Thread: In response to #CoronaVirus my #behavioralhealth employer retooled to #telementalhealth in about ten days; I'll share observations in hope others can benefit if they make the same #telehealthswitch. 1/n

I’m a clinical counseling Master’s student and my day job is on the EHR IT team; the following is in no particular order based on my experiences, and doesn’t represent the opinions of my employer. Laws where you are may affect whether you can deliver #teletherapy. 2/n

Tip the first: immediately now put any other IT projects or big initiatives on pause; moratorium on ehr upgrades for example. You need any and all tech people focused on smoothing the #distancetherapy transition. 3/n

Communications are gonna be key to whether this works. Establish clear decisionmaking authority via a small #telehealth governance group (clinician, IT, legal, client advocate/ombudsman); comms should come from this group.

Establish a cadence: when and by what channels will comms occur? How should info be cascaded to ensure everyone gets the same message (but not 100 times)? Establish a central mailbox where telehealth and covid questions should be sent.

Do a little reading on #crisiscommunications; this is a totally separate discipline to counseling.Trained clinicians *are not good* at communicating technical info, particularly when they are themselves “in” the crisis as opposed to being responders.

Short, directive information is essential. Get good at communicating in bulletpoints and active voice. Stop using “please” when relaying instructions; you are not in therapeutic connection mode relaying technical info to clinicians.

What #videoconferencing platform will you use? You may need to Macgyver this: figure out what you have to work with and how it can be used differently. This is the time to leverage tech-savvy interns to test your solution; testing takes time yes but you can't afford a misfire.

Since everyone's #SocialDistancing, congrats; you just became a #BYOD shop. You'll be supporting whatever tech clinicians have at home as well as troubleshooting a slew of #client devices.

You need different #informedconsent paperwork. Interns can take on work like getting paperwork signed, completing intakes, and triage assessments. They may also be able to do outreach/wellness checks via phone for established client.

Hint: interns' summer plans just went out the window. You can get help with all of this in exchange for supervision hours; call your local college or university to ask about grad students looking for work.

In the current crisis, clients seem to assent to #teletherapy because they are either comfortable with tech or they are desperate. These two groups require very different kinds and levels of technical support and therapeutic interaction.

Administrative staff can pivot to be virtual greeters, reaching out to clients before the first #teletherapy session to share instructions, test technology, and set expectations. Create a “virtual waiting room” to help the client be in the minset to benefit from the session.

Info for clients should take this format:
- Before you begi
- What to expectn
- How to get help
- Backup plan in emergency; what should the client do if they can't access #Zoom at the appointment time? Or if their session drops?

Write this stuff in "kitchen English"; that is, the plain language you would use sitting at the kitchen table with them. When people are under stress, their comprehension goes down, particularly about technology.

Do you need electronic/PDF versions of documents people usually complete on paper in your office? How will you gather signatures?

#Zoom healthcare version allows file sharing; this is one possible way to exchange paperwork. More about how to configure the settings later...there's a lot to understand and consider here.

On the subject of paperwork, you'll need a plan for renewals coming up; e.g. #informedconsent and HIPAA disclosures as well as revised treatment plans. Start by figuring out how many and who; again, this is work you can get admin or interns to do