Perspective on Practice

Thanks to advances in technology, health-care professionals can interact with their patients without being in the same room. And whether a practitioner is asking us about privacy issues related to using video chat or whether he or she can provide services from one state to a client in another, we're learning that the prospect of providing psychological services remotely is of increasing interest to our practice community.

Telehealth services can be broadly defined as including all interactions that are not in-person between health-care professionals and their patients. Differing definitions of telehealth appear in various federal and state laws, reimbursement policies, organization or facility policies or treatment guidelines, with the definition changing depending on the purpose or coverage terms of the law or policy at issue.

In response to members' interest, last year we joined with the Association of State and Provincial Psychology Board and the American Psychological Association Insurance Trust to create the Joint Task Force on the Development of Telepsychology Guidelines for Psychologists. This group will develop guidelines that will help psychologists navigate the numerous ethical, regulatory, legal and other practice-related issues that arise in using technology to deliver psychological services. The three organizations involved in this collaborative effort have appointed their members to the 10-member task force: four from APA, four from ASPPB and two from APAIT. This is the first time we've had a formal collaborative working group involving three different organizations.

The task force has developed a timeline for its work, outlining the key areas the guidelines should address and establishing four teams to begin drafting them. These teams have prepared their first drafts and the entire task force beginning its review of them this spring. The second step will be to prepare and share a draft of the guidelines for public comment, most likely in late spring or early summer of this year. APA will host a public comment period as a well as a session on the topic during our 2012 annual convention, Aug. 2-5, in Orlando, Fla. The APA convention session will present the details of the draft telepsychology guidelines, discuss feedback from the public and provide a face-to-face opportunity for APA members to talk about the guidelines with task force members.

When the draft guidelines are published for public comment, we'll be seeking your feedback. It's important that you don't limit your responses to any one particular technology or modality as the guidelines are intended to be broad and not limited to any particular types of technology.

While there needs to be more research into the field, studies published to date appear to show that using technology can be effective, safe and acceptable in treating a variety of patients. (For more details, see "Leading Psychology into the Telehealth World" in the Spring 2011 issue of Good Practice magazine.)

And while there seems to be growing coverage by payers for telehealth services, reimbursement still differs widely among Medicare, Medicaid, and private payers across states, causing confusion for the health-provider community. State licensure issues compound the availability of providers to serve patients using technology because of interstate practice concerns. While not every concern will be resolved by the task force, its charge is to develop practice guidelines as well as related documents that may include model regulatory guidance (encompassing interjurisdictional practice concerns) and risk management principles. The guidance will be beneficial to the profession.

As always, I welcome your comments.