not do anything they are not comfortable doing
- When performing movements, the patient is advised to have a bench or wall next to them
If a test can be translated to a safer option, eg lumbar flexion in lying versus standing, then we will use clinical judgment to make those choices.
If the progress of a patient is not satisfactory during the telehealth process, we will refer them to the appropriate health service
This is no different to face-to-face care.
If we are not happy or comfortable with the progress of that patient, we will refer them to the appropriate service.
As the online consultation industry grows, it is paramount that we put appropriate telehealth safety measures in place.
Consumers must feel that teleconsultations are safe and credible for them to feel comfortable using it.
We, as health professionals, also need to make sure that we are protected legally in this new era of healthcare.
Until next time,
Live with Passion & Serve with Care