(1) Telepsychology means the practice of
psychology via electronic communications technology by persons licensed under
T.C.A. §
63-11-203.
Electronic communications technology is information exchanged typically using
audio or visual technology that is part of a plan of care during a scheduled or
agreed upon time.
(2) Whenever
feasible, secure communications shall be used, such as encrypted text messages,
secure email, secure websites or secure real-time video.
(3) In order to practice telepsychology in
the state of Tennessee, one must hold a current, valid psychology license
issued by the Tennessee Board of Examiners in Psychology. The scope of practice
of a Psychologist is prescribed and limited by Tennessee Code Annotated, Title
63, Chapter 11 and the rules set forth in this chapter and Chapter
1180-01.
(4) Licensees cannot
provide telepsychology to patients domiciled or physically located in any
jurisdiction other than Tennessee. The provision of telepsychology to any
person domiciled or otherwise physically located in the State of Tennessee
subjects the licensee to the jurisdiction of the Board in all matters set forth
in the Tennessee Psychology Practice Act and implementing rules and
regulations, including all matters related to discipline.
(5) Licensees should recognize that
telepsychology is not appropriate for all psychological problems and patients,
and decisions regarding the appropriate use of telepsychology shall be made on
a case-by-case basis. Licensees practicing via telepsychology should be aware
of potential risks incurred when practicing psychology through the use of
electronic communications and take special care to conduct their professional
practice in a manner that protects the welfare of the patient. Licensees
practicing telepsychology shall:
(a) Conduct a
risk-benefit analysis and document findings specific to:
1. Whether the patient's presenting problems
and apparent condition are consistent with the use of telepsychology to the
patient's benefit; and
2. Whether
the patient has sufficient knowledge and skills in the use of the technology
involved in rendering the service or can use a personal aid or assistive device
to benefit from the service.
(b) Not provide telepsychology services to
any person or persons when the outcome of the risk-benefit analysis is
inconsistent with the delivery of telepsychology services, whether related to
clinical or technological issues.
(c) Prior to providing telepsychology
services, obtain the written informed consent of the patient which must
include, but is not limited to:
1. The
limitations and innovative nature of using electronic communications in the
provision of psychology services;
2. The potential risks to confidentiality of
information due to the use of electronic communication;
3. The potential risks of sudden and
unpredictable disruption of telepsychology services and how an alternative
means of re-establishing electronic or other connection will be used under such
circumstances;
4. The time and
manner in which the licensee will respond to electronic messages;
5. The emergent circumstances when the
licensee and patient will use alternative means of communication;
6. The other parties who may have access to
communications between the patient and the licensee;
7. The specific methods for ensuring that a
patient's electronic communications are directed only to the licensee or
supervisee; and
8. The manner in
which the licensee will store electronic communications exchanged with the
patient.
(d) Upon
initial and subsequent contacts with the patient, make reasonable efforts to
verify the identity of the patient.
(e) Obtain alternative means of contacting
the patient.
(f) Provide the
patient with alternative means of contacting the licensee.
(g) Establish a written agreement with the
patient relative to the patient's access to face-to - face emergency services
in the patient's geographical area in instances such as, but not limited to,
the patient experiencing a suicidal or homicidal crisis.
(h) Make reasonable efforts to protect and
maintain the confidentiality of the data and information relating to their
patients and inform them of the potentially increased risks, if any, of loss of
confidentiality inherent in the use of electronic communications.
(i) Ensure that confidential communications
stored electronically cannot be recovered and/or accessed by unauthorized
persons when the licensee disposes of electronic equipment and data.
(j) Document in the patient record that the
licensee conducted a patient encounter via electronic communication and state
the type or form of electronic communication used.
(k) Comply with all patient record
requirements as defined in Rule
1180-01-.06.
(6) In the context of a
face-to-face professional relationship, the following are exempt from this
rule:
(a) Electronic communications used
specific to appointment scheduling, billing, and/or the establishment of
benefits and eligibility for services; and
(b) Telephone or other electronic
communications made for the purpose of ensuring patient welfare in accordance
with reasonable professional judgment.
(7) Licensees providing supervision via
telepsychology shall be aware of the potential risks incurred when providing
supervision through the use of electronic communications and take special care
to conduct their supervision in a manner that protects the welfare of the
patients. Licensees providing supervision via electronic communications shall:
(a) Consider and document findings specific
to:
1. Whether the patient's presenting
problems and apparent condition are consistent with the use of telepsychology
in the supervisory process to the patient's benefit; and
2. Whether the supervisee has sufficient
knowledge and skills in the use of the technology involved in rendering the
supervision.
(b) Not
provide supervision via telepsychology services to any supervisee when the
outcome of the analysis required in parts (7)(a)1. and (7)(a)2. of this rule is
inconsistent with the delivery of supervision via telepsychology, whether
related to issues involving a given case or issues involving the technological
knowledge and skills of the supervisee.
(c) Prior to providing supervision via
telepsychology services, the supervisor and supervisee shall enter into a
written agreement which must include, but is not limited to:
1. The potential risks of sudden
unpredictable disruption of supervision that is dependent upon telepsychology
services and a plan for an alternative means of re-establishing electronic or
other connection under such circumstances;
2. The time and manner by which the
supervisor will respond to routine electronic messages from the
supervisee;
3. The emergent
circumstances when the supervisor and supervisee will use alternative means of
communication; and
4. The
precautionary measures that the supervisor and supervisee will take to ensure
that confidential communications stored electronically cannot be recovered
and/or accessed by unauthorized persons when the licensee disposes of
electronic equipment and data.
(d) Upon initial and subsequent contact with
the supervisee, make reasonable efforts to verify the identity of the
supervisee.
(e) Obtain alternative
means of contacting the supervisee.
(f) Provide to the supervisee alternative
means of contacting the supervisor.
