Telehealth, Teleconsultation and Virtual Coaching

Program-Specific Guidance

Child Care Health Consultation

• Healthy Child Care Colorado

Early Intervention

• Telehealth Training for EI Professionals
• EI Telehealth Padlet (Resources)

Virtual Coaching

• Tips for Getting Started with Virtual Coaching
• Video: Virtual Coaching in Early Childhood
• Expanding Quality Virtual Coaching Padlet (Resources)
• Expanding Quality General Coaching Information

Early Childhood Mental Health Consultation (ECMHC)

• Teleconsultation Guidance 

Other Supports

• EveryoneOn offers  a search engine by zip code that helps families identify low-cost internet options, computers, etc. near them. This website is also available in Spanish. Check it out at www.everyoneon.org. 
• PCs for People offers eligible families and tax-exempt 501(c)3 organizations with computers, computer repair, internet services and learning resources. To learn more visit https://www.pcsforpeople.org/. 
• Lifeline is a federal program that lowers the monthly cost of either phone or internet services. Due to COVID-19, Lifeline has temporarily waived usage requirements and general de-enrollment procedures until May 29, 2020. To get Lifeline, find a company near you. 

HIPAA Requirements for Telehealth

Visit HHS.gov for more information. 

Guidance on BAAs, including sample BAA provisions, is available at https://www.hhs.gov/hipaa/for-professionals/covered-entities/sample-business-associate-agreement-provisions/index.html.

Additional information about HIPAA Security Rule safeguards is available at https://www.hhs.gov/hipaa/for-professionals/security/guidance/index.html.

HealthIT.gov has technical assistance on telehealth at https://www.healthit.gov/telehealth.

Cyber Security Tips

Cyber Security

Cyber threats and associated malicious acts through phishing, ransomware, malware, and hacking are geared toward tricking the unsuspecting user and acquiring access to their work computer and/or personal information. Attackers are expected to try to take advantage of employees working from home and will be attempting to trick them into taking actions (clicking links, phishing, responding to request) intended to hack your information. Now is the time to be vigilant and protect your information. 

• Be even more vigilant and skeptical of unsolicited email and watch for phishing attacks.
• Be wary when opening emails and do not click on links from people you do not know.
• Do not provide agency or personal information in response to an email, pop-up webpage, or other communication you did not initiate.

 
General Security

• Make sure that the information on your screen is not visible by others in your home and lock your computer when you walk away from it.
• Similarly, ensure that work discussions cannot be easily heard by others in your home (i.e. shut the door). Use a headset, if available, rather than speakerphone.
• Do not allow others, including family members or roommates, to use your work computer.
• Avoid using public computers and/or public wi-fi to access, process, store, or transmit data.
• Do not permit others to have access to sensitive or confidential work information, e.g. computer or hard copy.
• Store records at home in a secure manner, a private, closed, and locked place if possible, i.e. locked cabinet.
• If transporting documents from your work location, do not leave documents visible and/or accessible in your vehicle. Lock them in your trunk if you must make a stop between your office and your home.  Treat them as you would a laptop.
• Do not share work passwords with others in your household.
• Use a complex password or an easy-to-remember passphrase.
• When transporting your laptop from your work location to a remote location, do not leave it visible and accessible in your vehicle. Lock it in your trunk if you must make a stop between your office and your home.
• Conduct virtual visits that ensure privacy of the participant.  Find a secure location in your home where you will not be interrupted or allow others at home to see or hear your visit.

 

Resources have been identified to guide programs and professionals as they implement new service delivery models utilizing available technology.

The following best practices were identified by Child Trends. 

Research-supported technological outreach strategies: 

• Video calls. Many states are allowing providers to use video calls to parents to address families’ needs for support. Parents as Teachers has partnered with the University of Southern California to test the use of video calls to offer home visiting services; preliminary research shows high rates of parent satisfaction. While video calls are a great way to reach families, not all families will be able to take advantage, and providers can support families through other means.
• Texting and messaging apps. Telehealth may also include providing supports using texting or messaging services, and some research finds that these technologies enhance the effectiveness of programs. 
• Online content. Telehealth may also involve providing relevant information online. Some parenting programs that typically offer information to parents in a group-based setting have offered online versions of their programs to reduce barriers to access, finding that outcomes were the same for in-person and web participation. Programs that use online content for parents have found that online versions of parent support can improve outcomes for families and for children. Parent engagement with online content can be strengthened when providers check in with parents about the content and reinforce ideas.

Providers may need to adjust typical service delivery strategies to best recognize and meet the needs of families. For example: 

• Families and providers need technology support. When using video conferencing, technology glitches may affect the quality of interactions with families. Programs should provide support to both staff and parents to troubleshoot problems. Not all families will have regular access to web-supported devices for virtual visits (although some providers are offering open access to wifi during the crisis), so programs should provide a range of telehealth support.
• Providers must be even more attentive to privacy concerns than usual during virtual visits, particularly around challenging topics such as depression or intimate partner violence. For example, a parent’s risk is potentially amplified given that they or other family members may be in close contact with an abuser who is also practicing social distancing. Providers must be able to communicate with other practitioners who have expertise in these difficult topics and can provide additional services to families—both of which can be done remotely.

While the field is learning how to best implement telehealth, programs can also adapt strategies from traditional home visiting as they move to virtual visits during the COVID-19 crisis. 

• Good communication skills remain important to engage with families. To communicate well using video, providers should set up equipment to allow eye contact with the family to strengthen rapport. They should minimize distractions such as background noise and think carefully about what is in their background (for example, choose a blank wall as a backdrop).
• Support to parents extends beyond the home visit. Programs can text to check in on parents or reinforce content between meetings. Texting to support parents can increase their overall engagement in the program.
• It’s important to create day and time boundaries for communication with families. Since telehealth technology is available around the clock, providers must be supported by programs to clearly set expectations and boundaries when they engage with families.