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Telehealth From Around the World - Segment 3 - How Do I Create a Therapeutic Alliance Using Telehealth?
Optimizing Telehealth - Telehealth Around the World
Episode 2: Strengthening the Telehealth Therapeutic Relationship.
Dr. Crawford: We're all sort of international with telehealth, we can Zoom anywhere. Recently, I was involved with colleagues from 17 other countries led by a team from Japan, looking at regulations that have changed over the course of the pandemic. There were three key things through this article.
One, is that regulations were relaxed in pretty much every country. Everyone of the 17 countries saw telehealth as a way to meet increased need and create access to health care during the pandemic. And in order to do so, they had to relax some of their regulations, which is both positive and negative. We looked at areas of how clinicians are remunerated for their work and where they could provide service. In some countries, they could only do rural service. In others, it opened up much more broadly. There were differences across countries, but most experienced relaxed regulations.
I think the bottom line and the next step is this idea that it's been downloaded onto us to decide who is appropriate for telehealth care. I think this needs further regulation. What is the duty of care? We know that duty of care is going to vary across different professions. So, as a psychiatrist, I have a particular duty of care which is really the minimum standard of care that I can provide. Things like meeting patient needs, transferring their care to other clinicians, and prescribing, I need to decide if they're appropriate via telehealth. If you're a psychologist, if you're a social worker, if you're a nurse, your duty of care is going to be different based on your role. The bottom line of this very long study that we did was that we relaxed regulation so that we could see more people, but what we actually need is a lot more regulation required going forward. And in most countries, there was even confusion in Canada and the US, about what was going to be sustained.
The other one I'll mention is platform. In Canada, prior to the pandemic, we had a specific platform we were supposed to use for telehealth. It had the highest level of security. It was centrally organized, as many things in Canada are. I think that's the big difference in the US, where there are multiple providers. But, in a public health care system, we had one extremely secure provider that actually made it more difficult. We did less than 1% of care via telehealth before the pandemic. The relaxation here in Canada was that you could literally use any platform. You could use Skype, you could use FaceTime, you could use whatever. We're now seeing that snap back because of issues around privacy and security. How easy it is to hack into that particular platform and whether health information and patient information is safe? We saw a lot of widening of regulations, then some snapping back, and now it’s unclear where it's going to land, which isn't a very satisfying answer. It does place a lot of pressure on us as providers.
https://telehealth.org
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By Marlene M. Maheu, PhDOptimizing Telehealth - Telehealth Around the World
Episode 2: Strengthening the Telehealth Therapeutic Relationship.
Dr. Crawford: We're all sort of international with telehealth, we can Zoom anywhere. Recently, I was involved with colleagues from 17 other countries led by a team from Japan, looking at regulations that have changed over the course of the pandemic. There were three key things through this article.
One, is that regulations were relaxed in pretty much every country. Everyone of the 17 countries saw telehealth as a way to meet increased need and create access to health care during the pandemic. And in order to do so, they had to relax some of their regulations, which is both positive and negative. We looked at areas of how clinicians are remunerated for their work and where they could provide service. In some countries, they could only do rural service. In others, it opened up much more broadly. There were differences across countries, but most experienced relaxed regulations.
I think the bottom line and the next step is this idea that it's been downloaded onto us to decide who is appropriate for telehealth care. I think this needs further regulation. What is the duty of care? We know that duty of care is going to vary across different professions. So, as a psychiatrist, I have a particular duty of care which is really the minimum standard of care that I can provide. Things like meeting patient needs, transferring their care to other clinicians, and prescribing, I need to decide if they're appropriate via telehealth. If you're a psychologist, if you're a social worker, if you're a nurse, your duty of care is going to be different based on your role. The bottom line of this very long study that we did was that we relaxed regulation so that we could see more people, but what we actually need is a lot more regulation required going forward. And in most countries, there was even confusion in Canada and the US, about what was going to be sustained.
The other one I'll mention is platform. In Canada, prior to the pandemic, we had a specific platform we were supposed to use for telehealth. It had the highest level of security. It was centrally organized, as many things in Canada are. I think that's the big difference in the US, where there are multiple providers. But, in a public health care system, we had one extremely secure provider that actually made it more difficult. We did less than 1% of care via telehealth before the pandemic. The relaxation here in Canada was that you could literally use any platform. You could use Skype, you could use FaceTime, you could use whatever. We're now seeing that snap back because of issues around privacy and security. How easy it is to hack into that particular platform and whether health information and patient information is safe? We saw a lot of widening of regulations, then some snapping back, and now it’s unclear where it's going to land, which isn't a very satisfying answer. It does place a lot of pressure on us as providers.
https://telehealth.org