PSYCHIATRIC ASSESSMENT FOR
THE PSYCHIATRIC-MENTAL HEALTH
NURSE PRACTITIONER -Q&A
In 2018, the American Psychiatric Association (APA), in conjunction with the
American Telemedicine Association (ATA) developed: - {✔✔ANSWER✔✔}-best
practices for providing videoconferencing-based telepsychiatric care-guidelines
inform the technical considerations and administrative requirements needed to
provide these services
best practices for providing videoconferencing-based telepsychiatric care: -
{✔✔ANSWER✔✔}--Use of a designated technology platform. Telesessions should
not be conducted using alternate platforms; however, an alternate plan, such as a
telephone call, may be used in case of technology failure.
-Provisions for the verification of confidential and secure client information. -
Sufficient bandwidth to provide clear, appropriate video and audio quality.
-Device compliance with Health Insurance Portability and Accountability Act of 1996
(HIPAA) and state requirements.
During telepsychiatry sessions, both the provider and client locations should be
treated as a - {✔✔ANSWER✔✔}-Confidential space
During telepsychiatry sessions, provisions must be taken to ensure: -
{✔✔ANSWER✔✔}--the discussion cannot be overheard by other-adequate lighting
and ambiance is provided that is appropriate to the session -place the camera so
that the eyes and face of the participants are visible
Telepsychiatry Legal and Regulatory Considerations: Best practices -
{✔✔ANSWER✔✔}--Malpractice insurance-Licensure requirements-Federal and state
prescribing guidelines -Reimbursement
Telepsychiatry Legal and Regulatory Considerations: Malpractice insurance -
{✔✔ANSWER✔✔}-Malpractice insurance is required and some policies require
additional policies for telehealth.
, Telepsychiatry Legal and Regulatory Considerations: Licensure requirements -
{✔✔ANSWER✔✔}-Licensure requirements differ from in-person practice.-Providers
must hold a license to practice in the state where the client resides.-The PMHNP is
responsible for following standards for the state in which they are practicing.
Telepsychiatry Legal and Regulatory Considerations: Federal and state prescribing
guidelines - {✔✔ANSWER✔✔}-Federal and state prescribing guidelines differ for
telepsychiatry.-The Ryan Haight Online Pharmacy Consumer Protection Act of 2008
governs the prescribing of controlled substances via teleconferencing.• To safely
prescribe, the provider must conduct an in-person medical evaluation at least once
every 24 months and comply with all federal and state prescribing guidelines.
Telepsychiatry Legal and Regulatory Considerations: Billing and Reimbursement -
{✔✔ANSWER✔✔}--Reimbursement varies by state and insurance provider.•
Currently, 48 states provide Medicaid reimbursement for telepsychiatry services.-pt
made aware of any and all financial charges that may arise from the services prior to
the commencement of initial services
Best practices for determining the appropriateness of telepsychiatry services include
consideration of the following: - {✔✔ANSWER✔✔}--cognitive capacity of the client-
client history and medical status -geographic distance to emergency facilities -client
support system
Best practices related to special populations: Forensic and Correctional -
{✔✔ANSWER✔✔}--follow applicable standards of consent in terms of client's legal
status and rights -develop clear, site-specific protocols
Telemental health Children and Adolescents: environment - {✔✔ANSWER✔✔}-
should facilitate the assessment by providing an adequate room size, furniture
arrangement, toys, and activities that allow the youth to engage with the
accompanying parent, presenter, and provider and demonstrate age-appropriate
skills
best practices related to special populations: Children and Adolescents -
{✔✔ANSWER✔✔}-follow the same guidelines presented for adults•modify care
based on developmental status (motor functioning, speech and language
capabilities, relatedness, and relevant regulatory issues)-include family as
appropriate-Providers should consider how the presenter's involvement can affect
service delivery -Appropriateness for telemental care shall consider safety of the
youth, the availability of supportive adults, the mental health status of those adults,
and ability of the site to respond to any urgent or emergent situations.
Best practices related to special populations: Geriatric - {✔✔ANSWER✔✔}--include
family as clinically appropriate-adapt care for cognitive or sensory impairment
best practices related to special populations: Military and Veteran -
{✔✔ANSWER✔✔}--be familiar with federal and organizational structures and
guidelines -be familiar with military cultural competence