6 Things to Remember When Practicing Telemedicine

January 28, 2021

Harold J. Bursztajn, MD

Thomas G. Gutheil, MD

Archie Brodsky

Mr Brodsky is a writer who has coauthored numerous books and articles in the mental-health field. Drs Bursztajn and Gutheil and Mr Brodsky are co-founders and Dr Norris is a member of the Program in Psychiatry and the Law at Harvard Medical School.

What 6 things are important to keep telemedicine practice running smoothly?

For more on standard of care, see Telepsychiatry: To Be or Not to Be, That Is the Question.

To read more on informed consent, see Duty of Care and Informed Consent.

For more on interstate practice, see Psychiatric Services for College Students Across State Lines.

To read more on confidentiality, see Sharing Patient Cases: Balancing Confidentiality and Educational Needs.

To see more on emergency psychiatry, check out 10 Most Common Presentations in Emergency Psychiatry.

To read more, see the original article on which this slideshow is based, Telepsychiatry: Practical Pointers and Potential Pitfalls.

1. American Psychiatric Association. What is Telepsychiatry? American Psychiatric Publishing; 2017.

2. APA Committee on Telepsychiatry & APA College Mental Health Caucus. College mental health, telepsychiatry: best practices, policy considerations & COVID-19. American Psychiatric Association. Accessed January 18, 2021. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Telepsychiatry/APA-College-Mental-Health-Telepsychiatry-COVID-19.pdf

3. Sales CP, McSweeney L, Saleem Y, Khalifa N. The use of telepsychiatry within forensic practice: a literature review on the use of videolink – a ten-year follow-up. J Forensic Psychiatr Psychol. 2018;29(3):387-402.

4. Layton DD, Niem J. Implementation and evaluation of videoconferencing for forensic competency evaluations. Telemed J E Health. 2020;26(7):929-934.

5. Yellowlees P, Shore JH. Telepsychiatry and Health Technologies: A Guide for Mental Health Professionals. American Psychiatric Publishing; 2018.

6. Gutheil TG, Brodsky A. Preventing Boundary Violations in Clinical Practice. Guilford; 2008.

7. Gunter TD. Forensic telepsychiatry. In: Benedek EP, Ash P, Scott CL, eds. Principles and Practice of Child and Adolescent Forensic Mental Health.American Psychiatric Publishing; 2010:83-90.

8. Yellowlees P, Shore JH. Psychiatric practice in the information age. In: Yellowlees P, Shore JH (Eds.). Telepsychiatry and Health Technologies: A Guide for Mental Health Professionals. Washington, DC: American Psychiatric Publishing, 2018:1-30.

9. AAPL Task Force Report. Videotaping of forensic evaluations. J Am Acad Psychiatry Law 1999; 27(2):345-358.

10. Constantinou M, Ashendorf L, McCaffery R. When the third-party observer of a neuropsychological evaluation is an audio-recorder. Clin Neuropsychologist 2002;16:407-412.

11. Gelso CJ. Effect of audiorecording and videorecording on client satisfaction and self-expression. J Consult Clin Psychol. 1973;40:455-461.

12. Zinberg NE. The private versus the public psychiatric interview. Am J Psychiatry. 1985;142(8):889-894.

13. Massachusetts General Laws: Chapter 272.99. https://malegislature.gov/laws/generallaws/partiv/titlei/chapter272/section99

14. Federation of State Medical Boards. US states and territories modifying requirements for telehealth in response to COVID-19. Updated January 13, 2021. https://www.fsmb.org/siteassets/advocacy/pdf/states-waiving-licensure-requirements-for-telehealth-in-response-to-covid-19.pdf

15. Robbins R, Brodim E. As insurers move this week to stop waiving telehealth co-pay, patients may have to pay more for virtual care. STAT. September 29, 2020. https://www.statnews.com/2020/09/29/united-healthcare-anthem-telemedicine-coverage-insurers/

16. Cash CD. Telepsychiatry and risk management. Innov Clin Neurosci. 2011;8(9):26-30.

17. Kois LE, Cox J, Peck AT. Forensic e-mental health: Review, research priorities, and policy directions. Psychology, Public Policy, and Law. Published online October 2020. https://doi.apa.org/doiLanding?doi=10.1037%2Flaw0000293

18. Bard TR, Bursztajn HJ. Triage trauma and moral distress. Psychiatric Times. October 1, 2020. https://www.psychiatrictimes.com/view/triage-trauma-moral-distress

19. Bursztajn HJ, Feinbloom RI, Hamm RM, Brodsky A. Medical Choices, Medical Chances: How Patients, Families, and Physicians Can Cope with Uncertainty. Delacorte; 1981. Routledge; 1990.

20. Gutheil TG, Bursztajn HJ, Brodsky A. Malpractice prevention through the sharing of uncertainty: informed consent and the therapeutic alliance. N Engl J Med. 1984;311:49–51.

21. Gutheil TG. Legal defense as ego defense: A special form of resistance to the therapeutic process. Psychiatr Quart. 1979;51:251–256.

22. Bursztajn HJ. More law and less protection: "critogenesis," "legal iatrogenesis," and medical decision-making. J Geriat Psychiatry. 1985;18:143-153.