Summer Travel and Telehealth: Maintaining Continuity of Care While Ensuring Compliance

Vol. 1, No. 6 | June 4, 2024 | By Dave Larsen, Väsentlig Consulting LLC

As a solo mental health practitioner providing telehealth services, the flexibility to work from anywhere with a reliable internet connection can be a significant advantage, particularly during the summer months when many clients and providers may have travel plans (Luxton et al., 2014).

However, delivering telehealth services while traveling requires careful consideration of ethical, legal, and logistical factors to ensure the continuity and quality of client care (Kramer et al., 2020). In this article, we'll explore key strategies and best practices for providing telehealth services while traveling, drawing on research and professional guidelines in the field.

Ethical Considerations for Traveling Telehealth Providers

The American Psychological Association's (APA) "Guidelines for the Practice of Telepsychology" (2013) emphasize that mental health providers delivering telehealth services must adhere to the same ethical standards as those providing in-person care. When traveling, practitioners must consider the following ethical issues:

• Competence: Ask yourself: “Can I really do telehealth when I’m traveling?” Providers must ensure that they have the necessary knowledge, skills, and training to deliver telehealth services effectively and ethically in different settings and contexts (APA, 2013).

• Informed Consent: Practitioners must obtain informed consent from clients prior to delivering telehealth services while traveling, disclosing any potential limitations, risks, or changes to the treatment plan (Luxton et al., 2014).

• Confidentiality: Mental health providers must take appropriate measures to protect client confidentiality and privacy when accessing or transmitting sensitive information while traveling, such as using secure, encrypted networks and devices (Kramer et al., 2020).

• Boundaries: Traveling providers must maintain clear professional boundaries with clients, even in less formal or structured settings, and avoid any interactions or activities that could undermine the therapeutic relationship (APA, 2013).

By prioritizing these ethical considerations, traveling telehealth providers can ensure that they are delivering high-quality, client-centered care that upholds the integrity of the profession (Luxton et al., 2014).

Legal and Regulatory Requirements for Interstate Telehealth

One of the most significant challenges for traveling telehealth providers is navigating the complex web of legal and regulatory requirements for interstate practice (Kramer et al., 2020). In the United States, mental health licensure is regulated at the state level, and each state has its own laws and regulations governing the practice of telehealth (APA, 2013).

Before providing telehealth services to clients located in a different state, practitioners must:

• Verify Licensure Requirements: Determine whether the state in which the client is located requires the provider to be licensed in that state or if there are any temporary practice provisions or reciprocity agreements (Kramer et al., 2020).

• Obtain Necessary Licenses or Approvals: If required, obtain the necessary licenses or approvals to practice telehealth in the client's state, which may involve completing additional applications, fees, or training (Luxton et al., 2014).

• Review State-Specific Regulations: Familiarize themselves with any state-specific regulations or guidelines for telehealth practice, such as informed consent requirements, documentation standards, or mandatory reporting laws (APA, 2013).

• Consult with Professional Organizations: Seek guidance from professional organizations, such as the Association of State and Provincial Psychology Boards (ASPPB) or the American Telemedicine Association (ATA), which provide resources and support for navigating interstate practice issues (Kramer et al., 2020).

By proactively addressing these legal and regulatory requirements, traveling telehealth providers can ensure that they are practicing within the bounds of the law and minimizing any potential risks to themselves or their clients (Luxton et al., 2014).

Technical Considerations for Traveling Telehealth Providers

In addition to ethical and legal considerations, traveling telehealth providers must also address a range of technical issues to ensure the quality and reliability of their services (Kramer et al., 2020). Key technical considerations include:

• Internet Connectivity: Providers must ensure that they have access to a stable, high-speed internet connection that can support secure video conferencing and data transmission (APA, 2013). This may involve researching internet options at travel destinations, purchasing mobile hotspots or international data plans, or identifying backup locations with reliable connectivity (Luxton et al., 2014).

• Device Security: Traveling providers must take appropriate measures to secure their devices, such as using strong passwords, enabling encryption, and installing updated antivirus software (Kramer et al., 2020). They should also avoid accessing sensitive client information on public or shared devices, such as hotel computers or library terminals (APA, 2013).

• Telehealth Platform Compatibility: Practitioners must ensure that their telehealth platform is compatible with the devices and operating systems they will be using while traveling, and that they have access to technical support in case of any issues (Luxton et al., 2014). They should also test their platform and equipment prior to travel to identify and resolve any potential problems (Kramer et al., 2020).

• Time Zone Differences: Traveling providers must be mindful of time zone differences when scheduling sessions with clients, particularly when crossing international borders (APA, 2013). They should communicate any changes to their availability or schedule well in advance and work with clients to find mutually agreeable times for sessions (Luxton et al., 2014).

By addressing these technical considerations proactively and thoroughly, traveling telehealth providers can ensure that they are able to deliver uninterrupted, high-quality care to their clients, regardless of their location (Kramer et al., 2020).

Best Practices for Maintaining Continuity of Care While Traveling

To maintain continuity of care and support client progress while traveling, telehealth providers should consider the following best practices:

• Communication and Planning: Prior to travel, providers should communicate their plans and any potential changes to the treatment schedule or format to their clients, allowing ample time for questions and adjustments (APA, 2013). They should also work with clients to develop a plan for maintaining progress and addressing any potential challenges or setbacks during the travel period (Luxton et al., 2014).

• Backup Providers and Resources: Traveling providers should identify and coordinate with backup providers or resources in case of emergencies or unexpected disruptions to their availability (Kramer et al., 2020). This may involve establishing referral relationships with local providers, providing clients with crisis hotline numbers or online resources, or ensuring that clients have access to their treatment records and plans (APA, 2013).

• Flexibility and Adaptation : Providers should be prepared to adapt their treatment plans and approaches to accommodate the unique challenges and opportunities of delivering care while traveling (Luxton et al., 2014). This may involve modifying session length or frequency, incorporating local resources or activities into treatment, or adjusting goals and expectations based on client needs and progress (Kramer et al., 2020).

• Self-Care and Professional Development: Traveling providers should prioritize their own self-care and professional development to ensure that they are able to provide high-quality, effective care to their clients (APA, 2013). This may involve setting boundaries around work hours and availability, engaging in stress-management and wellness practices, and seeking out opportunities for continuing education and peer consultation (Luxton et al., 2014).

By implementing these best practices, traveling telehealth providers can promote continuity of care, support client progress, and maintain their own professional and personal well-being while delivering services remotely (Kramer et al., 2020).

Conclusion

The ability to deliver telehealth services while traveling offers significant benefits for both mental health providers and clients, including increased flexibility, accessibility, and continuity of care. However, it also presents unique ethical, legal, technical, and logistical challenges that require careful consideration and planning (Luxton et al., 2014).

By prioritizing ethical principles, complying with legal and regulatory requirements, addressing technical considerations, and implementing best practices for maintaining continuity of care, solo mental health practitioners can effectively and responsibly deliver telehealth services while traveling (Kramer et al., 2020).

As the demand for telehealth services continues to grow, particularly in the context of the COVID-19 pandemic and beyond, it is essential for mental health providers to stay informed about the evolving landscape of telehealth practice and to continuously adapt and improve their skills and strategies for delivering high-quality, client-centered care remotely (APA, 2013).

By embracing the opportunities and challenges of traveling telehealth practice, solo mental health practitioners can expand their reach, enhance their flexibility, and provide vital support to clients in need, regardless of geographic location or circumstance (Luxton et al., 2014).

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References:

American Psychological Association. (2013). Guidelines for the practice of telepsychology. American Psychologist, 68(9), 791-800. https://doi.org/10.1037/a0035001

Kramer, G. M., Kinn, J. T., & Mishkind, M. C. (2020). Legal, regulatory, and risk management issues in the use of technology to deliver mental health care. Cognitive and Behavioral Practice, 27(3), 249-259. https://doi.org/10.1016/j.cbpra.2019.04.003

Luxton, D. D., Pruitt, L. D., & Osenbach, J. E. (2014). Best practices for remote psychological assessment via telehealth technologies. Professional Psychology: Research and Practice, 45(1), 27-35. https://doi.org/10.1037/a0034547

Shore, J. H., Yellowlees, P., Caudill, R., Johnston, B., Turvey, C., Mishkind, M., Krupinski, E., Myers, K., Shore, P., Kaftarian, E., & Hilty, D. (2018). Best practices in videoconferencing-based telemental health April 2018. Telemedicine and e-Health, 24(11), 827-832. https://doi.org/10.1089/tmj.2018.0237

Smith, K., Ostinelli, E., Macdonald, O., & Cipriani, A. (2020). Covid-19 and telepsychiatry: Development of evidence-based guidance for clinicians. JMIR Mental Health, 7(8), e21108. https://doi.org/10.2196/21108