Fillable Printable Bhs Policy 410

Bhs Policy 410

Arizona Departm ent of Health Services Current Effective Date: 4/1/2015

Division of Behavioral Health Services Last Review Date: 2/24/2015

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

P0LICY: 410, Use of Telemedicine

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1. PURPOSE:

To establish guidelines for the use of telemedicine using interactive video conferencing.

2. TERMS:

Definitions for terms are located online at http://www.azdhs.gov/bhs/definitions/index.php

The following terms are refer enced in this section:

Telemedicine

Informed Consent

3. PROCEDURES:

a. The T/RBHAs and subcontracted providers shall use teleconferencing to extend the

availability of clinical, educational and administrative services. All clinical services

provided through the interactive video teleconferencing will conform to established

policies for confidentiality and maintenance of records.

b. T/RBHAs will ensure that all prescribing of controlled substances through telemedicine

will conform to all federal and state regulations.

c. Interactive video functions are approved for the following purposes:

i. Direct c lin ic a l s ervices;

ii. Case consultations;

iii. Collateral services;

iv. Training and education;

v. Administrat ive activities of participating agencies;

vi. Management activities including Quality Management, Grievance and Appeal,

Finance, Advocacy, Utilization and Risk Management, Clinical Consultation, and

MIS; and

vii. Other uses as approved by the T/RBHA.

d. Informed Consent

i. Before a health care provider delivers health care via Telemedicine, verbal or

written informed consent from the behavioral health recipient or their health care

decision maker must be obtained.

ii. Informed consent can be provided by the behavioral health medical practitioner

or registered nurse with at least one year of behavioral health experience. When

providing informed consent it must be communicated in a manner that the person

and/or legal guardian can understand and comprehend. See

Policy 107, General

and Informed Consent for a list of specific elements that must be provided.

iii. Exceptions to this consent requirement include:

(1) If the telemedicine interaction does not take place in the physical presence of the

patient;

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410, Use of Telemedicine

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Arizona Departm ent of Health Services Current Effective Date: 4/1/2015

Division of Behavioral Health Services Last Review Date: 2/24/2015

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

P0LICY: 410, Use of Telemedicine

____________________________________________________________________________

(2) In an emergency situation in which the patient or the patient’s health care

decision maker is unable to give informed consent; or

(3) To the transmission of diagnostic images to a health care provider serving as a

consultant or the reporting of diagnostic test results by that consultant.

e. If a recording of the interactive video service is to be made, a separate consent to record

shall be obtained. Items to be included in the consent are:

i. Identifying information;

ii. A statement of understanding that a recording of information and images from

the interactive video service will be made;

iii. A descript ion of the uses for the recording;

iv. A statement of the person’s right to rescind the use of the r ec ord i ng;

v. A date upon which permission to use the recording will be void unless otherwise

renewed by signature of the person receiving the recorded service; and

vi. For persons receiving services related to alcohol and other drugs or HIV status,

written, time-limited informed consent must be obtained that specifies that no

material, including video-tape, may be re-disclosed.

f. If a telemedicine session is recorded, the recording must be maintained as a component

on the member’s medical record, in accordance with 45 C.F.R. Part 164.524 and

ADHS/DBHS Policy 802, Medical Record Standards

. The T/RBHAs will establish a

process that allows members to attain telemedicine information in their medical records.

g. Licensure

i. Before a health care provider delivers behavioral health care services through

telemedicine, the treating healthcare provider must be licensed in the state in

which the patient resides (see A.R.S. § 36-3601-3603

h. Confidentiality

i. At the time services are being delivered through interactive video equipment, no

person, other than those agreed to by the person receiving services will observe

or monitor the service either electronically or from “off camera.”

ii. To ensure confidentiality of telemedicine sessions providers must do the

following when providing services via telemedicine:

(1) The videoconferencing room door must remain closed at all times;

(2) If the room is used for other purposes, a sign must be posted on the door, stating

that a clinical session is in progress; and

(3) Implement any additional safeguards to ensure confidentiality in accordance with

ADHS/DBHS Polic y 1401, Conf identiality

for more information on Disclosure of

Behavioral Health information and telemedicine.

i. Documentation

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410, Use of Telemedicine

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Arizona Departm ent of Health Services Current Effective Date: 4/1/2015

Division of Behavioral Health Services Last Review Date: 2/24/2015

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

P0LICY: 410, Use of Telemedicine

____________________________________________________________________________

i. Medical records of telemedicine interventions must be maintained according to

usual practice.

ii. Electronically r ec or ded information of direct, consultative or collateral clinical

interviews will be maintained as part of the person’s clinical record. All policies

and procedures applied to storage and security of clinical information will apply.

iii. All re quir ed signat ures must be documented in the medical record, and must be

made available during auditing activities performed by ADHS/DBHS.

j. The T/RBHA shall establish policies and procedures for scheduling and prioritization of

use of interactive video conferenc ing.

k. Reimbursement for telemedicine services should follow customary charges for the

delivery of the appropriate procedure code(s).

4. REFERENCES:

45 C.F.R. Part 164.524

A.R.S. § 36-3601-3603

R9-21-206.01

ADHS/RBHA Contrac ts

ADHS/TRBHA IG As

Policy 107, General and Informed Consent to Treatment

Policy 108, Psychotropic Medication; Prescribing and Monitoring

Policy 802, Medical Record Standards

Policy 1401, Confidentiality

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410, Use of Telemedicine

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