Telepractice FAQs – Pandemic Edition

Telepractice FAQs – Pandemic Edition2020-04-06T13:29:45-06:00

Due to the COVID-19 pandemic, public health orders are in place limiting face-to-face interactions. Many ACSLPA members are moving to virtual care to continue to serve clients.

The answers to common questions related to telepractice during the pandemic are included here. If you have unanswered questions, please contact dpp@acslpa.ca.

What is ‘telepractice?”2020-04-06T13:26:36-06:00

Telepractice is the practice of providing services using “virtual” or non “face-to-face” mediums. There are many different terms that might be used, including telepractice, virtual care, video conferencing, telehealth, and teletherapy. Even telephone consultations are considered telepractice.

What requirements does ACSLPA have for members who want to do telepractice?2020-04-06T13:11:43-06:00

Members providing services via telepractice should familiarize themselves with the following:

  1. ACSLPA’s Telepractice Guideline (https://www.acslpa.ca/wp-content/uploads/2019/05/Telepractice.pdf) and
  2. ACSLPA’s Standard of Practice (1.5 Virtual Care – https://www.acslpa.ca/members-applicants/key-college-documents/standards-of-practice/1-7-virtual-care/).

ACSLPA members are expected to practice in accordance with the Standards of Practice and Code of Ethics. ACSLPA members must remain professional and ethical when providing services in this manner.

While telepractice can be an excellent solution to serving clients of all ages, there can be some risks associated with providing services via telepractice (e.g., privacy, poor video/audio quality) and not all types of services will be conducive to the medium.

What privacy legislation is applicable for ACSLPA members?2020-04-06T13:25:28-06:00

To date, the pandemic has not resulted in privacy legislation being relaxed in Alberta. ACSLPA members need to be informed of the legislation that specifically applies to their own practice setting.

For example, members working for AHS will fall under the Health Information Act (HIA), members in private practice fall under the Personal Information Protection Act (PIPA), and members working for school boards and certain other agencies will most often fall under the Freedom of Information and Protection of Privacy Act (FOIP).

In addition to legislation, members should take general steps to protect privacy as well. When providing services, make sure that your session cannot be overheard or seen by others in your home/office. Ensure your camera doesn’t show personal information about your home/office to the client (e.g., keep those lunch containers and personal mail out of view).

It is strongly recommended that you do not leave your email, phone numbers, addresses, or locations on any online social media forums. Provide clients with a method to contact you directly.

What platforms meet ACSLPA’s requirements? What platforms does ACSLPA recommend?2020-04-06T13:11:31-06:00

ACSLPA doesn’t endorse or recommend any one platform over another. There are many possible options. Members will need to look at their options and make an informed decision about the platform chosen.

When thinking about meeting privacy requirements, consider:

  1. Encryption of audio and video should be end-to-end.
  2. The platform should not record/store those video sessions unless we ask it to (we need to be able to tell our clients how their information is collected, stored, used and disclosed).
  3. Where is the data stored? Although there’s no requirement that it’s stored in Canada, it is important to know that information stored on US servers can be accessed under the US laws (USA Patriot Act, USA Freedom Act). This information would need to be shared with clients as part of gathering informed consent.

Members should have sound reasoning for choosing the platform they do. In all cases, the use of encrypted platforms is preferred. However, in certain situations, it may be acceptable to use another platform that is more easily accessible to your client. ACSLPA members will need to carefully consider the risks of using unsecure platforms.

ACSLPA members must make the best decision they can for which platform they choose to use. Members should have sound reasons for their choice and should take steps to mitigate risks to clients.

It is common for employing agencies to recommend and support a particular platform. As employees of these agencies, ACSLPA members would typically follow the guidance provided by their employer. Members should still be prudent consumers of the advice they receive from their employer and ask clarifying questions as needed to ensure privacy can be met. Following employer protocols can be included as justification for the member’s choice of platform.

Do I need to get a new informed consent?2020-04-06T13:24:35-06:00

Yes. A move to telepractice represents new/different risks to your clients and therefore members are expected to obtain informed consent. Clients may wish to opt out of services delivered in this way once they understand the risks.

You might consider “how” you gather consent as it does not need to be in writing (consent can be verbal). Consent (or refusal of consent) must be documented.

Your informed consent discussion should include information about added risks (e.g., privacy), the types of services you can/cannot provide in this manner, and any other information that might be specific to their situation.

What do I need to look for in a telepractice platform besides security?2020-04-06T13:23:10-06:00

When choosing a platform, you might want to think about:

  • Speed/bandwidth – choose a platform that has sufficient speed and bandwidth to prevent pixelating and audio degradation (and have a plan for when it happens during a session).
  • User-friendliness of the platform – choose a platform that is easy for your clients to use as well as yourself.
  • The ability to allow multiple hosts if you are hosting and working with others who also host.
  • The ability to connect with and link together numerous clients at a time (if providing group services). This is also important for supervision of support personnel.
  • The ability to share your screen.
  • The ability to take control of your client’s mouse in order to guide them through activities.
Does my professional liability insurance cover me when I provide services by telepractice?2020-04-06T13:22:16-06:00

The specifics of insurance policies will vary by insurance provider. ACSLPA members should contact their provider to ensure coverage or to discuss any particulars related to their coverage.

Can I complete standardized tests via telepractice?2020-04-23T11:32:47-06:00

Maybe. Unless a standardized test includes normative data for administration over the same medium, you would not be able to report the standardized scores (percentile ranks, standard scores). Although raw scores could be reported, they generally don’t add much value to your diagnosis. If administering standardized tests through telepractice, you will probably need to use the information in a “dynamic” or qualitative manner – it may help you to form your clinical impression/diagnosis. Bear in mind that some tests cannot be re-administered in a certain timeframe, so if you use it informally and then have the opportunity to reassess a client soon (in person, should the public health orders be removed), you may not be able to use that same test.

Although you may not be able to do the typical assessments, there are many things you can do to get to a clinical impression. You can use questionnaires, language samples, and observation through telepractice.

Some test manufacturers include information about test administrtion via telepractice. Reviewing what is possible and allowable by the test manufacturer is reommended.

Can support personnel be involved in providing services using telepractice?2020-04-06T13:20:07-06:00

Yes. There are no “rules” stating that support personnel cannot be involved in telepractice sessions. Support personnel can be trained to perform numerous tasks including group and individual sessions. They may need additional training in use of the platform and how to troubleshoot technical issues.

As per the ACSLPA guidelines for working with support personnel (https://www.acslpa.ca/members-applicants/key-college-documents/guidelines-protocols/), ACSLPA members are responsible for the training of, delegation of tasks to, and the supervision of support personnel. ACSLPA members will need to establish supervision commensurate with the support person’s knowledge, skills, abilities and comfort. Members must also remove any tasks if the support person is not able to adequately perform that task.

Do I have to record sessions?2020-04-06T13:18:08-06:00

No. there is no requirement to record sessions. If you do decide to record a session for a particular purpose, be sure to obtain consent for the recording. It is important to define the activity that will be recorded, explain what the recording will be used for and explain how and for how long the recording will be stored.

What registration requirements are there if I’m serving clients who live in another province?2020-04-06T13:17:44-06:00

This will vary depending on the jurisdiction in which the client lives; it is important to be aware of is the legislative requirements in other provinces. Where regulation is in place (the majority of Canadian provinces), members will need to reach out to the respective jurisdiction to determine what is required.

Can clients be reimbursed by their private insurance (extended benefits) for services provided by telepractice?2020-04-06T13:14:59-06:00

Maybe. While it appears that some benefits providers have extended their coverage, some may not have. Encourage your client to contact their provider for specific information. This is best done before they begin receiving services (so there are no surprises for either of you).

Are there online resources online for telepractice?2020-04-06T13:14:26-06:00

Yes. There are groups that are established (and many new groups) on social media that provide shared content such as consent forms, materials and resources, and discussion. Members should look for reputable sources of information. Check who is posting information and how they might be regulated/legislated in their jurisdiction. Remember, online platforms are world wide and there are often no requirements or rules regarding who might be posting information.