Evolving standards of care in the age of cybertechnology

Abstract

Behavioral health professionals are making increased use of cybertechnology to deliver services to patients, communicate with patients, gather information about patients, and communicate with colleagues. The advent of cybertechnology - included the Internet, text (SMS), email, video, cloud storage of electronic records, and other forms of electronic communication and documentation - has introduced novel and unprecedented ethical and risk-management challenges. This article provides an overview of emerging issues related to informed consent; delivery of services; privacy, confidentiality, and privileged communication; boundary issues and dual relationships; documentation; and practitioners' relationships with colleagues. The author highlights new standards of care that are being incorporated into licensing statutes and regulations; professional codes of ethics; and practice guidelines adopted by the professions of psychiatry, psychology, mental health counseling, marriage and family therapy, and clinical social work.

Clinical Information Systems – Seen through the Ethics Lens

“…Whether the users should acquire these competencies via formal education or informal learning was often not explicitly mentioned. However, hands-on recommendations that were derived from prior literature reviews [66][67][68][69][70] or from existing standards of care [71] on how to make use of technology safely were presented and could serve as guidance for educational measures of any kind.…”

“…Although many of the publications referred to ethical tenets and to the need for education, only a few expanded on ethical competencies directly. Reamer [71] citing various standards of care summarized that providers needed to acquire competencies to balance benefits and risks, to maintain confidentiality and privacy also in the context of ensuring the professional boundaries, to confirm the identity of the patient and to assess the patient's necessary level of familiarity and comfort with the technology, i.e., social media and telemedicine. Other authors leaned on general professional ethics to be applied when using social media in care situations [64,65,72].…”

“…Alshakhs et al [61] Bittner et al [66] Bopp et al [63] Brisson et al [33] Chandawarkar et al [69] Demiray et al [62] Estrada-Hernandez and Bahr [60] Geis et al [67] Ho and Quick [57] Jaremko et al [70] Le Barge and Broom [65] Modell et al [59] Reamer [71] Robillard et al [68] Sussman and DeJong [72] Zimba et al [64]…”

How to best use digital technology to help your patients

“…A s psychiatrists, we are increasingly using digital technology, such as e-mail, video conferencing, social media, and text messaging, to communicate with and even treat our patients. 1 The benefits of using digital technology for treating patients include, but are not limited to, enhancing access to psychiatric services that are unavailable due to a patient's geographical location and/or physical disability; providing more cost-effective delivery of services; and creating more ways for patients to communicate with their physicians. 1 While there are benefits to using digital technology, there are also possible repercussions, such as breaches of confidentiality or boundary violations.…”

“…1 The benefits of using digital technology for treating patients include, but are not limited to, enhancing access to psychiatric services that are unavailable due to a patient's geographical location and/or physical disability; providing more cost-effective delivery of services; and creating more ways for patients to communicate with their physicians. 1 While there are benefits to using digital technology, there are also possible repercussions, such as breaches of confidentiality or boundary violations. 2 Although there is no evidence-based guidance about how to best use digital technology in patient care, 3 the following approaches can help you protect your patients and minimize your liability.…”