Working with Patients During the Coronavirus (COVID-19) Crisis

 

This is a challenging time for all of us.  As an allied healthcare professional, you will likely experience patients who have increased anxiety and fears.  In addition, patients may likely have added stressors such as financial concerns, managing children who are out of school for a prolonged period of time, and increased social isolation.  These stressful times may also elevate the potential for increased domestic violence and abuse within the home. 

Here are a few high-level tips to keep in mind during this time.

  • Help patients remain calm.  The news is filled with coronavirus coverage, some stores have minimal supplies, and patients may be out of work due to business closures.  As allied healthcare professional, you likely will provide support to patients experiencing these issues.  Remain calm and attempt to alleviate heightened anxiety;    
  • Safety remains paramount.  You may have patients who are at risk to harm themselves or others.  It remains paramount that patients seek proper emergency treatment when indicated.  Know your state specific reporting obligations for duty to warn/protect;[1]  
  • Take time for yourself and seek support from other colleagues.  This can be an incredibly challenging and draining time as a professional.  De-charge, take a walk, meditate, or employ other strategies to cope with the stressors you may experience.  Reach out to others to obtain support;    
  • Consider relaxing cancellation policies.  For those of you who have a cancellation policy such as 24/48-hour advanced cancellation, consider changing this.  People could be experiencing illness, last minute childcare issues, or may be fearful to come to your office.  Should you change your policy, ensure this is applicable to all patients.  Make sure your patient signs the updated policy and consider having an end date to change back to your previous policy once the emergency subsides; 
  • Client engagement/consent forms.  During this time, you should consider changing patient engagement forms.  You may need to alter your new client forms, forms regarding office practices, or, if your practice-type is changing to offer remote services, implement new telebehavioral health forms.  This is new territory that is changing the landscape of how services are offered.  It is important to gather ideas from others to obtain language/guidance on how to best communicate with patients.  Check your profession’s website for resources.  Additionally, professional listservs can be of particular assistance; and 
  • Consider using telebehavioral health methods.  Patients may not be able to come into your office for a regularly scheduled in-person appointment.  Talk with each patient to inquire whether his/her insurer covers remote sessions.  There are several resources available.[2]  A word of caution, given this is an hour-by-hour changing issue, it is important that you stay on top of applicable state or federal emergency orders/declarations as they could change.  Check your state governmental website to determine if there are loosening or changing regulations to allow distance treatment.  If your patient is in another state, you should also know whether you can provide distance treatment to him/her without facing a potential licensure issue.  

Conclusion

We realize this is not an exhaustive list; rather, it is an overview of some of the issues to consider.  This is evolving.  We will post additional blogs in the coming days. 



[1]National Conference of State Legislatures, Mental Health Professionals’ Duty to Warn, http://www.ncsl.org/research/health/mental-health-professionals-duty-to-warn.aspx 

[2] Coronavirus (COVID-19): new telehealth rules and procedure codes for testing, https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/coronavirus_testing_telehealth.html; Congress waives telehealth restrictions for coronavirus screening.  American Telemedicine Association cheers the $8 billion emergency funding legislation, which it says will expand the toolkits of healthcare professionals working to combat the COVID-19 outbreak,https://www.healthcareitnews.com/news/congress-waives-telehealth-restrictions-coronavirus-screening; Medicare & Coronavirus (Telehealth & related services), https://www.medicare.gov/medicare-coronavirus#500; American Psychological Association, Guidelines for the Practice of Telepsychology, https://www.apa.org/pubs/journals/features/amp-a0035001.pdf, developed by the APA, ASPPB, and The Trust; American Academy of Child and Adolescent Psychiatry. Practice Parameter for Telepsychiatry with Children and Adolescents, https://www.jaacap.org/article/S0890-8567(08)60154-9/pdf; American Medical Association, Ethical Practice in Telemedicine, https://www.ama-assn.org/delivering-care/ethics/ethical-practice-telemedicine; American Psychiatric Association and American Telemedicine Association, Best Practices in Videoconferencing-Based Telemental Health (April 2018), file:///C:/Users/lambertk/AppData/Local/Packages/Microsoft.MicrosoftEdge_8wekyb3d8bbwe/TempState/Downloads/APA-ATA-Best-Practices-in-Videoconferencing-Based-Telemental-Health%20(1).pdf; American Telemedicine Association, Practical Guidelines for Videoconferencing Based Telemental Health, http://www.ATA.org; Campbell, L. F., Millán, F., & Martin, J. N. (Eds.). (2017); A Telepsychology Casebook: Using Technology Ethically and Effectively in Your Professional Practice. Washington, DC: American Psychological Association; Center for Telehealth and eHealth Law, http://www.ctel.org; National Association of Social Workers Code of Ethics, https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English, 1.07 (m) Privacy and Confidentiality among other subsections, 2017; NASW, ASWB, CSWE, & CSWA Standards for Technology in Social Work Practice, https://www.socialworkers.org/includes/newIncludes/homepage/PRA-BRO-33617.TechStandards_FINAL_POSTING.pdf, 2017; United States Department of Health and Human Services, http://www.hhs.gov/ocr/privacy

 

 

 

Kristen Lambert, JD, MSW, LICSW, CPHRM, FASHRM
Healthcare Practice and Risk Management Innovation Officer
Trust Risk Management Services, Inc.

 

NOTE: This information is provided as a risk management resource and is not legal advice or an individualized personal consultation.  At the time this resource was prepared, all information was as current and accurate as possible; however, regulations, laws, or prevailing professional practice standards may have changed since the posting or recording of this resource. Accordingly, it is your responsibility to confirm whether regulatory or legal issues that are relevant to you have since been updated and/or to consult with your professional advisors or legal counsel for timely guidance specific to your situation. As with all professional use of material, please explicitly cite The Trust as the source if you reproduce or distribute any portion of these resources.  Reproduction or distribution of this resource without the express written permission of The Trust is strictly prohibited.

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NOTE: This information is provided as a risk management resource and is not legal advice or an individualized personal consultation. At the time this resource was prepared, all information was as current and accurate as possible; however, regulations, laws, or prevailing professional practice standards may have changed since the posting or recording of this resource. Accordingly, it is your responsibility to confirm whether regulatory or legal issues that are relevant to you have since been updated and/or to consult with your professional advisors or legal counsel for timely guidance specific to your situation. As with all professional use of material, please explicitly cite The Trust Companies as the source if you reproduce or distribute any portion of these resources. Reproduction or distribution of this resource without the express written permission of The Trust Companies is strictly prohibited.