Your browser doesn't support javascript.
Home-Based Telemental Health: A Proposed Privacy and Safety Protocol and Tool.
Sharma, Aditi; Feuer, Vera; Stuart, Barbara Krishna; Folk, Johanna B; Doan, Bridget T; Kulkarni, Chetana A; Ramtekkar, Ujjwal; Fortuna, Lisa; Myers, Kathleen.
  • Sharma A; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA.
  • Feuer V; Seattle Children's Hospital, Seattle, Washington, USA.
  • Stuart BK; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA.
  • Folk JB; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
  • Doan BT; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
  • Kulkarni CA; Department of Psychiatry, University of Toronto, Toronto, Canada.
  • Ramtekkar U; Hospital for Sick Children (SickKids), Toronto, Canada.
  • Fortuna L; Department of Psychiatry, University of Toronto, Toronto, Canada.
  • Myers K; Hospital for Sick Children (SickKids), Toronto, Canada.
J Child Adolesc Psychopharmacol ; 31(7): 464-474, 2021 09.
Article in English | MEDLINE | ID: covidwho-1429159
ABSTRACT

Objectives:

To describe the development of a protocol and practical tool for the safe delivery of telemental health (TMH) services to the home. The COVID-19 pandemic forced providers to rapidly transition their outpatient practices to home-based TMH (HB-TMH) without existing protocols or tools to guide them. This experience underscored the need for a standardized privacy and safety tool as HB-TMH is expected to continue as a resource during future crises as well as to become a component of the routine mental health care landscape.

Methods:

The authors represent a subset of the Child and Adolescent Psychiatry Telemental Health Consortium. They met weekly through videoconferencing to review published safety standards of care, existing TMH guidelines for clinic-based and home-based services, and their own institutional protocols. They agreed on three domains foundational to the delivery of HB-TMH environmental safety, clinical safety, and disposition planning. Through multiple iterations, they agreed upon a final Privacy and Safety Protocol for HB-TMH. The protocol was then operationalized into the Privacy and Safety Assessment Tool (PSA Tool) based on two keystone medical safety constructs the World Health Organization (WHO) Surgical Safety Checklist/Time-Out and the Checklist Manifesto.

Results:

The PSA Tool comprised four modules (1) Screening for Safety for HB-TMH; (2) Assessment for Safety During the HB-TMH Initial Visit; (3) End of the Initial Visit and Disposition Planning; and (4) the TMH Time-Out and Reassessment during subsequent visits. A sample workflow guides implementation.

Conclusions:

The Privacy and Safety Protocol and PSA Tool aim to prepare providers for the private and safe delivery of HB-TMH. Its modular format can be adapted to each site's resources. Going forward, the PSA Tool should help to facilitate the integration of HB-TMH into the routine mental health care landscape.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Child Health Services / Clinical Protocols / Adolescent Health Services / Telemedicine / Privacy / Patient Safety / COVID-19 / Home Care Services / Mental Health Services Type of study: Clinical Practice Guide Limits: Adolescent / Child / Humans Country/Region as subject: North America Language: English Journal: J Child Adolesc Psychopharmacol Journal subject: Pediatrics / Psychopharmacology Year: 2021 Document Type: Article Affiliation country: Cap.2021.0020

Full text: Available Collection: International databases Database: MEDLINE Main subject: Child Health Services / Clinical Protocols / Adolescent Health Services / Telemedicine / Privacy / Patient Safety / COVID-19 / Home Care Services / Mental Health Services Type of study: Clinical Practice Guide Limits: Adolescent / Child / Humans Country/Region as subject: North America Language: English Journal: J Child Adolesc Psychopharmacol Journal subject: Pediatrics / Psychopharmacology Year: 2021 Document Type: Article Affiliation country: Cap.2021.0020