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The Washington State Health Care Authority Recently Published a document: 

Telehealth Tips for Individual Receiving Services


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Northwest MHTTC and the Behavioral Health Training, Workforce and Policy Innovation Center of the BHI partnered to present an 8-session telehealth learning series for behavioral health providers across the continuum of behavioral health care in Washington State in response to COVID-19.

The webinar series met twice weekly for four weeks and addressed a variety of topics related to telehealth, including operational and administrative issues (such as billing), equipment and technology requirements, and strategies to provide effective clinical care.  


This learning series is part of a coordinated statewide response to provide technical assistance to behavioral health organizations in the context of the COVID-19 pandemic and beyond. These efforts are led by the University of Washington Behavioral Health Institute in partnership with WA State Health Care Authority (HCA)WA Division of Behavioral Health and Recovery (DBHR), the University of Washington Department of Psychiatry and Behavioral Sciences, the nine Accountable Communities of Health, the five Medicaid Managed Care Organizations, and the Northwest MHTTC and others.  These training sessions and other telehealth resources will be posted to a new Behavioral Health Telehealth Resource Website.  

 The series specifically helps the continuity of operations in WA to support access to care, equipment, technical assistance, billing and staff training for behavioral health providers in Washington State. 


Week 1

 Training #1:  Telehealth Nuts & Bolts Kick-Off

April 22, 2020, 2-3pm PT 

SlidesQA_1​, Recording

Learning objectives:

  • Review the definition of telehealth
  • Review access to HCA laptops and Zoom accounts
  • Review Zoom tips and functionality
  • Review HIPAA regulations for telehealth
  • Identify needs for further training and assistance​
Resources:

Washington Health Care Authority:

Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS):

Training #2: Myths and Facts You Need to Know 

April 24, 2020 11am-12pm PT 
Slides, QA​, Recording​​

​Learning objectives:

  • Understand common myths that patients and providers might have about Clinical Video Teleconferencing.
  • Review the literature that supports Clinical Video Teleconferencing and refutes these myths.
  • Begin to develop confidence in providing care using Clinical Video Teleconferencing.​​

Resources:

Washington Health Care Authority:

​Week 2

Training #3: Billing and Reimbursement

April 29, 2020, 2-3pm PT 
Slides, QA​, Recording 

​Learning objectives:

  • Review Medicare billing and reimbursement for telehealth during the Covid19 public health emergency
  • Review private payer billing and reimbursement for telehealth during the Covid19 public health emergency

Presenters:

  • Gail Kreiger, Section Manager, Medicaid Compliance Review and Analytics, Medicaid Program Operations and Integrity, Washington Health Care Authority
  • Cathy Britain, Executive Director of the Telehealth Alliance of Oregon

Resources:

Washington Health Care Authority

Resources on Medicare

Resources on Private Payers and ERISA

Training #4: Introduction to Digital Health: Getting Started and Safety Planning 

May 1, 11am-12​​​pm PT 
Slides, QA, Recording​

Presenter:

  • Brad Felker, MD. VA Puget Sound Health Care System; Professor, University of Washington Department of Psychiatry & Behavioral Sciences

Learning objectives:

  • Dos and Don'ts to seeing up your clinic space and providing quality Clinical Video Teleconferencing (CVT) care
  • Dos and Don'ts to preparing the patient for their first clinical session via CVT
  • Dos and Don'ts to Safety Planning 
Resources:​ ​​​​​​​​​​​

​​​Week 3

Training #5: Creating a Clinical Workflow for Telehealth

May 6, 2 - 3pm PT ​
Slides, QA, Recording 

Learning Objective:

  • List the four components of a telemedicine clinic work flow.​

Presenter:

  •  Jennifer Erickson, DO, Acting Assistant Professor in the UW Department of Psychiatry and Behavioral Sciences​
Resources: 


Training #6: Telehealth and Substance Use Disorders

May 8, 11am-12pm PT 
Slides, QA, Recording

Learning Objectives

  • Briefly review what the evidence says about telehealth SUD treatment
  • Outline a telehealth SUD visit
  • Develop understanding around special considerations for SUD treatment
  • Highlight changes in SUD treatment due to the Pandemic
  • Describe supplemental digital programs​

Presenter:

  • Mark Duncan, MD. Assistant Professor, UW Department of Psychiatry and ​​Behavioral Sciences; Co-Medical Director UW PACC, Telepsychiatry Rotation, and Advanced Collaborative Care - Addictions Medical Education


Week 4

Training #7:  CFR and HIPAA  
May 13, 2 - 3 PM PST

Training Objectives:

  • Identify basic requirements of 42 CFR Part 2 and HIPAA
  • Explore recent changes to federal privacy laws outlined within the CARES Act
  • Explore privacy law application to telehealth in accordance with recently released SAMHSA and OCR guidance
  • Describe how to access resources and TA provided by the Center of Excellence for Protected Health Information (CoE-PHI)

Presenters:

  • Christine Khaikin, JD- CoE-PHI Health Policy
  • Sally Friedman, JD – CoE-PHI Senior Health Privacy Training and TA Director
  • Caroline Waterman, MA, LRC, CRC- CoE-PHI SUD Lead
  • Michael Graziano, MPA, CoE-PHI Project Director

Training #8: Telemedicine with Children and Families

May 15, 2020 

Slides, QA, Recording​ 

Learning Objectives:

  • Discuss the use of telemedicine for children and adolescents
  • Review consenting and privacy issues for telemedicine with children​

Presenter:​ Robert Hilt, MD, Professor UW Department of Psychiatry & Behavioral Sciences; Seattle Children's Hospital; Program Director, Partnership Access Line (PAL)

Resources: 



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Beginning May 22, 2020 the Behavioral Health Institute continues to host trainings on Friday's from 11AM -12PM. 

 

Using Telehealth For Groups

May 22, 2020

Slides, QA, Recording


Reources:

Sample of Telemental Health Group Agreement.pdf


Learning objectives:

  • Describe adaptations needed to facilitate Behavioral Health groups within the telehealth modality.
  • Discuss privacy and confidentiality-related considerations for home-based telemental health groups.
  • Identify strategies to set up and facilitate telemental health groups.​
Presenter: Erika M Shearer, PhD is a staff psychologist on the Promoting Access through Telemental Health (PATH) team at the VA Puget Sound Health Care System (VAPSHCS), American Lake Division.


The New Normal? Engaging Youth and Families in Tele Behavioral Health​ ​

May 29, 2020, 11-12PM PST

Learning objectives:

  • Identify at least 2 unique challenges or barriers to engaging youth and families in behavioral health services via telehealth modalities
  • Learn at least 2 ways to engage youth and families effectively in behavioral health services via telehealth modalities.​
Presenter: 
Georganna Sedlar, PhD. Assistant Professor, Psychiatry and Behavioral Sciences, UW SOM


​Enhancing Clinical Engagement using Telehealth​ 
June 5, 2020 11-12 PST


Learning Objectives:​

1. Identify three challenges to clinical engagement in telehealth

2. Identify three potential methods to improve therapeutic alliance in the telehealth modality

3. Recognize three ways to mitigate technology disruptions.​


Presenter: Dr. Smucker Barnwell


Prescribing mHealth Apps in Mental Health Treatment 

June 12, 2020 11-12 PST

 

Recording,Slides, Q&A​ ​


Learning objectives:

  1. Familiarity with available tools for rating mHealth apps
  2. Understanding of informed consent elements specific to recommendation of mHealth apps
  3. Awareness of best practices when introducing and utilizing mHealth apps in treatment​

Presenter: Dr. Kristen Perry 


How can we Improve Health Equity and Cultural Competence in the era of Covid-19 

6/19/​2020, 11- 12 PST


Recording​, Slides​​​, Q&A​​​


 Learning objectives:

  • Define health equity, culture and implicit bias
  • Describe how healthy disparities increases secondary effects of the COVID-19 pandemic risk and poor patient health outcomes
  • Explore how telehealth can assist in bridging the health equity gap
  • List at least three PCP and staff telehealth opportunities to promote health equity and cultural competency

 

Presenter: Karen L. Hill

Provider Self Care in Telehealth during the Covid PHE 

6/26/2020, 11- 12PM

Recording, Slides, Q&A ​

Learning Objectives - An overview on how trauma informed approaches and self-care tips can be used to help support those who are providing behavioral health services during the time of the COVID-19 pandemic, and ongoing societal unrest.

Presenters ​- Keri Waterland and Diana Cockrell

Preparing the Patient for Telehealt
7/10/2020, 11-12 PM PST
Presenter ​ - Tammy Arndt ​
Learning Objectives: 
- Understanding technology requirements for virtual care 
- Evaluate patient capacity to receive virtual care​ 
- Facilitate the patient experience 

Clinical Supervision over Telehealth ​​​

7/17/2020, 11 - 12 PM PST

Recording, Slides​, Q&A

​Learning Objectives -​

  • ​Participants will learn how to use the flexibility of the telehealth platform to best support trainee learning and delivery of care​
  • Participants will understand important issues around safety and how best to develop a safety protocol ​

Presenter - Amanda Focht, MD


Changes Related to Prescribing for Controlled Substances as a Result of COVID 

7/24/2020, 11-12 PM PST

Recording​, Slides​, Q&A 

​Learning Objectives​​

Presenter - Russell McCann, PhD 

Suicide Risk Assessment over T

elehealth

:

Review federal and state laws that relevant to te​lepsychiatry

Learn how COVDI-19 has impacted telepsychiatry policy

Become aware of telepsychiatry resources​

Recording, Slides​, Q&A

​Learning Objectives - 

  1. Distinguish between direct and indirect drivers of suicide
  2. Describe the pros and cons of suicide assessment approaches
  3. Describe technology options for assessment and management of suicide risk

Presenter - Kate Comtois, PhD​



Making the Best Use of the Video Conferencing Technolog

y

1 Starts with a discussion of the equipment available and strategies for using the equipment. To view Technology Video 1, click here (3:20 length)

Technology Video 2 considers the layout of the room and making sure the provider conveys the proper image to the client. Should there really be a picture of Alfred E. Neuman behind the provider? To view Technology Video 2, click here (5:07 length)

Technology Video 3 continues the discussion of proper provider room setup with a look at lighting and how to best be seen by the client. To view Technology Video 3, click here (5:17 length)

Technology Video 4 considers the idea that beyond the picture, the sound is truly critical. Jonathan discusses the need for and techniques of ensuring the outgoing sound is the best possible. To view Technology Video 4, click here (8:20 length)

Technology Video 5 is a review of the provider placement before the camera or the angles involved in appearing at one's best to project a professional and appropriate image to the client. To view Technology Video 5, click here (11:37 length)

Technology Video 6 The last of the technology discussions emphasizes the importance of regular testing of the connection in order to avoid a last-minute panic if there is a technology problem that appears just when the patient encounter is scheduled to start. To view Technology Video 6, click here (2:05 Length)

Professional and Clinical Considerations

Professional/Clinical Video 1 covers personal preparation and self-setup for the provider as he/she gets ready for the encounter. To view Professional/Clinical Video 1, click here (4:10 length)

Professional/Clinical Video 2 discusses policies and protocols for the encounter. To view Professional/Clinical Video 2, click here (10:42 length)

Professional/Clinical Video 3 takes a look at video etiquette and discusses methods for ensuring the encounter goes as smoothly as possible. To view Professional/Clinical Video 3, click here (5:23 length)

Professional/Clinical Video 4 offers some insights into patient engagement and tactics for ensuring the patient/client fully participates in the process. To view Professional/Clinical Video 4, click here (8:20 length)

Professional/Clinical Video 5 works through cognitive interpersonal approaches to conducting the encounter to ensure the client/patient receives the best care possible for the situation. To view Professional/Clinical Video 5, click here (7:58 length)

Professional/Clinical Video 6 contains a discussion on the use of relaxation imagery for the client. Will hypnosis work over a video encounter? Jonathan discusses that topic as well. To view Professional/Clinical Video 6, click here (7:55 length)

Professional/Clinical Video 7 considers the challenges and solutions to working with families or groups via telehealth connections. Strategies for holding encounters with more than one person are covered. To view Professional/Clinical Video 7, click here  (14:51 length)

Two terrific videos for getting started in telehealth

Here are two additional training videos we recommend. Although these two video are not specific to behavioral health they are applicable.  What we like about these (aside from the fact they are well done and short) is that they include one short video to share with patients – patient education about what to expect is important and often missing.  We want to acknowledge the Pacific Basin Telehealth Resource Center, the Hawaii Department of Health and the Western States Regional Genetics Network for their great work and for letting us use their material.

Telehealth Best Practices for Providers

 ​Find Resources and Recording Here​ ​(click on the "Webinars" tab and the Washington conversation follows the National conversation).



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