Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

OBJECTIVE: The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. METHODS: This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. RESULTS: There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. CONCLUSIONS: Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

Evaluating the benefits of a live, simulation-based telebehavioral health training for a deploying army reserve unit.

Telebehavioral health (TBH) has previously been reported as underutilized in the Afghan Theater of Operations despite efforts to expand the number of operational TBH sites. A lack of training on TBH services and equipment was identified as a probable cause. The National Center for Telehealth and Technology (T2) provided members of the 1972nd Medical Detachment (Combat Stress Control [CSC]) U.S. Army Reserve with an in-person TBH training designed to provide the unit with hands-on knowledge and skills to deliver TBH services in theater. A key training component consisted of placing unit members in live, simulated clinical and technical scenarios they were likely to encounter while deployed. Evaluations suggest that the training was successful at preparing the 1972nd CSC for its TBH mission. During its deployment, the 1972nd CSC led an approximate 40% expansion of TBH services, including the direct provision of around 700 clinical encounters. Several best practice recommendations were identified including: (1) maintain the hands-on component, (2) use lessons learned to develop scenarios, (3) incorporate training into daily activities, and (4) tailor training while ensuring that all stakeholders have the same base knowledge set. To our knowledge, this is the most comprehensive process improvement evaluation of a predeployment telehealth training available.